| Author | Cremonese, Cleber | |
| Author | Souza, Fabio Neves | |
| Author | Palma, Fabiana Almerinda Gonçalves | |
| Author | Sodré, Jonatas Fernandes Araújo | |
| Author | Brito, Ricardo Lustosa | |
| Author | Ribeiro, Priscyla dos Santos | |
| Author | Santana, Juliet Oliveira | |
| Author | Coelho, Rachel Helena | |
| Author | Ticona, Juan P. Aguilar | |
| Author | Nazaré, Romero J. | |
| Author | Oliveira, Daiana de | |
| Author | Silva, Cainã Queiroz | |
| Author | Eyre, Max T. | |
| Author | Mendes, Vinícius de Araújo | |
| Author | Knee, Jackie | |
| Author | Ristow, Paula | |
| Author | Stauber, Christine E. | |
| Author | López, Yeimi Alexandra Alzate | |
| Author | Giorgi, Emanuele | |
| Author | Diggle, Peter J. | |
| Author | Reis, Mitermayer Galvão G. | |
| Author | Cumming, Oliver | |
| Author | Ko, Albert | |
| Author | Costa, Federico | |
| Access date | 2023-10-16T17:00:02Z | |
| Available date | 2023-10-16T17:00:02Z | |
| Document date | 2023 | |
| Citation | CREMONESE, Cleber et al. Simplified sewerage to prevent urban leptospirosis transmission: a cluster non-randomised controlled trial protocol in disadvantaged urban communities of Salvador, Brazil. BMJ Open, v.13, 1-13, 2023. | en_US |
| ISSN | 2044-6055 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/60812 | |
| Sponsorship | Wellcome Trust.
Department of Health and Social Assistance (DHSC).
National Institute for Health Research (NIHR).
UK Official Development Assistance Fund (ODA). | en_US |
| Language | eng | en_US |
| Publisher | BMJ Publishing Group | en_US |
| Rights | open access | en_US |
| Subject in Portuguese | Bacteriologia | en_US |
| Subject in Portuguese | Epidemiologia | en_US |
| Subject in Portuguese | Saúde pública | en_US |
| Subject in Portuguese | Leptospirose | en_US |
| Title | Simplified sewerage to prevent urban leptospirosis transmission: a cluster non-randomised controlled trial protocol in disadvantaged urban communities of Salvador, Brazil | en_US |
| Type | Article | en_US |
| DOI | 10.1136/bmjopen-2022-065009 | |
| Abstract | Introduction: Leptospirosis is a globally distributed zoonotic and environmentally mediated disease that has emerged as a major health problem in urban slums in developing countries. Its aetiological agent is bacteria of the genus Leptospira, which are mainly spread in the urine of infected rodents, especially in an environment where adequate sanitation facilities are lacking, and it is known that open sewers are key transmission sources of the disease. Therefore, we aim to evaluate the effectiveness of a simplified sewerage intervention in reducing the risk of exposure to contaminated environments and Leptospira infection and to characterise the transmission mechanisms involved. Methods and analysis: This matched quasi-experimental study design using non-randomised intervention and control clusters was designed to assess the effectiveness of an urban simplified sewerage intervention in the low-income communities of Salvador, Brazil. The intervention consists of household-level piped sewerage connections and community engagement and public involvement activities. A cohort of 1400 adult participants will be recruited and grouped into eight clusters consisting of four matched intervention-control pairs with approximately 175 individuals in each cluster in baseline. The primary outcome is the seroincidence of Leptospira infection assessed through five serological measurements: one preintervention (baseline) and four postintervention. As a secondary outcome, we will assess Leptospira load in soil, before and after the intervention. We will also assess Leptospira exposures before and after the intervention, through transmission modelling, accounting for residents' movement, contact with flooding, contaminated soil and water, and rat infestation, to examine whether and how routes of exposure for Leptospira change following the introduction of sanitation. Ethics and dissemination: This study protocol has been reviewed and approved by the ethics boards at the Federal University of Bahia and the Brazilian National Research Ethics Committee. Results will be disseminated through peer-reviewed publications and presentations to implementers, researchers and participating communities. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de 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. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Biologia. Salvador, BA, Brasil / Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Belo Horizonte, MG, Brasil / Universidade Federal da Bahia. Instituto Nacional de Ciência e Tecnologia em Estudos Interdisciplinares e Transdisciplinares em Ecologia e Evolução. Instituto de Biologia. Salvador, BA, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Geociências. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Faculdade de Economia. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | en_US |
| Affilliation | London School of Hygiene & Tropical Medicine. Faculty of Infectious Tropical Diseases. Disease Control Department. London, UK. | en_US |
| Affilliation | Universidade Federal da Bahia. Faculdade de Economia. Salvador, Bahia, Brasil. | en_US |
| Affilliation | London School of Hygiene & Tropical Medicine. Faculty of Infectious Tropical Diseases. Disease Control Department. London, UK. | en_US |
| Affilliation | Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Biologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto Nacional de Ciência e Tecnologia em Estudos Interdisciplinares e Transdisciplinares em Ecologia e Evolução. Instituto de Biologia. Salvador, BA, Brasil. | en_US |
| Affilliation | Department of Population Health Sciences. School of Public Health. Georgia State University. Atlanta, Georgia, USA. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil. | en_US |
| Affilliation | Lancaster University Lancaster Medical School. Lancaster, UK. | en_US |
| Affilliation | Lancaster University Lancaster Medical School. Lancaster, UK. | en_US |
| Affilliation | Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Department of Epidemiology of Microbial Diseases. School of Public Health. Yale University. New Haven, Connecticut, USA. | en_US |
| Affilliation | London School of Hygiene & Tropical Medicine. Faculty of Infectious Tropical Diseases. Disease Control Department. London, UK. | en_US |
| Affilliation | Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Department of Epidemiology of Microbial Diseases. School of Public Health. Yale University. New Haven, Connecticut, USA. | en_US |
| Affilliation | Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Lancaster University Lancaster Medical School. Lancaster, UK / Ministério da Saúde. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Department of Epidemiology of Microbial Diseases. School of Public Health. Yale University. New Haven, Connecticut, USA. | en_US |
| Subject | Bacteriology | en_US |
| Subject | Epidemiology | en_US |
| Subject | Public health | en_US |
| Subject | Leptospirosis | en_US |
| DeCS | Bacteriologia | en_US |
| DeCS | Epidemiologia | en_US |
| DeCS | Saúde pública | en_US |
| DeCS | Leptospirose | en_US |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
