The Estimated Burden of Human Leptospirosis in Thailand Based on National Surveillance Data (2004-2020): A Case Study of Mahasarakham Province.

Leptospirosis is still an important public health problem in Thailand. We analyzed the burden of disease between 2004 - 2020 in Mahasarakham, Thailand. General Additive Modeling (GAM) was used to explain the evolution of leptospirosis cases per sub-district. Leptospirosis cases increased from 2004 to 2012, plateaued during 2012-2017, and slightly declined from 2017 to 2020. Results of a general additive model showed that the number of leptospirosis cases by sub-district of Mahasarakham province and by year was likely explained by human population size, cattle size, rainfall, and urban area cover. Sub-districts situated in low elevations with dense cattle farming were at risk for leptospirosis during periods of heavy rainfall. These results raise the need to improve surveillance and public education campaigns for leptospirosis prevention. Collaboration among public health, livestock sector, environment sector, and local communities using the One Health approach is vital for effective leptospirosis prevention and control.