Leptospirosis Burden Epidemiology Reference Group (LERG)

Informal Consultation on Global Burden of Leptospirosis

On 23 - 25 October 2006, the World Health Organization (WHO) convened an international consultation to assess potential methods for a global burden of leptospirosis study, recognizing that no reliable global burden estimates exist to date.

The goal of the meeting was to develop a strategic framework and identify the next steps required to estimate the global burden of leptospirosis with the objective to discuss the current state of evidence available to conduct a global burden of disease study on leptospirosis.

The Global Burden of Disease (GBD) study provides a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY). One DALY is a health gap measure, equating to one year of healthy life lost.

Conclusions and recommendations
  • A Leptospirosis Epidemiological Reference Group (LERG) will be established.
  • Partnership with the World Organisation for Animal Health (OIE) on the burden of disease (BOD) in animals will be explored.
  • A BOD study would need to include time or time-space modelling of the contribution that both outbreaks and endemic leptospirosis make to the disease burden.
  • A BOD study may need to incorporate climate into the mathematical models, especially in regions for which there is limited data and as a future step, the BOD study may involve forecasting given the predicted long-term climactic and socioeconomic changes.
  • The current lack of information on resistance and susceptibility to leptospirosis will need to be addressed in future proposed disease models.
  • An analysis of cost-effectiveness should be performed in a second phase in the BOD study.
  • Performance of national BOD studies for leptospirosis are strongly encouraged by WHO and will be needed to validate the estimates generated by the global BOD study.
A possible Natural History Model