Work

Global seroprevalence of Leptospira spp. infection in workers with occupational risk: a systematic review with meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Introduction Leptospirosis is a globally important zoonosis with a strong occupational component, frequently associated with exposure to environments contaminated by the urine of infected animals. Seroprevalence estimates vary substantially across occupations, geographic regions, and diagnostic approaches. This systematic review and meta-analysis aimed to estimate the global seroprevalence of Leptospira spp . among occupationally exposed workers and investigate potential sources of between-study heterogeneity. Methods This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420261356167). Searches were conducted in LILACS, MEDLINE, Scopus, Web of Science, PubMed, and ScienceDirect, covering studies published from January 1, 2011 to February 9, 2026. Studies reporting serological diagnosis and quantitative sampling data were included. Methodological quality was assessed using the JBI Critical Appraisal Checklist. Pooled seroprevalence was estimated using a random-effects model, and heterogeneity was assessed using Cochran’s Q and I² statistics. Subgroup analyses were performed according to geographic region, diagnostic method, and occupational category. Sensitivity analyses, funnel plot assessment, Egger’s regression test, and meta-regression were also conducted. Results A total of 42 studies comprising 11,155 participants and 2,419 seropositive individuals were included. The pooled global seroprevalence was 18.3% (95% CI: 11.7 -27.4%), with substantial between-study heterogeneity (I² = 96.7%; p < 0.0001). Seroprevalence was higher in Asia and Africa and lower in Europe and the Americas. Geographic region significantly contributed to between-study variability, whereas diagnostic method and occupational category did not significantly explain heterogeneity. Meta-regression revealed a significant decrease in seroprevalence with increasing publication year (β = −0.146, 95% CI: −0.285 to −0.007; χ²M = 4.23, p = 0.0397), explaining 5.81% of the observed heterogeneity. Egger’s regression test indicated funnel plot asymmetry (p = 0.005), suggesting potential small-study effects or publication bias. Discussion The findings demonstrate substantial serological evidence of exposure to Leptospira spp . among occupationally exposed workers worldwide, with considerable geographic variability and between-study heterogeneity. These results highlight the need for standardized surveillance and diagnostic strategies, as well as targeted occupational health interventions integrating human, animal, and environmental components within a One Health framework.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1931298