Ridalva Dias Martins Felzemburgh|Guilherme S. Ribeiro|Federico Costa|Renato Barbosa Reis|José E. Hagan|Astrid X. T. O. Melendez|Deborah Bittencourt Mothé Fraga|Francisco S. Santana|Sharif B. Mohr|Balbino Lino dos Santos|Adriano Q. Silva|Andréia C. Santos|Romy R. Ravines|Wagner de Souza Tassinari|Marília Sá Carvalho|Mitermayer Galvão dos Reis|Albert I. Ko
Prospective Study of Leptospirosis Transmission in an Urban Slum Community: Role of Poor Environment in Repeated Exposures to the Leptospira Agent
Fundação Oswaldo Cruz|Ministry of Health|Universidade Federal da Bahia|Fundação Oswaldo Cruz|Ministry of Health|Universidade Federal da Bahia|Instituto de Saúde|Fundação Oswaldo Cruz|Ministry of Health|Yale University|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Yale University|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Secretaria da Saúde|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Escola Nacional de Saúde Pública|Ministry of Health|Fundação Oswaldo Cruz|Universidade Federal Rural do Rio de Janeiro|Escola Nacional de Saúde Pública|Ministry of Health|Fundação Oswaldo Cruz|Escola Nacional de Saúde Pública|Ministry of Health|Fundação Oswaldo Cruz|Fundação Oswaldo Cruz|Ministry of Health|Fundação Oswaldo Cruz|Ministry of Health|Yale University
background leptospirosis emerged urban health problem slum settlements rapidly spread worldwide created conditions ratborne transmission prospective studies performed determine disease burden identify risk factors infection provide information needed guide interventions marginalized communities methodologyprincipal findings enrolled followed cohort 2003 residents slum community city salvador brazil baseline oneyear serosurveys performed identify primary secondary leptospira infections defined respectively seroconversion fourfold rise microscopic agglutination titers used multinomial logistic regression models evaluate risk exposures acquiring primary secondary infection total 51 leptospira infections identified among 1585 79 participants completed oneyear followup protocol crude infection rate 378 per 1000 personyears secondary infection rate 23 times higher primary infection rate 717 311 infections per 1000 personyears respectively male gender 288 95 ci 140591 lower per capita household income 054 95 ci 030098 increase 1 per person per day independent risk factors primary infection contrast 1534 year age group 1082 95 ci 1388508 proximity residence open sewer 095 091099 increase 1 distance significant risk factors secondary infection conclusionssignificance study found slum residents high risk 3 per year acquiring leptospira infection reinfection frequent event occurs regions slum settlements proximity open sewers effective prevention leptospirosis therefore require interventions address infrastructure deficiencies contribute repeated exposures among slum inhabitants