Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/7799
Title: Prospective study of leptospirosis transmission in an urban slum community: role of poor environment in repeated exposures to the leptospira agent
Authors: Felzemburgh, Ridalva Dias Martins
Ribeiro, Guilherme de Sousa
Costa, Federico
Renato B. Reis
Hagan, José Edward
Melendez, Astrid X. T. O
Deborah Fraga
Francisco S. Santana
Sharif Mohr
Santos, Balbino L. dos
Silva, Adriano Queiroz
Andréia C. Santos
Ravines, Romy R
Tassinari, Wagner S
Carvalho, Marilia Sá
Reis, Mitermayer Galvão dos
Ko, Albert Icksang
Affilliation: Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Enfermagem. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Yale University. Department of Epidemiology of Microbial Diseases. School of Public Health. New Haven, Connecticut, USA
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Yale University. Department of Epidemiology of Microbial Diseases. School of Public Health. New Haven, Connecticut, USA
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Secretaria Estadual de Saúde da Bahia. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Escola Nacional da Saúde Pública. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional da Saúde Pública. Rio de Janeiro, RJ, Brasil / Universidade Federal Rural do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Escola Nacional da Saúde Pública. Rio de Janeiro, RJ, Brasil
Abstract: Background: Leptospirosis has emerged as an urban health problem as slum settlements have rapidly spread worldwide and created conditions for rat-borne transmission. Prospective studies have not been performed to determine the disease burden, identify risk factors for infection and provide information needed to guide interventions in these marginalized communities. Methodology/Principal Findings: We enrolled and followed a cohort of 2,003 residents from a slum community in the city of Salvador, Brazil. Baseline and one-year serosurveys were performed to identify primary and secondary Leptospira infections, defined as respectively, seroconversion and four-fold rise in microscopic agglutination titers. We used multinomial logistic regression models to evaluate risk exposures for acquiring primary and secondary infection. A total of 51 Leptospira infections were identified among 1,585 (79%) participants who completed the one-year follow-up protocol. The crude infection rate was 37.8 per 1,000 person-years. The secondary infection rate was 2.3 times higher than that of primary infection rate (71.7 and 31.1 infections per 1,000 person-years, respectively). Male gender (OR 2.88; 95% CI 1.40– 5.91) and lower per capita household income (OR 0.54; 95% CI, 0.30–0.98 for an increase of $1 per person per day) were independent risk factors for primary infection. In contrast, the 15–34 year age group (OR 10.82, 95% CI 1.38–85.08), and proximity of residence to an open sewer (OR 0.95; 0.91–0.99 for an increase of 1 m distance) were significant risk factors for secondary infection. Conclusions/Significance: This study found that slum residents had high risk (.3% per year) for acquiring a Leptospira infection. Re-infection is a frequent event and occurs in regions of slum settlements that are in proximity to open sewers. Effective prevention of leptospirosis will therefore require interventions that address the infrastructure deficiencies that contribute to repeated exposures among slum inhabitants.
keywords: Leptospirose
Leptospira
Favelas
Saúde urbana
Fatores de risco
Masculino
Infecção
Issue Date: 2014
Publisher: Public Library of Science
Citation: FELZEMBURGH, R. D. et al. Prospective study of leptospirosis transmission in an urban slum community: role of poor environment in repeated exposures to the leptospira agent. PLoS Neglected Tropical Diseases,v. 8, n. 5, p. e2927, 2014.
ISSN: 1935-2727
10.1371/journal.pntd.0002927
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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