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https://www.arca.fiocruz.br/handle/icict/57109
WHY IS LEPTOSPIROSIS HARD TO AVOID FOR THE IMPOVERISHED? DECONSTRUCTING LEPTOSPIROSIS TRANSMISSION RISK AND THE DRIVERS OF KNOWLEDGE, ATTITUDES, AND PRACTICES IN A DISADVANTAGED COMMUNITY IN SALVADOR, BRAZIL
Empobrecido
Risco de transmissão
Comunidade desfavorecida
Salvador - Brasil
Author
Affilliation
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Biologia. Salvador, BA, Brasil.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil /Department of Epidemiology of Microbial Diseases. Yale School of Public Health. New Haven, Connecticut, United States of America.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil/ Department of Epidemiology of Microbial Diseases. Yale School of Public Health. New Haven, Connecticut, United States of America.
Department of Evolution. Ecology and Behaviour. The University of Liverpool. United Kingdom.
Department of Wildlife, Fish, and Environmental Studies. Swedish University of Agricultural Sciences. Umeå, Sweden.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto Saúde Coletiva. Salvador, BA, Brasil.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Biologia. Salvador, BA, Brasil.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil /Department of Epidemiology of Microbial Diseases. Yale School of Public Health. New Haven, Connecticut, United States of America.
Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil/ Department of Epidemiology of Microbial Diseases. Yale School of Public Health. New Haven, Connecticut, United States of America.
Department of Evolution. Ecology and Behaviour. The University of Liverpool. United Kingdom.
Department of Wildlife, Fish, and Environmental Studies. Swedish University of Agricultural Sciences. Umeå, Sweden.
Abstract
Background: Several studies have identified socioeconomic and environmental risk factors for infectious disease, but the relationship between these and knowledge, attitudes, and practices (KAP), and more importantly their web of effects on individual infection risk, have not previously been evaluated. Methods: We conducted a cross-sectional KAP survey in an urban disadvantaged community in Salvador, Brazil, leveraging on simultaneously collected fine-scale environmental and epidemiological data on leptospirosis transmission. Findings: Residents’ knowledge influenced their attitudes which influenced their practices. However, different KAP variables were driven by different socioeconomic and environmental factors; and while improved KAP variables reduced risk, there were additional effects of socioeconomic and environmental factors on risk. For example, males and those of lower socioeconomic status were at greater risk, but once we controlled for KAP, male gender and lower socioeconomic status themselves were not direct drivers of seropositivity. Employment was linked to better knowledge and a less contaminated environment, and hence lower risk, but being employed was independently associated with a higher, not lower risk of leptospirosis transmission, suggesting travel to work as a high risk activity. Interpretation: Our results show how such complex webs of influence can be disentangled. They indicate that public health messaging and interventions should take into account this complexity and prioritize factors that limit exposure and support appropriate prevention practices.
Keywords in Portuguese
LeptospiroseEmpobrecido
Risco de transmissão
Comunidade desfavorecida
Salvador - Brasil
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