Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut 06511, United States.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia 40110-040, Brazil.
Environ Sci Technol. 2021 Dec 7;55(23):15882-15890. doi: 10.1021/acs.est.1c04916. Epub 2021 Nov 12.
Leptospirosis is an environmentally transmitted zoonotic disease caused by pathogenic spp. that affects poor communities worldwide. In urban slums, leptospirosis is associated with deficient sanitary infrastructure. Yet, the role of sewerage in the reduction of the environmental contamination with pathogenic has not been explored. Here, we conducted a survey of the pathogen in soils surrounding open and closed sewer sections in six urban slums in Brazil. We found that soils surrounding conventionally closed sewers (governmental interventions) were 3 times less likely to contain pathogenic (inverse OR 3.44, 95% CI = 1.66-8.33; < 0.001) and contained a 6 times lower load of the pathogen (0.82 log units difference, < 0.01) when compared to their open counterparts. However, no differences were observed in community-closed sewers (poor-quality closings performed by the slum dwellers). Human fecal markers (BacHum) were positively associated with pathogenic even in closed sewers, and rat presence was not predictive of the presence of the pathogen in soils, suggesting that site-specific rodent control may not be sufficient to reduce the environmental contamination with . Overall, our results indicate that sewerage expansion to urban slums may help reduce the environmental contamination with the pathogen and therefore reduce the risk of human leptospirosis.
钩端螺旋体病是一种由致病性 spp.引起的环境传播性人畜共患病,影响着全球贫困社区。在城市贫民窟中,钩端螺旋体病与卫生基础设施不足有关。然而,下水道系统在减少致病性 spp.对环境的污染方面的作用尚未得到探索。在这里,我们调查了巴西六个城市贫民窟中开放和封闭下水道周围土壤中的病原体。我们发现,传统上封闭的下水道(政府干预)周围的土壤中,致病性 spp.的含量要低 3 倍(反向 OR 3.44,95%CI=1.66-8.33; < 0.001),并且病原体的载量低 6 倍(0.82 个对数单位的差异, < 0.01)。然而,在社区封闭的下水道(贫民窟居民进行的劣质封闭)中没有观察到差异。人类粪便标志物(BacHum)即使在封闭的下水道中也与致病性 spp.呈正相关,而老鼠的存在并不能预测土壤中病原体的存在,这表明针对特定地点的啮齿动物控制可能不足以减少病原体对环境的污染。总体而言,我们的结果表明,将下水道系统扩展到城市贫民窟可能有助于减少环境中病原体的污染,从而降低人类钩端螺旋体病的风险。