SynthesisPLoS neglected tropical diseases2015
A Systematic Review of the Mortality from Untreated Leptospirosis.
Synthesis in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Efficacy and safety outcomes reported in human leptospirosis studies to inform the development of a core outcome and core outcome measurement set: A systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge.BMC infectious diseases · 2024Pooled it
- Probable Leptospirosis in the Adventure Traveler with Freshwater Exposure: Narrative Review and Case Series.Pathogens (Basel, Switzerland) · 2026Review
- Evaluating the diagnostic accuracy of clinical judgement and rapid tests for leptospirosis in the Philippines: implications for public health management.Infectious diseases of poverty · 2026Article
- Leptospirosis in the Caribbean Region between 2000 and 2022: A scoping review of morbidity and mortality.PLoS neglected tropical diseases · 2026Article
- Endemicity, Clinical Features, Risk Factors, and the Potential for Severe Infection inTropical medicine and infectious disease · 2025Article
- Presentation and Clinical Course of Leptospirosis in a Referral Hospital in Far North Queensland, Tropical Australia.Pathogens (Basel, Switzerland) · 2025Article
- Leptospirosis.Nature reviews. Disease primers · 2025Review
- Secondary sclerosing cholangitis: an unusual presentation of leptospirosis.Tropical medicine and health · 2025Article
- Factors associated with the lethality of human leptospirosis in Brazil.Cadernos de saude publica · 2025Article
- Serologically Confirmed Human Leptospirosis in Colombia, 2015-2020.The American journal of tropical medicine and hygiene · 2024Article
- Human Case of Leptospirosis During a Canine Disease Outbreak - Wyoming, 2023.MMWR. Morbidity and mortality weekly report · 2024Article
- Acute Calculous Cholecystitis Associated with Leptospirosis: Which is the Emergency? A Case Report and Literature Review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Article
- Relevance of Polymerase Chain Reaction in Early Diagnosis of Leptospirosis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia.Microorganisms · 2023Review
- Article
- Fatal acute undifferentiated febrile illness among clinically suspected leptospirosis cases in Colombia, 2016-2019.PLoS neglected tropical diseases · 2023Article
- Demographic and clinical risk factors associated with severity of lab-confirmed human leptospirosis in Colombia, 2015-2020.PLoS neglected tropical diseases · 2023Article
- Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase.Microorganisms · 2023Review
- Distribution, frequency and clinical presentation of leptospirosis and coinfections: a systematic review protocol.BMJ open · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundLeptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. METHODOLOGY/PRINCIPAL
findingsA comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limitations in study design, diagnostic tests and missing data. Median series mortality was 2.2% (Range 0.0-39.7%), but mortality was high in jaundiced patients (19.1%) (Range 0.0-39.7%), those with renal failure 12.1% (Range 0-25.0%) and in patients aged over 60 (60%) (Range 33.3-60%), but low in anicteric patients (0%) (Range 0-1.7%).
conclusionsThis systematic review contributes to our understanding of the mortality of untreated leptospirosis and provides data for the estimation of DALYs attributable to this disease. We show that mortality is significantly higher in older patients with icteric disease or renal failure but is lower in younger, anicteric patients. Increased surveillance and accurate point-of-care diagnostics are required to better understand the incidence and improve diagnosis of disease. Empirical treatment strategies should prioritize early treatment to improve outcomes from leptospirosis.
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