Abstract
Few studies have addressed Leptospira seroprevalence and risk factors in urban populations in Colombia. This study aimed to determine seroprevalence and factors associated with Leptospira infection in inhabitants of an urban district of Cali, Colombia. We collected sociodemographic and environmental data, as well as blood samples, from 353 subjects selected through a multistage cluster sampling design. We performed microagglutination test for the eight main Leptospira serogroups circulating in the region, considering a cut-off titer of ≥ 1:100. Most participants were female (226, 64.8%), with mean age 41.4 years, and 89 (32.6%) lived in low-low socioeconomic stratum (SES-1). Overall seroprevalence was 12.2% (95%CI: 10.3%-14.4%). Factors associated with Leptospira infection were SES 1, older age, single marital status, ethnic groups (Afro-Colombian and white/mestizo), school students, absence of toilet, barefoot walking, travel outside Cali in the previous month, and absence of skin and mucous-membrane lesions in the previous month. Our study suggests domestic and peridomiciliary transmission of Leptospira likely related to activities of daily living and inadequate environmental conditions. SES-1 is a major factor associated with Leptospira infection (adjusted OR = 4.08; 95%CI: 2.54-6.53; p < 0.001), suggesting that social and environmental conditions are key elements for endemicity of Leptospira infection in the study area. Epidemiological surveillance, improvement of environmental and sanitary conditions in various SES-1 areas, and community educational campaigns are recommended.
Highlights
Leptospirosis is a zoonotic disease of public health importance worldwide, especially in developing and tropical countries
We initially found that contact with water sources other than the aqueduct in the previous month (OR = 0.44; 95% confidence interval (95%CI): 0.25-0.78; p = 0.006) and dog ownership (OR = 0.51; 95%CI: 0.35-0.74; p = 0.001) were associated with lower prevalence of Leptospira infection, but these variables were dropped from further analysis in the multivariate model due to lack of significance
Our study found no increased prevalence associated with dog ownership or observation of rodents, which have been reported as risk factors for urban leptospirosis in several studies elsewhere [2,7,8,18,39]
Summary
Leptospirosis is a zoonotic disease of public health importance worldwide, especially in developing and tropical countries. It is caused by pathogenic bacterial species of the genus Leptospira, and it was initially considered an occupational disease associated with rural environments, it is a reemerging disease in both urban and rural contexts [1,2,3,4]. Occupational exposure, high seasonal rainfall, flooding, poor sanitation, inadequate solid waste accumulation, barefoot walking, contact with domestic and wild animals, rat infestations, and even water sports are among the most important determinants in the transmission dynamics of leptospirosis [2,5,6,8]
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