Leptospirosis has been overlooked in Africa and lack of awareness has been a major limitation in quantifying the burden of disease. Medical clinicians often lack awareness of leptospirosis as a differential diagnosis for malaria and other endemic acute febrile illnesses1 and have limited access to laboratory facilities for diagnostic support. The lack of data on leptospirosis in many African countries2 means that local public and animal health of�cials and governments are unaware of this disease and its potential impact on both human and animal health, as well as consequent socio-economic and environmental impacts.

Leptospirosis research activities have remained fragmented with researchers from both Africa and elsewhere often working in isolation. There is very little disease-speci�c infrastructure or expertise in Africa and with little continuity at study sites, within countries or indeed within regions. However, several leptospirosis workers are involved in projects in the African countries3-5 and many people receive regular requests from students and professionals interested in working on leptospirosis in Africa. A clear need has been identi�ed to bring together those involved with and concerned about the leptospirosis situation in Africa to address and overcome these challenges.

BUILDING AN AFRICAN LEPTOSPIROSIS NETWORKJackie Benschop1, Kathryn Allan2, Ahmed Fayaz1, Armanda Bastos3, Julie Collins-Emerson1, John A. Crump4, Gauthier Dobigny5, Mohamed El Azhari6, Wael F. El-Tras7, Jo Halliday2, Stephane Kouadio Kof�8, Johanna Lindahl9, Georgies Mgode10, Mark Moseley11, Benjamin Mubemba12, Preneshni Naicker13, Soanandrasana Rahelinirina14, Fanjasoa Rakotomanana14, Pierre-Alain Rubbo15, and other members of the African Leptospirosis Network

1Massey University, New Zealand; 2University of Glasgow, Scotland; 3University of Pretoria, South Africa; 4University of Otago, New Zealand; 5Université d'Abomey-Calavi, Benin; 6Pasteur Institute of Morocco, Morocco; 7Kafrelsheikh University, Egypt; 8Université Félix Houphouet-Boigny, Cote d’Ivoire; 9International Livestock Research Institute, Kenya; 10Sokoine University of Agriculture, Tanzania; 11University of Aberdeen, Scotland; 12Copperbelt University, Zambia; 13University of Cape Town, South Africa; 14Institut Pasteur de Madagascar, Madagascar; 15Institut Pasteur de Bangui, Central African Republic.

Leptospirosis Researchers at Massey University, New Zealand and at the University of Glasgow, Scotland with Dr Rudy Hartskeerl from the WHO/FAO/OIE Leptospirosis Reference Laboratory in the Netherlands have established a network to foster communication and advance activities and initiatives around leptospirosis in the African continent. At November 29 2016 we have 47 people in the network with approximately half located on the continent. Current network participants heighten awareness of this network and identify individuals and institutional and governmental agencies who would bene�t from membership.Through our Alfresco Collaboration Platform:• those with an interest in leptospirosis in Africa are

identi�ed, and can participate and share expertise• existing, new and evolving evidence for the presence,

epidemiology, management and burden of leptospirosis in African countries is disseminated and shared

• evidence about leptospirosis in humans, animals and the environment can be collated and used to raise awareness of this disease in African countries and internationally

• capacity building in areas of disease recognition, epidemiology, and management in people, animals and the environment can be encouraged

• protocols can be made available (e.g. laboratory SOPs, rodent trapping and abattoir sampling)

• funding sources can be identified and pursued

Background

Why build a network?

A keynote presentation on ‘Leptospirosis: commonly forgotten in Africa’ (Georgies Mgode, Sokoine University of Agriculture, Tanzania) led to an informal meeting of leptospirologists interested in assisting the development of awareness and understanding of leptospirosis in Africa at the European Leptospirosis Society Meeting (April 2015, The Netherlands). Subsequently, a second, larger meeting was held in association with the International Leptospirosis Society meeting (October 2015, Indonesia) to further develop plans to establish a formal network of those involved in, or interested in being involved in, researching leptospirosis in Africa. And this was endorsed at the Global Leptospirosis Environmental Action Network (GLEAN, WHO) meeting (November 2015, Brazil).

Growing interest in lepto in Africa

What are we doing?

Geographic distribution of acute human leptospirosis andcon�rmed animal Leptospira spp. infection in Africa. Adapted from Allan et al. (2015) PLoS NTD 9(9) e0003899.

Future plansWe aim to identify which of the following are useful recommendations or interventions for addressing human leptospirosis in diverse settings in Africa:• Assessment of the performance of currently

available rapid tests in multiple settings to help with case detection.

• A diagnostic algorithm that could be used in the absence of a laboratory test.

• Clinical guidelines for managing patients with severe leptospirosis (either from a confirmed or suspected diagnosis).

• An evidence-based chemoprophylaxis protocol.• Support for identification of infecting serovar.• Securing scholarships for attendance at the

International Leptospirosis Society meeting and workshops in New Zealand in 2017.

• Holding an African Leptospirosis Network meeting in 2018 in Africa.

References1. Crump JA, Morrissey AB, Nicholson WL, et al. Etiology of

severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study. PLoS Negl Trop Dis 2013;7:e2324.

2. Allan KJ, Biggs HM, Halliday JE, et al. Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for 'One Health' in Africa. PLoS Negl Trop Dis 2015;9:e0003899.

3. Dreyfus A, Dyal JW, Pearson R, et al. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda. PLoS Negl Trop Dis 2016;10:e0004858.

4. Dobigny G, Garba M, Tatard C, et al. Urban Market Gardening and Rodent-Borne Pathogenic Leptospira in Arid Zones: A Case Study in Niamey, Niger. PLoS Negl Trop Dis 2015;9:e0004097.

5. Mgode GF, Machang'u RS, Mhamphi GG, et al. Leptospira Serovars for Diagnosis of Leptospirosis in Humans and Animals in Africa: Common Leptospira Isolates and Reservoir Hosts. Plos Neglected Tropical Diseases 2015;9.

Boma, Kilimanjaro Region, Tanzania Kibera, Nairobi, Kenya

Irrigation, Niamey, Niger

Dissection, Pasteur Institute, Cote d'Ivoire

Market, Weru Weru, TanzaniaGrazing, Kilimanjaro Region, Tanzania

Network member

Both animal and human illness dataAnimal carrier data onlyHuman illness data onlyNo data

Sampling, Kilimanjaro Region, Tanzania Dumping Site, Côte d’Ivoire