A road map for leptospirosis research and health policies based on country needs in Latin America.

This report summarizes the presentations, discussions and the recommendations coming from the Oswaldo Cruz Institute/FIOCRUZ International Workshop for Leptospirosis Research Based on Country Needs and the 5th Global Leptospirosis Environmental Action Network meeting, which was held in the city of Rio de Janeiro, Brazil, 10-12 November 2015. The event focused on health policy and worked to develop a road map as a consensus document to help guide decision-making by policymakers, funding bodies, and health care professionals. The direction that leptospirosis research should take in the coming years was emphasized, taking into account the needs of countries of Latin America, as well as experiences from other world regions, as provided by international experts. The operational concepts of "One Health" and translational research underlaid the discussions and the resulting recommendations. Despite the wide geographic distribution of leptospirosis and its impact in terms of incidence, morbidity, and mortality, leptospirosis is not yet considered a "tool-ready" disease for global initiatives. Surveillance programs need new tools and strategies for early detection, prevention, and follow-up. The major recommendations developed at the Rio meeting cover both health policy and research. The health policy recommendations should be taken into account by decisionmakers, government officials, and the Pan American Health Organization. The priorities for research, technological development, and innovation should be considered by research institutions, universities, and stakeholders.

WWOSC 2014: research needs for better health resilience to weather hazards.

The first World Weather Open Science Conference (WWOSC, held from 17-21 August 2014 in Montreal, Québec), provided an open forum where the experience and perspective of a variety of weather information providers and users was combined with the latest application advances in social sciences. A special session devoted to health focused on how best the most recent weather information and communication technologies (ICT) could improve the health emergency responses to disasters resulting from natural hazards. Speakers from a plenary presentation and its corresponding panel shared lessons learnt from different international multidisciplinary initiatives against weather-related epidemics, such as malaria, leptospirosis and meningitis and from public health responses to floods and heat waves such as in Ontario and Quebec, Canada. Participants could bear witness to recent progress made in the use of forecasting tools and in the application of increased spatiotemporal resolutions in the management of weather related health risks through anticipative interventions, early alert and warning and early responses especially by vulnerable groups. There was an agreement that resilience to weather hazards is best developed based on evidence of their health impact and when, at local level, there is a close interaction between health care providers, epidemiologists, climate services, public health authorities and communities. Using near real time health data (such as hospital admission, disease incidence monitoring…) combined with weather information has been recommended to appraise the relevance of decisions and the effectiveness of interventions and to make adjustments when needed. It also helps appraising how people may be more or less vulnerable to a particular hazard depending on the resilience infrastructures and services. This session was mainly attended by climate, environment and social scientists from North American and European countries. Producing a commentary appears to be an effective way to share this session's conclusions to research institutions and public health experts worldwide. It also advocates for better linking operational research and decision making and for appraising the impact of ICT and public health interventions on health.

A global, multi-disciplinary, multi-sectorial initiative to combat leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN).

Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory confirmation. The complexity that surrounds the transmission dynamics, particularly in epidemic situations, requires a coordinated, multi-disciplinary effort. Therefore, the Global Leptospirosis Environmental Action Network (GLEAN) was developed to improve global and local strategies of how to predict, prevent, detect, and intervene in leptospirosis outbreaks in order to prevent and control leptospirosis in high-risk populations.

Rapid tests for diagnosis of leptospirosis: current tools and emerging technologies.

Leptospirosis is an emerging zoonosis with a worldwide distribution but is more commonly found in impoverished populations in developing countries and tropical regions with frequent flooding. The rapid detection of leptospirosis is a critical step to effectively manage the disease and to control outbreaks in both human and animal populations. Therefore, there is a need for accurate and rapid diagnostic tests and appropriate surveillance and alert systems to identify outbreaks. This review describes current in-house methods and commercialized tests for the rapid diagnosis of acute leptospirosis. It focuses on diagnostic tests that can be performed with minimal training and limited equipment in less-developed and newly industrialized countries, particularly in resource-limited settings and with results in minutes to less than 4 hours. We also describe recent technological advances in the field of diagnostic tests that could allow for the development of innovative rapid tests in the near future.

Climate services to improve public health.

A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

Leptospirosis: a silent epidemic disease.

This special issue of International Journal of Environmental Research and Public Health is dedicated to leptospirosis, an endemic zoonotic disease that is a cause of many acute undifferentiated fevers, especially in tropical countries. While it can be debated whether leptospirosis is an emerging disease, it is evident that it is becoming an emerging public health problem. It is recognized as a disease of epidemic potential that has a significant health impact in many parts of the world.

A road map for leptospirosis research and health policies based on country needs in Latin America

This report summarizes the presentations, discussions and the recommendations coming from the Oswaldo Cruz Institute/FIOCRUZ International Workshop for Leptospirosis Research Based on Country Needs and the 5th Global Leptospirosis Environmental Action Network meeting, which was held in the city of Rio de Janeiro, Brazil, 10–12 November 2015. The event focused on health policy and worked to develop a road map as a consensus document to help guide decision-making by policymakers, funding bodies, and health care professionals. The direction that leptospirosis research should take in the coming years was emphasized, taking into account the needs of countries of Latin America, as well as experiences from other world regions, as provided by international experts. The operational concepts of “One Health” and translational research underlaid the discussions and the resulting recommendations. Despite the wide geographic distribution of leptospirosis and its impact in terms of incidence, morbidity, and mortality, leptospirosis is not yet considered a “tool-ready” disease for global initiatives. Surveillance programs need new tools and strategies for early detection, prevention, and follow-up. The major recommendations developed at the Rio meeting cover both health policy and research. The health policy recommendations should be taken into account by decisionmakers, government officials, and the Pan American Health Organization. The priorities for research, technological development, and innovation should be considered by research institutions, universities, and stakeholders.

En este informe se resumen las ponencias, los debates y las recomendaciones del taller internacional para la investigación sobre la leptospirosis basada en las necesidades de los países organizado por el Instituto Oswaldo Cruz/FIOCRUZ y la quinta reunión de la Red Global de Acción Ambiental contra la Leptospirosis, que se celebró en la ciudad del Rio de Janeiro (Brasil), del 10 al 12 de noviembre del 2015. El evento se centró en las políticas de salud y en la elaboración de una hoja de ruta que sirviese como un documento guía consensuado para la toma de decisiones de los formuladores de políticas, los organismos de financiamiento y los profesionales de la salud. Se hizo hincapié en la dirección que tiene que tomar la investigación sobre la leptospirosis en los próximos años, en la que se deben tener en cuenta las necesidades de los países de América Latina, así como a las experiencias de otras regiones del mundo, de acuerdo con las consideraciones de los expertos internacionales. Los conceptos operativos de “Una sola salud” y de la investigación traslacional fueron la base de los debates y de las recomendaciones resultantes. A pesar de la extensa distribución geográfica de la leptospirosis y su repercusión desde el punto de vista de la incidencia, la morbilidad y la mortalidad, la leptospirosis no se considera todavía una enfermedad con herramientas listas para ser aplicadas (tool-ready) en las iniciativas a nivel mundial. Los programas de vigilancia necesitan herramientas y estrategias nuevas para llevar a cabo la detección temprana, la prevención y el seguimiento. Las recomendaciones principales que se emitieron en la reunión de Rio cubrieron tanto el ámbito de las políticas de salud como el de la investigación. Las recomendaciones que se refieren a las políticas de salud deben ser tenidas en cuenta por los encargados de tomar decisiones, los funcionarios de gobierno y la Organización Panamericana de la Salud. Las prioridades de la investigación, el desarrollo tecnológico y la innovación deben ser incorporadas por las instituciones de investigación, las universidades y los interesados directos.

Trata-se de um resumo das apresentações, debates e recomendações do Workshop Internacional para Pesquisa em Leptospirose com Base nas Necessidades dos Países do Instituto Oswaldo Cruz/FIOCRUZ e 5a Reunião da Rede Global de Ação Ambiental em Leptospirose, realizados na cidade do Rio de Janeiro, Brasil, de 10 a 12 de novembro de 2015. Os participantes do evento debateram políticas de saúde e elaboraram um guia como documento de consenso para orientar a tomada de decisão pelos responsáveis por políticas, agências de financiamento e profissionais da saúde. Destacou-se o rumo a ser tomado em pesquisa em leptospirose nos próximos anos levando em consideração as necessidades dos países da América Latina, assim como as experiências de outras regiões do mundo, conforme estabelecido por especialistas internacionais. Os conceitos práticos da perspectiva “One Health” (Um Mundo, Uma Saúde) e pesquisa translacional foram a base dos debates e das recomendações conseguintes. Apesar da ampla distribuição geográfica e do seu impacto em termos de incidência, morbidade e mortalidade, a leptospirose ainda não é considerada uma doença “tool ready” para iniciativas globais. Os programas de vigilância precisam de novas ferramentas e estratégias para detecção precoce, prevenção e acompanhamento. As principais recomendações elaboradas na reunião do Rio englobam política de saúde assim como pesquisa e elas devem ser levadas em consideração pelas autoridades, funcionários do governo e Organização Pan-Americana da Saúde. As instituições de pesquisa, universidades e interessados diretos devem atentar para as prioridades em pesquisa, desenvolvimento tecnológico e inovação.