Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua

Bacallao, Jorge; Schneider, María Cristina; Nájera, Patricia; Aldighieri, Sylvain; Soto, Aida; Marquiño, Wilmer; Sáenz, Carlos Abel Córdova; Jiménez, Eduardo García; Moreno, Gilberto; Chavez, Octavio E.; Galan, Deise I.; Espinal, Marcos

doi:10.3390/ijerph110808301

Cited by 23 publications

(21 citation statements)

References 17 publications

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“…Coverage of education and performance in standardized high school exams are similar variables, both being negatively related to human leptospirosis occurrence. Similar results have been obtained with socioeconomic factors such as illiteracy, which characterizes socially vulnerable populations 34,45,46 . Overpopulation in urban areas has been associated with human leptospirosis outbreaks 47 , and in our data, a similar tendency was observed when human leptospirosis incidence decreased in municipalities where the percentage of the population living in non-urban areas was larger.…”

Section: Variablessupporting

confidence: 84%

Environmental and socioeconomic determinants of leptospirosis incidence in Colombia

et al. 2019

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Human leptospirosis is an infection that most often affects tropical countries. Since 2007, Colombia requires the notification of disease cases, enabling the observation of an increase in cases in recent years. The objectives of this article were to analyze environmental and socioeconomic variables and to evaluate their relationship with human leptospirosis cases. This is an ecological study on human leptospirosis cases aggregated by municipality and reported between 2007 and 2016. Spatial aggregation assessment was made using the Getis-Ord Gi method, and negative binomial regression was used to evaluate the relationship between environmental and socioeconomic variables with human leptospirosis. During the study period, 9,928 cases of human leptospirosis were reported, and 58.9% of municipalities reported at least one case. Four hotspots of human leptospirosis, including 18 municipalities, were identified. The results of the negative binomial model confirmed the importance of the effects of education, poverty and some climatic variables on the decadal incidence rate of human leptospirosis. Our results confirm the importance of socioeconomic determinants such as social marginality associated with violence and education, as well as ecological variables such as rainfall, height above sea level and forest coverage on the incidence rate of human leptospirosis at municipal scale.

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Section: Variablessupporting

confidence: 84%

Environmental and socioeconomic determinants of leptospirosis incidence in Colombia

et al. 2019

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“…At present, more than one billion of the world’s inhabitants live in slum settlements. In these settings, large epidemics of leptospirosis have increasingly been reported [ 6 – 8 ]. The infection is caused by a spirochetal bacterium from the genus Leptospira .…”

Section: Introductionmentioning

confidence: 99%

“…Infections in the urban setting are largely due to a single serogroup, L . interrogans serogroup Icterohaemorrhagiae, which is acquired during contact with soil or water contaminated with urine of the rat reservoir from which the pathogen is shed [ 5 , 6 , 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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“…Socioeconomic drivers include living in dense urban or peri-urban areas with inadequate waste collection and sanitation, which is often associated with vulnerable populations [ 16 ]. Leptospirosis has been linked to poverty, lack of water and sanitation, and poor housing conditions [ 12 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface

et al. 2015

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BackgroundLeptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface.Methodology and findingsThe risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03–2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26–2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09–1.11) and rice (RR: 1.003; CI95%: 1.002–1.04).ConclusionUrban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface.

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Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua

Cited by 23 publications

References 17 publications

Environmental and socioeconomic determinants of leptospirosis incidence in Colombia

Environmental and socioeconomic determinants of leptospirosis incidence in Colombia

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

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface

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