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Epidemiological changes in the incidence of human leptospirosis in Thailand: Findings from the National Disease Surveillance System from 2013 to 2022 - 03/09/25

Doi : 10.1016/j.idnow.2025.105108 
Chanasan Sawangpol a, b, Natnaree Aimyong c, d, Arthit Phosri e, f,
a Master of Public Health Program, Faculty of Public Health, Mahidol University, Bangkok, Thailand 
b Social Medicine Department, Vachira Phuket Hospital, Phuket, Thailand 
c Interdisciplinary Studies and Lifelong Education (I-Grad), Faculty of Public Health, Mahidol University, Bangkok, Thailand 
d Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand 
e Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand 
f Center of Excellence on Environmental Health and Toxicology (EHT), Office of the Permanent Secretary (OPS), Ministry of Higher Education, Science, Research and Innovation (MHESI), Bangkok, Thailand 

Corresponding author at: Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, 4th Floor, 2nd Building, Rajvithi Road, Bangkok 10400, Thailand.Department of Environmental Health SciencesFaculty of Public HealthMahidol University4th Floor, 2nd Building, Rajvithi RoadBangkok10400Thailand

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Highlights

A decreasing trend in leptospirosis incidence was observed from 2013 to 2021.
Leptospirosis incidence recently increased in 2022 following the COVID-19 pandemic.
Duration from symptom onset to medical encounter was associated with leptospirosis mortality.
Age, region, and healthcare facility and service were associated with leptospirosis mortality.
Findings underscore the need to enhance the effectiveness of the existing surveillance system.

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Abstract

Objectives

To describe the epidemiological changes in leptospirosis incidence from 2013 to 2022, and to further quantify factors associated with leptospirosis mortality in Thailand.

Methods

We analyzed the epidemiological trends of leptospirosis incidence using data from the National Disease Surveillance System from January 2013 to December 2022 and estimated potential factors associated with leptospirosis mortality using a multiple logistic regression model.

Results

A total of 25,006 cases were reported during the study period, with an average incidence rate of 3.8 cases per 100,000 population. The incidence rate gradually decreased from 2013 to 2021, followed by a sharp increase in 2022. The case fatality rate increased steadily from 2013 to 2015 and then began to decline after 2015. A higher incidence rate was observed in men than in women, in individuals aged ≥15 years than in children <15 years, in residents of rural areas than urban areas, in people living in the southwestern region than in those living in other regions, and in individuals engaged in agriculture. We also observed that age groups, regions of residence, healthcare facilities and services, and duration from symptom onset to treatment initiation were significantly associated with a mortality risk from leptospirosis.

Conclusion

A decreasing trend in leptospirosis incidence was observed from 2013 to 2021, followed by a recent increase in 2022, indicating that it is crucial to enhance the current surveillance system for implementing targeted interventions and to develop appropriate guidelines for reducing leptospirosis incidence and mortality by controlling the associated prognostic factors.

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Keywords : Leptospirosis, Epidemiology, Mortality, Surveillance system, Thailand


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Vol 55 - N° 6

Article 105108- septembre 2025 Retour au numéro
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