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Recommendations

Credits: G. Moreno

• Develop studies in order to better understand the kinetics of the disease both in the period of low incidence (preparatory phase) and the period of high incidence or seasonal increase (response phase).
• Analytical studies on the pathogenesis and immunity of the disease for the development of alternative therapies and creation of vaccines.
• Establish the algorithm for the rapid test for the diagnosis of leptospirosis.
• Identify and support technically a reference laboratory for Central America for the diagnosis of leptospirosis.
• Create a reliable indicator for epidemiological surveillance in order to evaluate silent and endemic areas (suggestion: proportion of ELISA tests for leptospirosis in febrile patients).
• Conduct further ecological analysis with more environmental variables in the country

Conclusions

• Proposal of multicenter studies in pilot sites for risk factors and to evaluate surveillance systems, understanding the natural history of the disease.
• Establish a working group to design a preliminary proposal for eco-epidemiological studies and operational research through pilot or sentinel sites.
• In order to evaluate strategies on population dynamics of rodents, the Brazilian Ministry of Health offers technical assistance in methodological aspects for the implementation of eco-epidemiological studies.
• With the support and technical assistance of the WHO Collaborating Center (FIOCRUZ) the identification of a Subregional laboratory in coordination with PAHO was carried out.