# Leptospirosis in Southeast Asia: Investigating Seroprevalence, Transmission Patterns, and Diagnostic Challenges

## TL;DR

Leptospirosis is a major health issue in Southeast Asia, and better diagnostics, surveillance, and One Health strategies are needed to control it.

## Contribution

The paper highlights diagnostic and surveillance gaps and proposes a One Health approach for improved leptospirosis control in Southeast Asia.

## Key findings

- Leptospirosis transmission in Southeast Asia is influenced by environmental and socioeconomic factors.
- Current diagnostic tools are inadequate for resource-limited settings, leading to underdiagnosis.
- A One Health approach is recommended to integrate human, animal, and environmental health sectors.

## Abstract

Leptospirosis remains a significant public health and economic burden in Southeast Asia, particularly in low- and middle-income countries where environmental, occupational, and socioeconomic factors contribute to its endemicity. Transmission is driven by close interactions between humans and infected animal reservoirs, alongside climatic conditions such as heavy rainfall and flooding. The region’s high but variable seroprevalence reflects inconsistencies in diagnostic methodologies and surveillance systems, complicating disease burden estimation. Major gaps persist in diagnostic capabilities, with current tools often unsuitable for resource-limited settings, leading to underdiagnosis and delayed treatment. Environmental modeling and spatial epidemiology are underutilized due to limited interdisciplinary data integration and predictive capacity. Addressing these challenges requires a One Health approach that integrates human, animal, and environmental health sectors. Key policy recommendations include harmonized surveillance, standardized and validated diagnostics, expanded vaccination programs, improved animal husbandry, and targeted public education. Urban infrastructure improvements and early warning systems are also critical, particularly in disaster-prone areas. Strengthened governance, cross-sectoral collaboration, and investment in research and innovation are essential for sustainable leptospirosis control. Implementing these measures will enhance preparedness, reduce disease transmission, and contribute to improved public health outcomes in all sectors across the region.