Abstract
Human leptospirosis is an infection that most often affects tropical countries. Since 2007, Colombia requires the notification of disease cases, enabling the observation of an increase in cases in recent years. The objectives of this article were to analyze environmental and socioeconomic variables and to evaluate their relationship with human leptospirosis cases. This is an ecological study on human leptospirosis cases aggregated by municipality and reported between 2007 and 2016. Spatial aggregation assessment was made using the Getis-Ord Gi method, and negative binomial regression was used to evaluate the relationship between environmental and socioeconomic variables with human leptospirosis. During the study period, 9,928 cases of human leptospirosis were reported, and 58.9% of municipalities reported at least one case. Four hotspots of human leptospirosis, including 18 municipalities, were identified. The results of the negative binomial model confirmed the importance of the effects of education, poverty and some climatic variables on the decadal incidence rate of human leptospirosis. Our results confirm the importance of socioeconomic determinants such as social marginality associated with violence and education, as well as ecological variables such as rainfall, height above sea level and forest coverage on the incidence rate of human leptospirosis at municipal scale.
Highlights
Leptospirosis is a disease caused by pathogenic bacteria of the Leptospira genus, affecting both humans and animals 1
This study aimed to evaluate the relationships between a set of environmental and socioeconomic variables and human leptospirosis cases that occurred in Colombia from 2007 to 2016, at municipal level
9,928 human leptospirosis cases were reported to SIVIGILA, with an annual incidence rate ranging from 1.1 (2016) to 5.4 (2011) cases per 100,000 inhabitants for the entire country
Summary
Leptospirosis is a disease caused by pathogenic bacteria of the Leptospira genus, affecting both humans and animals 1. Leptospirosis is one of the most common zoonoses worldwide, it affects tropical countries most often 2. Leptospirosis was a predominantly rural occupational risk until major urbanization occurred during the 20th century. Transmission risk is associated with climate, natural disasters, poverty and marginality 3. In Colombia, leptospirosis has been analyzed mainly from an animal health perspective, as it is prevalent in canines [4,5,6], bovines [7,8], pigs 9 and primates [10,11]. In humans, some studies have reported seroprevalences ranging from 6% to 27.7% 14, and the circulation of 17 serovars has been recorded in the country [15,16]
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