Impact of environment and social gradient on leptospira infection in urban slums
Autor(a) principal: | |
---|---|
Data de Publicação: | 2008 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFBA |
Texto Completo: | http://repositorio.ufba.br/ri/handle/ri/14007 |
Resumo: | Background:Leptospirosis has become an urban health problem as slum settlements have expanded worldwide. Efforts to identify interventions for urban leptospirosis have been hampered by the lack of population-based information on Leptospira transmission determinants. The aim of the study was to estimate the prevalence of Leptospira infection and identify risk factors for infection in the urban slum setting. Methods and Findings:We performed a community-based survey of 3,171 slum residents from Salvador, Brazil. Leptospira agglutinating antibodies were measured as a marker for prior infection. Poisson regression models evaluated the association between the presence of Leptospira antibodies and environmental attributes obtained from Geographical Information System surveys and indicators of socioeconomic status and exposures for individuals. Overall prevalence of Leptospira antibodies was 15.4% (95% confidence interval [CI], 14.0–16.8). Households of subjects with Leptospira antibodies clustered in squatter areas at the bottom of valleys. The risk of acquiring Leptospira antibodies was associated with household environmental factors such as residence in flood-risk regions with open sewers (prevalence ratio [PR] 1.42, 95% CI 1.14–1.75) and proximity to accumulated refuse (1.43, 1.04–1.88), sighting rats (1.32, 1.10–1.58), and the presence of chickens (1.26, 1.05–1.51). Furthermore, low income and black race (1.25, 1.03–1.50) were independent risk factors. An increase of US$1 per day in per capita household income was associated with an 11% (95% CI 5%–18%) decrease in infection risk. Conclusions: Deficiencies in the sanitation infrastructure where slum inhabitants reside were found to be environmental sources of Leptospira transmission. Even after controlling for environmental factors, differences in socioeconomic status contributed to the risk of Leptospira infection, indicating that effective prevention of leptospirosis may need to address the social factors that produce unequal health outcomes among slum residents, in addition to improving sanitation. |
id |
UFBA-2_6608ccf9a988f86c98c6f41db6cf550f |
---|---|
oai_identifier_str |
oai:repositorio.ufba.br:ri/14007 |
network_acronym_str |
UFBA-2 |
network_name_str |
Repositório Institucional da UFBA |
repository_id_str |
1932 |
spelling |
Reis, Renato B.Ribeiro, Guilherme S.Felzemburgh, Ridalva Dias Martins2013-11-29T14:23:34Z2013-11-29T14:23:34Z2008-041935-2727http://repositorio.ufba.br/ri/handle/ri/14007v.2, n.4, p.e228.Background:Leptospirosis has become an urban health problem as slum settlements have expanded worldwide. Efforts to identify interventions for urban leptospirosis have been hampered by the lack of population-based information on Leptospira transmission determinants. The aim of the study was to estimate the prevalence of Leptospira infection and identify risk factors for infection in the urban slum setting. Methods and Findings:We performed a community-based survey of 3,171 slum residents from Salvador, Brazil. Leptospira agglutinating antibodies were measured as a marker for prior infection. Poisson regression models evaluated the association between the presence of Leptospira antibodies and environmental attributes obtained from Geographical Information System surveys and indicators of socioeconomic status and exposures for individuals. Overall prevalence of Leptospira antibodies was 15.4% (95% confidence interval [CI], 14.0–16.8). Households of subjects with Leptospira antibodies clustered in squatter areas at the bottom of valleys. The risk of acquiring Leptospira antibodies was associated with household environmental factors such as residence in flood-risk regions with open sewers (prevalence ratio [PR] 1.42, 95% CI 1.14–1.75) and proximity to accumulated refuse (1.43, 1.04–1.88), sighting rats (1.32, 1.10–1.58), and the presence of chickens (1.26, 1.05–1.51). Furthermore, low income and black race (1.25, 1.03–1.50) were independent risk factors. An increase of US$1 per day in per capita household income was associated with an 11% (95% CI 5%–18%) decrease in infection risk. Conclusions: Deficiencies in the sanitation infrastructure where slum inhabitants reside were found to be environmental sources of Leptospira transmission. Even after controlling for environmental factors, differences in socioeconomic status contributed to the risk of Leptospira infection, indicating that effective prevention of leptospirosis may need to address the social factors that produce unequal health outcomes among slum residents, in addition to improving sanitation.Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2013-11-29T14:23:34Z No. of bitstreams: 1 Guilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdf: 478791 bytes, checksum: bc20ab0ac739b3eb325b2225aac534ec (MD5)Made available in DSpace on 2013-11-29T14:23:34Z (GMT). No. of bitstreams: 1 Guilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdf: 478791 bytes, checksum: bc20ab0ac739b3eb325b2225aac534ec (MD5) Previous issue date: 2008-04San FranciscoPublic Library of ScienceLeptospiraInfectionRisk FactorsImpact of environment and social gradient on leptospira infection in urban slumsPLoS Negl. Trop. Dis.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessengreponame:Repositório Institucional da UFBAinstname:Universidade Federal da Bahia (UFBA)instacron:UFBAORIGINALGuilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdfGuilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdfapplication/pdf478791https://repositorio.ufba.br/bitstream/ri/14007/1/Guilherme%20Ribeiro.%20Impact%20of%20environment%20and%20social%20gradient%20on%20leptospira...2008..pdfbc20ab0ac739b3eb325b2225aac534ecMD51LICENSElicense.txtlicense.txttext/plain1345https://repositorio.ufba.br/bitstream/ri/14007/2/license.txtff6eaa8b858ea317fded99f125f5fcd0MD52TEXTGuilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdf.txtGuilherme Ribeiro. Impact of environment and social gradient on leptospira...2008..pdf.txtExtracted texttext/plain53508https://repositorio.ufba.br/bitstream/ri/14007/3/Guilherme%20Ribeiro.%20Impact%20of%20environment%20and%20social%20gradient%20on%20leptospira...2008..pdf.txtdb942cf292533673b0c2b1f792692e09MD53ri/140072022-07-01 10:46:50.455oai:repositorio.ufba.br:ri/14007VGVybW8gZGUgTGljZW7vv71hLCBu77+9byBleGNsdXNpdm8sIHBhcmEgbyBkZXDvv71zaXRvIG5vIFJlcG9zaXTvv71yaW8gSW5zdGl0dWNpb25hbCBkYSBVRkJBLgoKIFBlbG8gcHJvY2Vzc28gZGUgc3VibWlzc++/vW8gZGUgZG9jdW1lbnRvcywgbyBhdXRvciBvdSBzZXUgcmVwcmVzZW50YW50ZSBsZWdhbCwgYW8gYWNlaXRhciAKZXNzZSB0ZXJtbyBkZSBsaWNlbu+/vWEsIGNvbmNlZGUgYW8gUmVwb3NpdO+/vXJpbyBJbnN0aXR1Y2lvbmFsIGRhIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRhIEJhaGlhIApvIGRpcmVpdG8gZGUgbWFudGVyIHVtYSBj77+9cGlhIGVtIHNldSByZXBvc2l077+9cmlvIGNvbSBhIGZpbmFsaWRhZGUsIHByaW1laXJhLCBkZSBwcmVzZXJ2Ye+/ve+/vW8uIApFc3NlcyB0ZXJtb3MsIG7vv71vIGV4Y2x1c2l2b3MsIG1hbnTvv71tIG9zIGRpcmVpdG9zIGRlIGF1dG9yL2NvcHlyaWdodCwgbWFzIGVudGVuZGUgbyBkb2N1bWVudG8gCmNvbW8gcGFydGUgZG8gYWNlcnZvIGludGVsZWN0dWFsIGRlc3NhIFVuaXZlcnNpZGFkZS4KCiBQYXJhIG9zIGRvY3VtZW50b3MgcHVibGljYWRvcyBjb20gcmVwYXNzZSBkZSBkaXJlaXRvcyBkZSBkaXN0cmlidWnvv73vv71vLCBlc3NlIHRlcm1vIGRlIGxpY2Vu77+9YSAKZW50ZW5kZSBxdWU6CgogTWFudGVuZG8gb3MgZGlyZWl0b3MgYXV0b3JhaXMsIHJlcGFzc2Fkb3MgYSB0ZXJjZWlyb3MsIGVtIGNhc28gZGUgcHVibGljYe+/ve+/vWVzLCBvIHJlcG9zaXTvv71yaW8KcG9kZSByZXN0cmluZ2lyIG8gYWNlc3NvIGFvIHRleHRvIGludGVncmFsLCBtYXMgbGliZXJhIGFzIGluZm9ybWHvv73vv71lcyBzb2JyZSBvIGRvY3VtZW50bwooTWV0YWRhZG9zIGVzY3JpdGl2b3MpLgoKIERlc3RhIGZvcm1hLCBhdGVuZGVuZG8gYW9zIGFuc2Vpb3MgZGVzc2EgdW5pdmVyc2lkYWRlIGVtIG1hbnRlciBzdWEgcHJvZHXvv73vv71vIGNpZW5077+9ZmljYSBjb20gCmFzIHJlc3Ryae+/ve+/vWVzIGltcG9zdGFzIHBlbG9zIGVkaXRvcmVzIGRlIHBlcmnvv71kaWNvcy4KCiBQYXJhIGFzIHB1YmxpY2Hvv73vv71lcyBzZW0gaW5pY2lhdGl2YXMgcXVlIHNlZ3VlbSBhIHBvbO+/vXRpY2EgZGUgQWNlc3NvIEFiZXJ0bywgb3MgZGVw77+9c2l0b3MgCmNvbXB1bHPvv71yaW9zIG5lc3NlIHJlcG9zaXTvv71yaW8gbWFudO+/vW0gb3MgZGlyZWl0b3MgYXV0b3JhaXMsIG1hcyBtYW5077+9bSBhY2Vzc28gaXJyZXN0cml0byAKYW8gbWV0YWRhZG9zIGUgdGV4dG8gY29tcGxldG8uIEFzc2ltLCBhIGFjZWl0Ye+/ve+/vW8gZGVzc2UgdGVybW8gbu+/vW8gbmVjZXNzaXRhIGRlIGNvbnNlbnRpbWVudG8KIHBvciBwYXJ0ZSBkZSBhdXRvcmVzL2RldGVudG9yZXMgZG9zIGRpcmVpdG9zLCBwb3IgZXN0YXJlbSBlbSBpbmljaWF0aXZhcyBkZSBhY2Vzc28gYWJlcnRvLgo=Repositório InstitucionalPUBhttp://192.188.11.11:8080/oai/requestopendoar:19322022-07-01T13:46:50Repositório Institucional da UFBA - Universidade Federal da Bahia (UFBA)false |
dc.title.pt_BR.fl_str_mv |
Impact of environment and social gradient on leptospira infection in urban slums |
dc.title.alternative.pt_BR.fl_str_mv |
PLoS Negl. Trop. Dis. |
title |
Impact of environment and social gradient on leptospira infection in urban slums |
spellingShingle |
Impact of environment and social gradient on leptospira infection in urban slums Reis, Renato B. Leptospira Infection Risk Factors |
title_short |
Impact of environment and social gradient on leptospira infection in urban slums |
title_full |
Impact of environment and social gradient on leptospira infection in urban slums |
title_fullStr |
Impact of environment and social gradient on leptospira infection in urban slums |
title_full_unstemmed |
Impact of environment and social gradient on leptospira infection in urban slums |
title_sort |
Impact of environment and social gradient on leptospira infection in urban slums |
author |
Reis, Renato B. |
author_facet |
Reis, Renato B. Ribeiro, Guilherme S. Felzemburgh, Ridalva Dias Martins |
author_role |
author |
author2 |
Ribeiro, Guilherme S. Felzemburgh, Ridalva Dias Martins |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Reis, Renato B. Ribeiro, Guilherme S. Felzemburgh, Ridalva Dias Martins |
dc.subject.por.fl_str_mv |
Leptospira Infection Risk Factors |
topic |
Leptospira Infection Risk Factors |
description |
Background:Leptospirosis has become an urban health problem as slum settlements have expanded worldwide. Efforts to identify interventions for urban leptospirosis have been hampered by the lack of population-based information on Leptospira transmission determinants. The aim of the study was to estimate the prevalence of Leptospira infection and identify risk factors for infection in the urban slum setting. Methods and Findings:We performed a community-based survey of 3,171 slum residents from Salvador, Brazil. Leptospira agglutinating antibodies were measured as a marker for prior infection. Poisson regression models evaluated the association between the presence of Leptospira antibodies and environmental attributes obtained from Geographical Information System surveys and indicators of socioeconomic status and exposures for individuals. Overall prevalence of Leptospira antibodies was 15.4% (95% confidence interval [CI], 14.0–16.8). Households of subjects with Leptospira antibodies clustered in squatter areas at the bottom of valleys. The risk of acquiring Leptospira antibodies was associated with household environmental factors such as residence in flood-risk regions with open sewers (prevalence ratio [PR] 1.42, 95% CI 1.14–1.75) and proximity to accumulated refuse (1.43, 1.04–1.88), sighting rats (1.32, 1.10–1.58), and the presence of chickens (1.26, 1.05–1.51). Furthermore, low income and black race (1.25, 1.03–1.50) were independent risk factors. An increase of US$1 per day in per capita household income was associated with an 11% (95% CI 5%–18%) decrease in infection risk. Conclusions: Deficiencies in the sanitation infrastructure where slum inhabitants reside were found to be environmental sources of Leptospira transmission. Even after controlling for environmental factors, differences in socioeconomic status contributed to the risk of Leptospira infection, indicating that effective prevention of leptospirosis may need to address the social factors that produce unequal health outcomes among slum residents, in addition to improving sanitation. |
publishDate |
2008 |
dc.date.issued.fl_str_mv |
2008-04 |
dc.date.accessioned.fl_str_mv |
2013-11-29T14:23:34Z |
dc.date.available.fl_str_mv |
2013-11-29T14:23:34Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufba.br/ri/handle/ri/14007 |
dc.identifier.issn.none.fl_str_mv |
1935-2727 |
dc.identifier.number.pt_BR.fl_str_mv |
v.2, n.4, p.e228. |
identifier_str_mv |
1935-2727 v.2, n.4, p.e228. |
url |
http://repositorio.ufba.br/ri/handle/ri/14007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Public Library of Science |
publisher.none.fl_str_mv |
Public Library of Science |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFBA instname:Universidade Federal da Bahia (UFBA) instacron:UFBA |
instname_str |
Universidade Federal da Bahia (UFBA) |
instacron_str |
UFBA |
institution |
UFBA |
reponame_str |
Repositório Institucional da UFBA |
collection |
Repositório Institucional da UFBA |
bitstream.url.fl_str_mv |
https://repositorio.ufba.br/bitstream/ri/14007/1/Guilherme%20Ribeiro.%20Impact%20of%20environment%20and%20social%20gradient%20on%20leptospira...2008..pdf https://repositorio.ufba.br/bitstream/ri/14007/2/license.txt https://repositorio.ufba.br/bitstream/ri/14007/3/Guilherme%20Ribeiro.%20Impact%20of%20environment%20and%20social%20gradient%20on%20leptospira...2008..pdf.txt |
bitstream.checksum.fl_str_mv |
bc20ab0ac739b3eb325b2225aac534ec ff6eaa8b858ea317fded99f125f5fcd0 db942cf292533673b0c2b1f792692e09 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFBA - Universidade Federal da Bahia (UFBA) |
repository.mail.fl_str_mv |
|
_version_ |
1801502525023584256 |