1. Leptospirosis studies in SAR: CIP highlights from Nepal and Sri Lanka Regional Training in Animal and Human Health Epidemiology in South Asia

2. Background One of the most widespread bacterial zoonotic disease globally. Spread mostly by animal urine contaminating the environment Mild to fatal clinical forms Cattle, dogs, horses and pigs are the most commonly infected domestic animals Rodents are usual wild reservoirs. Increasing number of outbreaks reported recently. A neglected tropical disease with serious impact on human as well as animal health/ economy.

3. Objectives Estimate the disease burden among study population Investigate prevalence of etiological agent Investigate the animal human link

4. Methods Fever surveillance study (Nepal) and a case based study (SL) Study participants were followed up Laboratory confirmation using using standard methods (MAT) Risk factor identification Testing of selected household animal species & rodents

5. Results 7/295 (2.4%) fever patients (Nepal) tested positive in screening (acute sample only) 9/22 serovars tested positive in screening (Nepal) Agriculture (paddy-based) is associated in over 55% of suspected cases (SL) 25% of exposures are direct animal handling (SL)

6. Recommendations Information on development of human/animal diagnostics on leptospirosis. Evidence on human-animal link to develop preventive strategies. Continued one health approach in conducting research on zoonotic diseases. Expand one health approach beyond project level.

7. Thank you