Policy Options for Prevention of Leptospirosis Epidemics: A Scoping Review

Background: Leptospirosis is a widespread zoonotic disease causing over one million cases and 60,000 deaths annually. This review aimed to identify and assess policy options for leptospirosis prevention using the One Health approach and One Health Governance Index (OHGI) framework. Methods: PubMed, Web of Science, Scopus, and Cochrane Library were searched for full-text academic articles, along with Google Scholar and reference lists from Jan 2008 to Dec 2023. A scoping review was conducted following Arksey and O'Malley's framework and PRISMA-ScR guidelines. Articles were retrieved from major databases using defined keywords. Eligible studies focused on community-based policies for human leptospirosis prevention. Two reviewers independently assessed quality, and data were categorized by One Health domains and analyzed using the OHGI framework. Results: Forty-two studies were included. Common policy strategies involved sanitation education, medical training, surveillance of humans, animals, and environments, legal controls on exposure sources, infrastructure upgrades, and vaccination. Tools like GIS and climate data supported preparedness. Policy options most addressed rule of law, effectiveness, and equity. Conclusion: Preventing leptospirosis epidemics demands coordinated, context-specific One Health policies that address implementation gaps and promote equity across vulnerable settings.