Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil

Araújo, Wildo Navegantes de; Finkmoore, Brooke; Ribeiro, Guilherme S.; Reis, Renato Barbosa; Felzemburgh, Ridalva Dias Martins; Hagan, José E.; Reis, Mitermayer Galvão dos; Ko, Albert I.; Costa, Federico

doi:10.4269/ajtmh.2012.12-0245

Cited by 43 publications

(46 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Through these analyses, we found that Leptospira transmission in urban slums occurs due to the interaction of poverty, geography and climate. Our analysis of long-term prospective data confirms previous studies that identified socioeconomic and environmental risk factors but were limited by their retrospective design or limited follow-up [ 12 , 20 – 22 , 33 ]. Importantly, we found that among other mechanisms for environmental exposure, at-risk slum residents become infected with Leptospira through behaviors that lead to contact with contaminated soil and mud, mobilized most often by floodwater during heavy rain events.…”

Section: Discussionsupporting

confidence: 85%

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundRat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent.Methodology/Principal FindingsWe performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003–2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7–40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00–2.16), contact with mud (OR 1.57, 95% CI 1.17–2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82–1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific “hot-spots” consistently had higher transmission risk during study years.Conclusions/SignificanceThe risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that topographic factors such as household elevation and inadequate drainage increase risk by promoting contact with mud and suggest that the soil-water interface serves as the environmental reservoir for spillover transmission. The use of a spatiotemporal approach allowed the identification of geographic outliers with unexplained risk patterns. This approach, in addition to guiding targeted community-based interventions and identifying new hypotheses, may have general applicability towards addressing environmentally-transmitted diseases that have emerged in complex urban slum settings.

show abstract

Section: Discussionsupporting

confidence: 85%

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Selection of the independent variables was based on literature reviews that identified factors that had been, or plausibly could be, associated with likelihood of rodent contact or risk of rodent-borne diseases (e.g., leptospirosis and hantavirus). These included socio-demographic factors (e.g., age, gender, education, and economic status), 9,14,15 behavioral factors (e.g., cultivationrelated tasks), environmental factors (e.g., home characteristics), 4 and cultural context factors (e.g., knowing of the existence of leptospirosis). 16 Of these independent variables, 19 were dichotomous and three were continuous.…”

Section: Methodsmentioning

confidence: 99%

“…These included socio-demographic factors (e.g., age, gender, education, and economic status), 9,14,15 behavioral factors (e.g., cultivationrelated tasks), environmental factors (e.g., home characteristics), 4 and cultural context factors (e.g., knowing of the existence of leptospirosis). 16 Of these independent variables, 19 were dichotomous and three were continuous. For each dichotomous variable, the comparison group is described first, followed by the reference group.…”

Section: Methodsmentioning

confidence: 99%

Characteristics Associated with Contact with Rodents In, Around, and Outside Homes in Khon Kaen Province, Thailand

Suwannarong¹,

Chapman²

2015

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Rodents are an important reservoir for zoonotic diseases. To enhance the evidence on the human-rodent interface, this cross-sectional study was conducted in 2011 to investigate characteristics associated with rodent contact in Khon Kaen Province, Thailand. A standardized, interviewer-administered questionnaire elicited information from 201 adults (101 males and 100 females). Overall, 86.6% of participants reported encountering or seeing evidence of rodents in or near the home, whereas 57.2% encountered rodents while working with crops. Encountering rodents in or near the home was positively associated with the number of agricultural activities, whereas encountering rodents during crop work was positively associated with perceiving that disease can be acquired from rodents, the number of food crops grown, the number of agricultural activities, and living in a house with wooden walls. Surprisingly, neither outcome was associated appreciably with gender, age, or setting (urban, forest, or agricultural). These results provide information on the potential risk of rodent-borne zoonoses; this evidence has implications for risk communication strategies in this province and likely elsewhere.

show abstract

“…Residents of another urban slum in Salvador identified improving trash collection as necessary to control leptospirosis in their community and reported current payment for private trash collection service to avoid trash accumulation in their community or a willingness to pay for this service. Residents reported removing trash on a daily basis but identified that trash cans are >50 m from their homes (118). Leptospira interrogans and L. icterohaemorrhagiae are pathogens of severe diseases that may cluster in urban areas where trash accumulates (123) but are also found in rural households in peri-domestic open containers (debris found around the household areas including buckets, pails, jars, barrels, and old tires) (123).…”

Section: Urban Zoonosis Associated With Solid Wastementioning

confidence: 99%

Solid Wastes Provide Breeding Sites, Burrows, and Food for Biological Disease Vectors, and Urban Zoonotic Reservoirs: A Call to Action for Solutions-Based Research

Krystosik

Njoroge

Odhiambo

et al. 2020

Front. Public Health

140

View full text Add to dashboard Cite

Background: Infectious disease epidemiology and planetary health literature often cite solid waste and plastic pollution as risk factors for vector-borne diseases and urban zoonoses; however, no rigorous reviews of the risks to human health have been published since 1994. This paper aims to identify research gaps and outline potential solutions to interrupt the vicious cycle of solid wastes; disease vectors and reservoirs; infection and disease; and poverty. Methods: We searched peer-reviewed publications from PubMed, Google Scholar, and Stanford Searchworks, and references from relevant articles using the search terms ("disease" OR "epidemiology") AND ("plastic pollution," "garbage," and "trash," "rubbish," "refuse," OR "solid waste"). Abstracts and reports from meetings were included only when they related directly to previously published work. Only articles published in English, Spanish, or Portuguese through 2018 were included, with a focus on post-1994, after the last comprehensive review was published. Cancer, diabetes, and food chain-specific articles were outside the scope and excluded. After completing the literature review, we further limited the literature to "urban zoonotic and biological vector-borne diseases" or to "zoonotic and biological vector-borne diseases of the urban environment." Results: Urban biological vector-borne diseases, especially Aedes-borne diseases, are associated with solid waste accumulation but vector preferences vary over season and region. Urban zoonosis, especially rodent and canine disease reservoirs, are associated with solid waste in urban settings, especially when garbage accumulates over time, creating burrowing sites and food for reservoirs. Although evidence suggests the link between plastic pollution/solid waste and human disease, measurements are not standardized, confounders are not rigorously controlled, and the quality of evidence varies. Here we propose a framework for solutions-based research in three areas: innovation, education, and policy. Krystosik et al. Solid Wastes and Disease Vectors and Reservoirs Conclusions: Disease epidemics are increasing in scope and scale with urban populations growing, climate change providing newly suitable vector climates, and immunologically naïve populations becoming newly exposed. Sustainable solid waste management is crucial to prevention, specifically in urban environments that favor urban vectors such as Aedes species. We propose that next steps should include more robust epidemiological measurements and propose a framework for solutions-based research.

show abstract

Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil

Cited by 43 publications

References 17 publications

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil

Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil

Characteristics Associated with Contact with Rodents In, Around, and Outside Homes in Khon Kaen Province, Thailand

Solid Wastes Provide Breeding Sites, Burrows, and Food for Biological Disease Vectors, and Urban Zoonotic Reservoirs: A Call to Action for Solutions-Based Research

Contact Info

Product

Resources

About