Renato Barbosa Reis|Guilherme S. Ribeiro|Ridalva Dias Martins Felzemburgh|Francisco S. Santana|Sharif B. Mohr|Astrid X. T. O. Melendez|Adriano Queiroz|Andréia C. Santos|Romy R. Ravines|Wagner de Souza Tassinari|Marília Sá Carvalho|Mitermayer Galvão dos Reis|Albert I. Ko
Impact of Environment and Social Gradient on Leptospira Infection in Urban Slums
Fundação Oswaldo Cruz|Ministry of Health|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|Cornell University|Fundação Oswaldo Cruz|Ministry of Health
leptospirosis become urban health problem slum settlements expanded worldwide efforts identify interventions urban leptospirosis hampered lack populationbased information leptospira transmission determinants aim study estimate prevalence leptospira infection identify risk factors infection urban slum settingwe performed communitybased survey 3171 slum residents salvador brazil leptospira agglutinating antibodies measured marker prior infection poisson regression models evaluated association presence leptospira antibodies environmental attributes obtained geographical information system surveys indicators socioeconomic status exposures individuals overall prevalence leptospira antibodies 154 95 confidence interval ci 140168 households subjects leptospira antibodies clustered squatter areas bottom valleys risk acquiring leptospira antibodies associated household environmental factors residence floodrisk regions open sewers prevalence ratio pr 142 95 ci 114175 proximity accumulated refuse 143 104188 sighting rats 132 110158 presence chickens 126 105151 furthermore low income black race 125 103150 independent risk factors increase us1 per day per capita household income associated 11 95 ci 518 decrease infection riskdeficiencies sanitation infrastructure slum inhabitants reside found environmental sources leptospira transmission even controlling environmental factors differences socioeconomic status contributed risk leptospira infection indicating effective prevention leptospirosis may need address social factors produce unequal health outcomes among slum residents addition improving sanitation