{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:48:39Z","timestamp":1792432119493,"version":"4.5.0"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Leptospirosis is considered to be the most widespread, yet neglected, re-emerging zoonotic disease caused by infection with a pathogenic species of the genus Leptospira. Although this disease is prevalent in Bangladesh, the recent epidemiological status has not yet been well documented. In this study, we aimed to determine the prevalence of leptospirosis among febrile patients using different diagnostic methods and to characterize the epidemiological features and species of Leptospira in Mymensingh, north\u2013central Bangladesh. Among the blood samples of 186 patients with suspected leptospirosis who met the inclusion criteria, including having a fever for more than 5 days (November 2021\u2013June 2022), 88 samples (47%) were Leptospira-positive according to IgM LAT, IgM ELISA, or nested PCR (positivity rates: 38%, 37%, and 42%, respectively). Nested PCR showed a significantly higher positivity rate (54%) in patients with a short fever (5\u201310 day) than the other methods did, with lower rates among those with a longer fever. Leptospirosis cases were more common in males (68%), those 16\u201345 years of age (70%), residents of rural areas (81%), and farmers (41%). In addition to a fever, myalgia and jaundice were found in more than 70% of the patients, while variable symptoms were observed. The 16S rRNA sequencing analysis revealed that the Leptospira species in all the 22 samples tested were L. wolffii, belonging to the pathogenic subclade P2. This study showed the recent epidemiological features of leptospirosis in Bangladesh, indicating the presumptive predominance of L. wolffii since 2019.<\/jats:p>","DOI":"10.3390\/idr16040049","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T13:10:28Z","timestamp":1721913028000},"page":"638-649","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiological Features of Leptospirosis and Identification of Leptospira wolffii as a Persistently Prevailing Species in North\u2013Central Bangladesh"],"prefix":"10.3390","volume":"16","author":[{"given":"Monira","family":"Sultana","sequence":"first","affiliation":[{"name":"Department of Microbiology, Nilphamari Medical College, Nilphamari 5300, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyamal Kumar","family":"Paul","sequence":"additional","affiliation":[{"name":"Netrokona Medical College, Netrokona 2400, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Anjuman","family":"Nasreen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazia","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Kamrul","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sirajganj 250 Bed Bongamata Sheikh Fazilatunnesa Mujib General Hospital, Sirajganj 6700, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arup","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultana Shabnam","family":"Nila","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsana","family":"Jahan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pabna Medical College, Pabna 6602, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7833-5904","authenticated-orcid":false,"given":"Fardousi Akter","family":"Sathi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasmia","family":"Hossain","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Jannatul","family":"Ferdaus","sequence":"additional","affiliation":[{"name":"Department of Oral Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8402-5349","authenticated-orcid":false,"given":"Meiji Soe","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0146-6211","authenticated-orcid":false,"given":"Nobumichi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Costa, F., Hagan, J.E., Calcagno, J., Kane, M., Torgerson, P., Martinez-Silveira, M.S., Stein, C., Abela-Ridder, B., and Ko, A.I. (2015). Global Morbidity and Mortality of Leptospirosis: A Systematic Review. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003898"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s10096-019-03797-4","article-title":"Leptospirosis: A neglected tropical zoonotic infection of public health importance-an updated review","volume":"39","author":"Karpagam","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.biologicals.2013.06.010","article-title":"Leptospirosis: Public health perspectives","volume":"41","author":"Guerra","year":"2013","journal-title":"Biologicals"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/0974-2700.40573","article-title":"Leptospirosis: The \u201cmysterious\u201d mimic","volume":"1","author":"Izurieta","year":"2008","journal-title":"J. Emerg. Trauma. Shock."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/00001432-200110000-00005","article-title":"Leptospirosis","volume":"4","author":"Vinetz","year":"2001","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fernandes, L.G.V., Stone, N.E., Roe, C.C., Goris, M.G.A., van der Linden, H., Sahl, J.W., Wagner, D.M., and Nally, J.E. (2022). Leptospira sanjuanensis sp. nov., a pathogenic species of the genus Leptospira isolated from soil in Puerto Rico. Int. J. Syst. Evol. Microbiol., 72.","DOI":"10.1099\/ijsem.0.005560"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e202302478","DOI":"10.26508\/lsa.202302478","article-title":"Genetic structure and diversity of the rfb locus of pathogenic species of the genus Leptospira","volume":"7","author":"Cosate","year":"2024","journal-title":"Life Sci. Alliance"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Vincent, A.T., Schiettekatte, O., Goarant, C., Neela, V.K., Bernet, E., Thibeaux, R., Ismail, N., Khalid, M.K.N.M., Amran, F., and Masuzawa, T. (2019). Revisiting the taxonomy and evolution of pathogenicity of the genus Leptospira through the prism of genomics. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007270"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1038\/nrmicro2208","article-title":"Leptospira: The dawn of the molecular genetics era for an emerging zoonotic pathogen","volume":"7","author":"Ko","year":"2009","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104241","DOI":"10.1016\/j.meegid.2020.104241","article-title":"Leptospira spp., a genus in the stage of diversity and genomic data expansion","volume":"81","author":"Caimi","year":"2020","journal-title":"Infect. Genet. Evol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Guglielmini, J., Bourhy, P., Schiettekatte, O., Zinini, F., Brisse, S., and Picardeau, M. (2019). Genus-wide Leptospira core genome multilocus sequence typing for strain taxonomy and global surveillance. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007374"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1017\/S0950268800051220","article-title":"Seroprevalence of leptospirosis in a rural flood prone district of Bangladesh","volume":"112","author":"Morshed","year":"1994","journal-title":"Epidemiol. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"766","DOI":"10.3201\/eid1105.041212","article-title":"Leptospirosis during dengue outbreak, Bangladesh","volume":"11","author":"LaRocque","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.4269\/ajtmh.2010.09-0574","article-title":"Leptospirosis as a cause of fever in urban Bangladesh","volume":"82","author":"Kendall","year":"2010","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100570","DOI":"10.1016\/j.nmni.2019.100570","article-title":"First molecular identification of two Leptospira species (Leptospira interrogans and Leptospira wolffii) in Bangladesh","volume":"31","author":"Aziz","year":"2019","journal-title":"New Microbes New Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100765","DOI":"10.1016\/j.nmni.2020.100765","article-title":"Predominance of Leptospira wolffii in north-central Bangladesh, 2019","volume":"38","author":"Rahman","year":"2020","journal-title":"New Microbes New Infect."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Das, P., Rahman, M.Z., Banu, S., Rahman, M., Chisti, M.J., Chowdhury, F., Akhtar, Z., Palit, A., Martin, D.W., and Ul Anwar, M. (2022). Acute febrile illness among outpatients seeking health care in Bangladeshi hospitals prior to the COVID-19 pandemic. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0273902"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.diagmicrobio.2008.10.017","article-title":"A simple and rapid nested polymerase chain reaction-restriction fragment length polymorphism technique for differentiation of pathogenic and nonpathogenic Leptospira spp.","volume":"63","author":"Djadid","year":"2009","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.mcp.2004.10.002","article-title":"Evaluation of lig-based conventional and real time PCR for the detection of pathogenic leptospires","volume":"19","author":"Palaniappan","year":"2005","journal-title":"Mol. Cell Probes"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s12038-008-0074-z","article-title":"Leptospirosis: An emerging global public health problem","volume":"33","author":"Vijayachari","year":"2008","journal-title":"J. Biosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4508","DOI":"10.1002\/jmv.27816","article-title":"Coinfection of leptospirosis and coronavirus disease 2019: A retrospective case series from a coastal region in South India","volume":"94","author":"Gupta","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Del Valle-Mendoza, J., Palomares-Reyes, C., Carrillo-Ng, H., Tarazona-Castro, Y., Kym, S., Aguilar-Luis, M.A., del Valle, L.J., Aquino-Ortega, R., Martins-Luna, J., and Pe\u00f1a-Tuesta, I. (2021). Leptospirosis in febrile patients with suspected diagnosis of dengue fever. BMC Res. Notes, 14.","DOI":"10.1186\/s13104-021-05627-3"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijid.2023.08.026","article-title":"Bangladesh\u2019s 2023 Dengue outbreak\u2014Age\/gender-related disparity in morbidity and mortality and geographic variability of epidemic burdens","volume":"136","author":"Haider","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_24","first-page":"785","article-title":"Serological & molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: A 10-year study","volume":"137","author":"Chaudhry","year":"2013","journal-title":"Indian. J. Med. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4997\/jrcpe.2020.208","article-title":"Epidemiological, clinical and laboratory features of leptospirosis compared to other acute febrile illnesses","volume":"50","author":"Balasundaram","year":"2020","journal-title":"J. R. Coll. Physicians Edinb."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e394","DOI":"10.1016\/j.ijid.2012.12.012","article-title":"A hospital-based study on seroprevalence of leptospirosis among febrile cases in northeastern Malaysia","volume":"17","author":"Rafizah","year":"2013","journal-title":"Int. J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wangrangsimakul, T., Althaus, T., Mukaka, M., Kantipong, P., Wuthiekanun, V., Chierakul, W., Blacksell, S.D., Day, N.P., Laongnualpanich, A., and Paris, D.H. (2018). Causes of acute undifferentiated fever and the utility of biomarkers in Chiangrai, northern Thailand. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006477"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Allan, K.J., Biggs, H.M., Halliday, J.E.B., Kazwala, R.R., Maro, V.P., Cleaveland, S., and Crump, J.A. (2015). Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for \u2018One Health\u2019 in Africa. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003899"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8542","DOI":"10.3390\/ijerph110808542","article-title":"Human leptospirosis trends: Northeast Thailand, 2001-2012","volume":"11","author":"Thipmontree","year":"2014","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Samrot, A.V., Sean, T.C., Bhavya, K.S., Sahithya, C.S., Chan-Drasekaran, S., Palanisamy, R., Robinson, E.R., Subbiah, S.K., and Mok, P.L. (2021). Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review. Pathogens, 10.","DOI":"10.3390\/pathogens10020145"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jmii.2013.03.001","article-title":"Laboratory diagnosis of leptospirosis: A challenge","volume":"46","author":"Musso","year":"2013","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1111\/j.1365-3156.2006.01727.x","article-title":"Polymerase chain reaction in comparison with serological tests for early diagnosis of human leptospirosis","volume":"11","author":"Fonseca","year":"2006","journal-title":"Trop. Med. Int. Health"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Krijger, I.M., Ahmed, A.A.A., Goris, M.G.A., Groot Koerkamp, P.W.G., and Meerburg, B.G. (2019). Prevalence of Leptospira Infection in Rodents from Bangladesh. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16122113"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1099\/ijs.0.64947-0","article-title":"Leptospira wolffii sp. nov., isolated from a human with suspected leptospirosis in Thailand","volume":"58","author":"Slack","year":"2008","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105347","DOI":"10.1016\/j.micpath.2021.105347","article-title":"A core and pan gene map of Leptospira genus and its interactions with human host","volume":"162","author":"Lata","year":"2022","journal-title":"Microb. Pathog."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Philip, N., Affendy, N.B., Ramli, S.N.A., Arif, M., Raja, P., Nagandran, E., Renganathan, P., Taib, N.M., Masri, S.N., and Yuhana, M.Y. (2020). Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in Central Malaysia. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008197"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40101-023-00347-y","article-title":"Leptospirosis in Malaysia: Current status, insights, and future prospects","volume":"42","author":"Philip","year":"2023","journal-title":"J. Physiol. Anthropol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1186\/2193-1801-2-362","article-title":"Characterization of leptospira isolates from animals and humans: Phylogenetic analysis identifies the prevalence of intermediate species in India","volume":"2","author":"Balamurugan","year":"2013","journal-title":"Springerplus"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"899","DOI":"10.4269\/ajtmh.2010.09-0721","article-title":"Molecular epidemiology of leptospirosis in northern Iran by nested polymerase chain reaction\/restriction fragment length polymorphism and sequencing methods","volume":"82","author":"Zakeri","year":"2010","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.meegid.2010.01.001","article-title":"Leptospira wolffii, a potential new pathogenic Leptospira species detected in human, sheep and dog","volume":"10","author":"Zakeri","year":"2010","journal-title":"Infect. Genet. Evol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.meegid.2015.11.033","article-title":"Isolation and clinical sample typing of human leptospirosis cases in Argentina","volume":"37","author":"Chiani","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1292\/jvms.20-0596","article-title":"DNA-based detection of Leptospira wolffii, Giardia intestinalis and Toxoplasma gondii in environmental feces of wild animals in Korea","volume":"83","author":"Kumari","year":"2021","journal-title":"J. Vet. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.3201\/eid2112.140659","article-title":"High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador","volume":"21","author":"Chiriboga","year":"2015","journal-title":"Emerg. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2060241","DOI":"10.1155\/2016\/2060241","article-title":"Molecular characterization of Leptospira spp. in environmental samples from North-Eastern Malaysia revealed a pathogenic strain, Leptospira alstonii","volume":"2016","author":"Azali","year":"2016","journal-title":"J. Trop. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3760674","DOI":"10.1155\/2017\/3760674","article-title":"Diversity of Leptospira spp. in rats and environment from urban areas of Sarawak, Malaysia","volume":"2017","author":"Pui","year":"2017","journal-title":"J. Trop. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"65","DOI":"10.7883\/yoken.JJID.2017.363","article-title":"Potentially Pathogenic Leptospira Species Isolated from a Waterfall in Thailand","volume":"71","author":"Suwanpakdee","year":"2018","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Thibeaux, R., Girault, D., Bierque, E., Soup\u00e9-Gilbert, M.-E., Rettinger, A., Douy\u00e8re, A., Meyer, M., Iraola, G., Picardeau, M., and Goarant, C. (2018). Biodiversity of Environmental Leptospira: Improving Identification and Revisiting the Diagnosis. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.00816"},{"key":"ref_48","first-page":"e78","article-title":"A systematic literature review of leptospirosis outbreaks worldwide, 1970\u20132012","volume":"44","author":"Groene","year":"2020","journal-title":"Rev. Panam. Salud Publica"},{"key":"ref_49","first-page":"290","article-title":"Leptospirosis in India: A systematic review and meta-analysis of clinical profile, treatment and outcomes","volume":"31","author":"Gupta","year":"2023","journal-title":"Infez. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.3201\/eid2108.150328","article-title":"Rickettsia felis Infection among Humans, Bangladesh, 2012-2013","volume":"21","author":"Ferdouse","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"100595","DOI":"10.1016\/j.nmni.2019.100595","article-title":"Molecular characterization of Orientia tsutsugamushi causing scrub typhus among febrile patients in north-central Bangladesh","volume":"32","author":"Paul","year":"2019","journal-title":"New Microbes New Infect."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3354\/cr00889","article-title":"Recent trends in the climate of Bangladesh","volume":"42","author":"Shahid","year":"2010","journal-title":"Clim. Res."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Cunha, M., Costa, F., Ribeiro, G.S., Carvalho, M.S., Reis, R.B., Nery, N., Pischel, L., Gouveia, E.L., Santos, A.C., and Queiroz, A. (2022). Rainfall and other meteorological factors as drivers of urban transmission of leptospirosis. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0007507"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"5066","DOI":"10.1038\/s41598-022-09079-y","article-title":"Spatial-temporal patterns and risk factors for human leptospirosis in Thailand, 2012-2018","volume":"12","author":"Chadsuthi","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"012001","DOI":"10.1088\/1755-1315\/423\/1\/012001","article-title":"Climate change-induced challenges to sustainable development in Bangladesh","volume":"423","author":"Mojid","year":"2020","journal-title":"IOP Conf. Ser. Earth Environ. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e23473","DOI":"10.1016\/j.heliyon.2023.e23473","article-title":"Environmental and Occupational Factors Associated with Leptospirosis: A Systematic Review","volume":"10","author":"Baharom","year":"2023","journal-title":"Heliyon"}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/4\/49\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:21:55Z","timestamp":1760109715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/4\/49"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":56,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["idr16040049"],"URL":"https:\/\/doi.org\/10.3390\/idr16040049","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,23]]}}}