Poverty, sanitation, and Leptospira transmission pathways in residents from four Brazilian slums.
Poverty, sanitation, and Leptospira transmission pathways in residents from four Brazilian slums.
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DOI：
10.1371/journal.pntd.0009256
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发表时间：
2021-03
影响因子：
3.8
通讯作者：
Costa F
中科院分区：
文献类型：
--
作者：
Khalil H;Santana R;de Oliveira D;Palma F;Lustosa R;Eyre MT;Carvalho-Pereira T;Reis MG;Ko AI;Diggle PJ;Alzate Lopez Y;Begon M;Costa F
由于个人、社会经济和环境因素，城市贫民窟的居民遭受人畜共患病的沉重负担。我们在巴西萨尔瓦多的四个城市贫民窟进行了一项横断面血清学调查，以描述贫困和卫生条件如何促进鼠传钩端螺旋体病的传播。1，318名参与者的血清流行率介于10.0%和13.3%之间。我们发现，与环境污染源接触，而不是老鼠水库的存在，是导致生活在卫生条件不足地区的居民面临更高风险的原因。此外，较贫穷的居民可能会远离家庭，持续的政府干预与较低的传播风险无关。高风险居民意识到他们的脆弱性，他们的努力改善了他们家附近的物理环境，但没有减少他们的感染机会。这项研究强调了了解风险的社会经济和环境决定因素的重要性，这应该指导干预工作。在全球范围内，超过10亿居民生活在城市贫民窟，那里的卫生设施不足增加了病原体及其动物宿主的传播。钩端螺旋体病是一种全球分布的细菌性疾病，在城市地区，细菌通过棕色老鼠传播。人类在暴露于被感染大鼠尿液污染的水或土壤/泥土后受到感染。在巴西萨尔瓦多市的四个城市贫民窟中，我们使用了一系列个人、社会经济和环境变量来了解它们如何相互影响，并定义居民的钩端螺旋体病暴露。贫困和卫生影响居民接触下水道水和泥浆的程度。此外，我们发现，虽然居民试图改善他们家附近的物理环境，但生活在卫生条件差的地区意味着他们的感染风险仍然很高。这项工作强调了社会经济和环境因素在确定疾病风险方面的重要性，并建议政府干预措施应侧重于改善社区最贫困地区的卫生状况。
Residents of urban slums suffer from a high burden of zoonotic diseases due to individual, socioeconomic, and environmental factors. We conducted a cross-sectional sero-survey in four urban slums in Salvador, Brazil, to characterize how poverty and sanitation contribute to the transmission of rat-borne leptospirosis. Sero-prevalence in the 1,318 participants ranged between 10.0 and 13.3%. We found that contact with environmental sources of contamination, rather than presence of rat reservoirs, is what leads to higher risk for residents living in areas with inadequate sanitation. Further, poorer residents may be exposed away from the household, and ongoing governmental interventions were not associated with lower transmission risk. Residents at higher risk were aware of their vulnerability, and their efforts improved the physical environment near their household, but did not reduce their infection chances. This study highlights the importance of understanding the socioeconomic and environmental determinants of risk, which ought to guide intervention efforts. Globally, more than 1 billion residents live in urban slums, where inadequate sanitation increases the spread of pathogens and their animal hosts. Leptospirosis is a globally distributed bacterial disease, and in urban areas the bacteria is spread by brown rats. Humans become infected upon exposure to water or soil/mud that was contaminated with the urine of infected rats. In four urban slums in the city of Salvador, Brazil, we used a range of individual, socioeconomic, and environmental variables to understand how they influence to one another and define o leptospirosis exposure in residents. Poverty and sanitation influenced the degree to which residents were exposed to sewer water and mud. Further, we found that while residents tried to improve the physical environment near their household, living in an area with poor sanitation mean that their infection risk remained high. This work highlight the importance of socioeconomic and environmental factors in determining disease risk, and suggests that governmental interventions should focus on improving sanitation changes in the poorest parts of the community.
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DOI：
10.4269/ajtmh.2012.12-0245
发表时间：
2013-02-01
影响因子：
3.3
作者：
de Araujo, Wildo Navegantes;Finkmoore, Brooke;Costa, Federico
通讯作者：
Costa, Federico
DOI：
10.3390/ijerph14040342
发表时间：
2017-03-24
影响因子：
--
作者：
Corburn J;Sverdlik A
通讯作者：
Sverdlik A
影响因子：
11.8
作者：
Gouvela, Edilane L.;Metcalfe, John;Ko, Albert I.
通讯作者：
Ko, Albert I.
影响因子：
11.8
作者：
Anjos, Rosangela O.;Mugabe, Vanio Andre;Ribeiro, Guilherme S.
通讯作者：
Ribeiro, Guilherme S.
影响因子：
3.8
作者：
Costa F;Wunder EA Jr;De Oliveira D;Bisht V;Rodrigues G;Reis MG;Ko AI;Begon M;Childs JE
通讯作者：
Childs JE