Greca Junior Haroldo, Machado Cassiana Dahlke, Kmetiuk Louise Bach, de França Danilo Alves, Rodrigues Nassarah Jabur Lot, Chechia do Couto Anahi, Langoni Helio, Monti Gustavo, Biondo Alexander Welker
Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil.
City Secretary of Health, Curitiba, Brazil.
Front Public Health. 2025 Jul 11;13:1596684. doi: 10.3389/fpubh.2025.1596684. eCollection 2025.
Homelessness has been considered one of the most vulnerable situations worldwide, alongside people private of liberty (incarceration) and country displacement (refugees). Structural inequality and exposure to diseases such as leptospirosis may be aggravated by individual issues including drug addiction, mental disorders and improper healthcare.
The present study has accessed persons experiencing homelessness to spp. exposure by microscopic agglutination test (MAT) for 30 serovars. This study was conducted in São Paulo city in southeastern Brazil and São José dos Pinhais city, belonging the eighth biggest metropolitan area of Brazil in Southern region.
In total, 21/243 (8.6%; 95% CI = 5.6-13.1%) persons experiencing homelessness were seropositive in the MAT. Location, condom use, and flea infestations were identified as statistically significant associated risk factors for exposure.
The presence of multiple spp. serovars may indicate bacterial diversity, even in urban settings. The results herein found for persons experiencing homelessness were not a surprise, as Brazil has been historically recognized as an endemic country for leptospirosis, with 3,810 leptospirosis cases on average per year and the majority living in densely populated urban areas. Multidisciplinary efforts and integrated policies may be crucial to mitigate leptospirosis and other infectious diseases in persons experiencing homelessness, as social neglection may impact on their fundamental rights to dignity and access to personal health.
无家可归被认为是全球最脆弱的状况之一，与被剥夺自由的人（监禁）和背井离乡的人（难民）一样。结构不平等以及接触钩端螺旋体病等疾病可能因药物成瘾、精神障碍和医疗保健不当等个人问题而加剧。
本研究通过显微镜凝集试验（MAT）对30种血清型检测了无家可归者的钩端螺旋体属暴露情况。本研究在巴西东南部的圣保罗市以及巴西南部属于巴西第八大大都市地区的圣若泽杜斯皮尼亚伊斯市进行。
总共21/243名（8.6%；95%置信区间=5.6 - 13.1%）无家可归者在MAT中呈血清阳性。地点、使用避孕套和跳蚤感染被确定为有统计学意义的暴露相关危险因素。
多种钩端螺旋体属血清型的存在可能表明细菌多样性，即使在城市环境中也是如此。本文针对无家可归者的研究结果并不令人意外，因为巴西历来被认为是钩端螺旋体病的流行国家，平均每年有3810例钩端螺旋体病病例，且大多数病例居住在人口密集的城市地区。多学科努力和综合政策对于减轻无家可归者的钩端螺旋体病和其他传染病可能至关重要，因为社会忽视可能会影响他们的尊严和获得个人健康的基本权利。
