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. 2015 Nov 12;9(11):e0004095.
doi: 10.1371/journal.pntd.0004095. eCollection 2015 Nov.

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface

Maria Cristina Schneider  1 , Patricia Najera  1 , Martha M Pereira  2 , Gustavo Machado  3 , Celso B dos Anjos  4 , Rogério O Rodrigues  5 , Gabriela M Cavagni  6 , Claudia Muñoz-Zanzi  7 , Luis G Corbellini  3 , Mariana Leone  1 , Daniel F Buss  8 , Sylvain Aldighieri  1 , Marcos A Espinal  1
Affiliations

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface

Maria Cristina Schneider et al. PLoS Negl Trop Dis. .

Abstract

Background: Leptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface.

Methodology and findings: The risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03-2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26-2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09-1.11) and rice (RR: 1.003; CI95%: 1.002-1.04).

Conclusion: Urban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Human cases of leptospirosis according to the residence site, by municipality, Rio Grande do Sul, 2008–2012.
Fig 2
Fig 2. Cumulative incidence of leptospirosis (10,000 habitants), by municipality, Rio Grande do Sul, 2008–2012.
Fig 3
Fig 3. Cumulative incidence for leptospirosis and ecoregions, Rio Grande do Sul, 2008–2012.
Fig 4
Fig 4. Cumulative incidence for leptospirosis type of soil and neossole type, by municipality Rio Grande do Sul, 2008–2012.
Fig 5
Fig 5. Cumulative incidence for leptospirosis, rice paddy plantation, and tobacco plantation, by municipality, Rio Grande do Sul, 2008–2012.
Fig 6
Fig 6. Cumulative incidence for leptospirosis and percentage of properties with up to 10 bovines, by municipality, Rio Grande do Sul, 2008–2012.
See this image and copyright information in PMC

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