Post-Exposure Chemoprophylaxis for Leptospirosis in Hydrological Disasters

Leptospirosis is a globally distributed zoonotic disease with higher incidence in tropical and subtropical regions, where environmental and socioeconomic conditions favor transmission. Hydrological disasters, particularly floods, substantially increase human exposure to contaminated water and the risk of outbreaks. This study aimed to synthesize current scientific evidence regarding post-exposure chemoprophylaxis for leptospirosis in hydrological disaster settings. An integrative review was conducted using PubMed, MEDLINE, BVS, SciELO, LILACS, and Google Scholar, including studies published between 2009 and 2025. Following PRISMA recommendations, 17 studies were included. The findings demonstrate strong associations between leptospirosis, socio-environmental vulnerability, inadequate sanitation, and extreme climatic events. Evidence from clinical trials and systematic reviews suggests that doxycycline-based chemoprophylaxis may reduce infection incidence in selected high-risk populations, although findings remain heterogeneous. Post-exposure chemoprophylaxis may represent a useful complementary preventive strategy in selected high-risk scenarios; however, its implementation should be evidence-based, epidemiologically targeted, and integrated with broader public health measures, including sanitation improvement, rodent control, surveillance, and disaster preparedness strategies.