BackgroundThe burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda.Methodology and Principal Findings359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2–40.3%) defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95%CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer ≥1:800) was 1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys nearby.Conclusions/SignificanceThe 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis should be a diagnostic consideration in febrile illness and “smear-negative malaria” in rural East Africa.

Leptospirosis is a zoonotic bacterial disease reported worldwide. In Uganda, seropositivity has been reported in both humans and domesticated animals, including cattle. However, it remains unknown whether cattle are shedding leptospires and thus acting as potential source for human leptospirosis. We conducted this cross‐sectional study in two cattle abattoirs in Kampala, Uganda between June and July 2017. Kidney and urine samples from 500 cattle sourced from across the country were analysed by real‐time PCR to establish the prevalence of Leptospira‐positive cattle and risk of exposure to abattoir workers. The species of infecting Leptospira was determined by amplification of secY gene and compared to reference sequences published in GenBank. Of 500 cattle tested, 36 (7.2%) had Leptospira DNA in their kidneys (carriers), 29 (5.8%) in their urine (shedders); with an overall prevalence (kidney and/or urine) of 8.8%. Leptospira borgpetersenii was confirmed as the infecting species in three cattle and Leptospira kirschneri in one animal. Male versus female cattle (OR = 3, p‐value 0.003), exotic versus local breeds (OR = 21.3, p‐value 0.002) or cattle from Western Uganda (OR = 4.4, p‐value 0.001) and from regions across the border (OR = 3.3, p‐value 0.032) versus from the central region were more likely to be Leptospira‐positive. The daily risk of exposure of abattoir workers to ≥1 (kidney and/or urine) positive carcass ranged from 27% (95% credibility interval 18.6–52.3) to 100% (95% CI 91.0–100.0), with halal butchers and pluck inspectors being at highest risk. In conclusion, cattle slaughtered at abattoirs in Uganda carry and shed pathogenic Leptospira species; and this may pose occupation‐related risk of exposure among workers in these abattoirs, with workers who handle larger numbers of animals being at higher risk.

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Seroprevalence of Leptospira spp. in cattle is unknown in Uganda. The aim of this study was to estimate the seroprevalence of L. interrogans Icterohaemorrhagiae, Pomona, L. kirschneri Butembo, Grippotyphosa, L. borgpetersenii Nigeria, Hardjo, Wolfii, and Kenya and an overall seroprevalence in cattle from Kole and Mbale districts. Two hundred-seventy five bovine sera from 130 small holder farms from Kole (n = 159) and Mbale (n = 116), collected between January and July 2015, were tested for antibodies against eight Leptospira strains by Microscopic Agglutination Test. A titer of ≥100 was considered seropositive, indicating past exposure. Overall, the seroprevalence was 19.27% (95% CI 14.9–24.5%). Pomona seroprevalence was highest with 9.45% (6.4–13.7%), followed by Kenya 5.09% (2.9–8.6%), Nigeria 4.00% (2.1–7.2%), Wolfii 3.27% (1.6–6.3%), Butembo 1.86% (0.7–4.4%), Hardjo 1.45% (0.5–3.9%), and Icterohaemorragiae and Grippotyphosa with less than 1% positive. Seroprevalence did not differ between districts and gender (p ≥ 0.05). Seven animals had titers ≥400. Cross-reactions or exposure to ≥1 serovar was measured in 43% of serum samples. Seroprevalence of 19% implies exposure of cattle to leptospires.

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