BACKGROUND: @entity2926 is a major @entity2927 with widespread distribution and a large impact on @entity1 health. Carrier animals excrete pathogenic Leptospira primarily in their urine. Infection occurs when the pathogen enters a host through mucosa or small skin abrasions. @entity1 and other animals are exposed to the pathogen by direct contact with urine, contaminated soil or water. While many factors influence environmental cycling and the transmission of Leptospira to @entity1 , the load of pathogenic Leptospira in the environment is likely to play a major role. Peridomestic @entity35 are often implicated as a potential source of @entity1 disease; however exposure to other animals is a risk factor as well. The aim of this report is to highlight the importance of various carrier animals in terms of the quantity of Leptospira shed into the environment. For this, we performed a systematic literature review and a meta-analysis of the amount of pathogen that various animal species shed in their urine. RESULTS: The quantity of pathogen has been reported for @entity291 , deer, @entity235 , @entity1 , @entity19 , and @entity35 , in a total of 14 research articles. We estimated the average Leptospira per unit volume shed by each animal species, and the daily environmental contribution by considering the total volume of urine excreted by each carrier animal. @entity35 excrete the highest quantity of Leptospira per millilitre of urine (median  =  5.7  *  10(6)  cells), but large mammals excrete much more urine and thus shed significantly more Leptospira per day (5.1  *  10(8) to 1.3  *  10(9)  cells). CONCLUSIONS: Here we illustrate how, in a low-income rural Ecuadorian community, host population demographics, and prevalence of @entity281 can be integrated with estimates of shed Leptospira to suggest that peridomestic @entity291 may be more important than @entity35 in environmental cycling and ultimately, transmission to @entity1 .

Meta-analysis to estimate the load of Leptospira excreted in urine: beyond XXXX as important sources of transmission in low-income rural communities.

@entity1 :: ('9606', 'Species') :: ['humans', 'human', 'Humans'] @entity2926 :: ('MESH:D007922', 'Disease') :: ['Leptospirosis'] @entity235 :: ('9615', 'Species') :: ['dogs'] @entity19 :: ('10090', 'Species') :: ['mice'] @entity2927 :: ('MESH:D015047', 'Disease') :: ['zoonotic disease'] @entity281 :: ('MESH:D007239', 'Disease') :: ['Leptospira infection'] @entity35 :: ('10116', 'Species') :: ['Rats', 'rats'] @entity291 :: ('9913', 'Species') :: ['cows', 'cattle']
@entity35 :: (10116,Species) :: ['rats']
