Institute of Collective Health, Federal University of Bahia, Salvador, Brazil.
Swedish University of Agricultural Sciences, Umeå, Sweden.
PLoS Negl Trop Dis. 2021 Mar 31;15(3):e0009256. doi: 10.1371/journal.pntd.0009256. eCollection 2021 Mar.
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.
城市贫民窟居民由于个人、社会经济和环境因素而承受着严重的人畜共患疾病负担。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，以确定贫困和卫生条件如何促成鼠类传播的钩端螺旋体病的传播。1318 名参与者的血清阳性率在 10.0%至 13.3%之间。我们发现，与鼠类储存库的存在相比，接触环境污染源会导致卫生条件较差地区的居民面临更高的风险。此外，较贫困的居民可能会在远离家庭的地方受到暴露，而持续的政府干预与较低的传播风险无关。处于高风险的居民意识到自己的脆弱性，他们努力改善家庭附近的物质环境，但并没有降低他们感染的机会。本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，这应该指导干预措施的开展。
