Please use this identifier to cite or link to this item: http://www.arca.fiocruz.br/handle/icict/2789
Title: Household transmission of leptospira infection in urban slum communities
Authors: Maciel, Elves Anderson Pires
Carvalho, Ana Luiza F. de
Nascimento, Simone F
Matos, Rosan B. de
Gouveia, Edilane Lins
Reis, Mitermayer Galvão dos
Ko, Albert Icksang
Affilliation: Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Secretaria Municipal de Saúde de Salvador. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Secretaria de Estado da Saúde da Bahia. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Cornell University. Weill Medical College. Division of International Medicine and Infectious Disease. New York, NY, USA
Abstract: Leptospirosis, a spirochaetal zoonotic disease, is the cause of epidemics associated with high mortality in urban slum communities. Infection with pathogenic Leptospira occurs during environmental exposures and is traditionally associated with occupational risk activities. However, slum inhabitants reside in close proximity to environmental sources of contamination, suggesting that transmission during urban epidemics occurs in the household environment.A survey was performed to determine whether Leptospira infection clustered within households located in slum communities in the city of Salvador, Brazil. Hospital-based surveillance identified 89 confirmed cases of leptospirosis during an outbreak. Serum samples were obtained from members of 22 households with index cases of leptospirosis and 52 control households located in the same slum communities. The presence of anti-Leptospira agglutinating antibodies was used as a marker for previous infection. In households with index cases, 22 (30%) of 74 members had anti-Leptospira antibodies, whereas 16 (8%) of 195 members from control households had anti-Leptospira antibodies. Highest titres were directed against L. interrogans serovars of the Icterohaemorrhagiae serogroup in 95% and 100% of the subjects with agglutinating antibodies from case and control households, respectively. Residence in a household with an index case of leptospirosis was associated with increased risk (OR 5.29, 95% CI 2.13-13.12) of having had a Leptospira infection. Increased infection risk was found for all age groups who resided in a household with an index case, including children <15 years of age (P = 0.008).This study identified significant household clustering of Leptospira infection in slum communities where recurrent epidemics of leptospirosis occur. The findings support the hypothesis that the household environment is an important transmission determinant in the urban slum setting. Prevention therefore needs to target sources of contamination and risk activities which occur in the places where slum inhabitants reside.
Keywords: Leptospirosis
Infection
Urban Slum Communities
Household Transmission
keywords: Leptospirose
Infecção
Comunidades urbanas degradadas
Transmissão Domiciliar
DeCS: Adolescente
Adulto
Distribuição por Idade
Anticorpos Antibacterianos
Brasil
Criança
Pré-Escolar
Feminino
Humanos
Leptospira
Leptospirose
Masculino
Meia-Idade
Áreas de Pobreza
Distribuição Espacial da População
Adulto Jovem
Issue Date: 2008
Publisher: Public Library of Science
Citation: MACIEL, E. A. P. et al. Household Transmission of Leptospira Infection in Urban Slum Communities. PLoS Neglected Tropical Diseases, v.2, n.1, p.1-6, 2008.
Description: Gostaríamos de agradecer à equipe do Hospital Couto Maia e o Secretário de Saúde de Salvador e do Estado da Bahia por sua assistência na condução do estudo; Amaro Silva por sua ajuda na localização do caso nas residências e também a todos os membros da comunidade em Salvador que participaram do estudo.
ISSN: 1935-2727
Appears in Collections:CPqGM - Artigos de Periódicos

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