Emerging technologies in leptospirosis: Advances in diagnostics, therapeutics, genomics and One Health surveillance

Leptospirosis is a globally important zoonotic disease with complex epidemiology and diverse clinical manifestations, posing significant challenges for diagnosis, treatment, and control.This review summarizes recent advances in leptospirosis diagnosis and management, highlighting emerging technologies and integrated approaches across human, animal, and environmental health sectors.Conventional diagnostic methods, particularly the microscopic agglutination test (MAT), remain reference standards but are limited by low sensitivity during early infection, technical complexity, and delayed turnaround times.Molecular approaches have enhanced early detection through direct identification of leptospiral nucleic acids, while innovations such as isothermal amplification, clustered regularly interspaced short palindromic repeats (CRISPR)-based diagnostics, and next-generation sequencing (NGS) offer rapid, sensitive, and field-deployable alternatives.Serological assays, including enzyme-linked immunosorbent assay (ELISA), latex agglutination, and ra pid immunochromatographic tests, continue to support diagnosis and surveillance, although their performance varies with disease stage and regional seroprevalence.Consequently, integrated diagnostic strategies combining molecular and serological methods are increasingly recommended to improve diagnostic accuracy.Prompt administration of antibiotics, including doxycycline and penicillin, remains essential for reducing disease severity and mortality.Advances in genomics, particularly whole-genome sequencing, are improving understanding of pathogen diversity, virulence, transmission dynamics, and outbreak epidemiology, thereby supporting more effective control measures.Furthermore, environmental surveillance of water, soil, and animal reservoirs, coupled with early warning systems within a One Health framework, is strengthening disease prediction and prevention.Continued progress in vaccine development, including recombinant and DNA-based platforms, offers promising opportunities for long-term control.Overall, integrating advanced diagnostics, genomics, targeted therapeutics, environmental surveillance, and One Health strategies is essential for effective leptospirosis management worldwide.