The prevalence of leptospirosis infections among humans in Malaysia: a systematic review and meta-analysis

Abstract

Leptospirosis is an infectious and zoonotic disease caused by pathogenic spirochetes of Leptospira. It affects global health issues, especially endemic in tropical and subtropical regions. This meta-analysis assessed the prevalence of leptospirosis in Malaysia and explored factors contributing to variability studies. A systematic review was conducted, which identified 301 records from six key databases. After eliminating duplicates and applying the inclusion criteria, 24 studies were selected for qualitative and quantitative analysis. Pooled prevalence and heterogeneity were calculated using a random-effects model. The pooled prevalence of leptospirosis was 26.7% (95% CI: 20.5–34.0%) with high heterogeneity (I² = 97.43%, p < 0.001). Thus, the reported prevalence decreased from 29.7% (2001–2010) to 18.1% (2011–2020). Additionally, cross-sectional studies reported a 27.4% prevalence, while prospective studies showed a higher rate (53.0%). Diagnostic methods affected the results, with MAT reporting 29.8% and combined PCR-MAT showing the highest prevalence at 31.9%. Leptospirosis remains common in Malaysia, demonstrating the need for better public health interventions, especially in flood-prone areas. Diagnostic techniques and surveillance must be improved and essential for better detecting and managing the disease.