Epidemiology of human and animal leptospirosis in Kenya: A systematic review and meta-analysis of disease occurrence, serogroup diversity and risk factors

Leptospirosis is a prevalent but understudied zoonotic disease in Kenya. A comprehensive review of the presence of the disease in various hosts is therefore needed to catalogue the research efforts and inspire future scientific inquiry on this neglected tropical disease. We therefore undertook this comprehensive review of published literature in leading databases and institutional repositories of relevant Kenyan higher institutions of learning. Literature spanning more than 70 years was identified and study areas showed a regional bias towards central, western, southern and coastal regions. The arid and semi-arid areas in the northern and eastern regions with large animal and wildlife populations that could facilitate leptospiral transmission were under-represented, and the inclusion of these pastoral regions could give a better picture of the country’s leptospirosis risk profile. Summary estimates in cattle and goats revealed considerable pooled seroprevalence of leptospirosis and the need for control in animal hosts. A low awareness among farmers, and animal and public health practitioners was found, demonstrating the need for education initiatives that can facilitate at-risk populations such as farmers. Additionally, the country lacks the capacity for MAT testing, and recent efforts to culture for leptospires are non-existent. Understanding the circulating serovars and strain diversity is crucial to the effective control of leptospirosis. Investments in diagnostics for peripheral and central laboratories are vital for public health response