Leptospirosis Outbreaks in Nicaragua: Identifying Critical Areas and Exploring Drivers for Evidence-Based Planning
Open Access
- 26 October 2012
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 9 (11), 3883-3910
- https://doi.org/10.3390/ijerph9113883
Abstract
Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide. In Central America, leptospirosis outbreaks have been reported in almost all countries; Nicaragua in particular has faced several outbreaks. The objective of this study was to stratify the risk and identify “critical areas” for leptospirosis outbreaks in Nicaragua, and to perform an exploratory analysis of potential “drivers”. This ecological study includes the entire country (153 municipalities). Cases from 2004 to 2010 were obtained from the country’s health information system, demographic and socioeconomic variables from its Census, and environmental data from external sources. Criteria for risk stratification of leptospirosis were defined. Nicaragua reported 1,980 cases of leptospirosis during this period, with the highest percentage of cases (26.36%) in León, followed by Chinandega (15.35%). Among the 153 municipalities, 48 were considered critical areas, 85 were endemic and 20 silent. Using spatial and statistical analysis, the variable presenting the most evident pattern of association with critical areas defined by top quintile of incidence rate is the percentage of municipal surface occupied by the soil combination of cambisol (over pyroclastic and lava bedrock) and andosol (over a volcanic ashes foundation). Precipitation and percentage of rural population are also associated with critical areas. This methodology and findings could be used for Nicaragua’s Leptospirosis Intersectoral Plan, and to identify possible risk areas in other countries with similar drivers.This publication has 22 references indexed in Scilit:
- Leptospirosis in American Samoa – Estimating and Mapping Risk Using Environmental DataPLoS Neglected Tropical Diseases, 2012
- Leptospirosis in American Samoa 2010: Epidemiology, Environmental Drivers, and the Management of EmergenceThe American Journal of Tropical Medicine and Hygiene, 2012
- Outbreak of Leptospirosis after Flood, the Philippines, 2009Emerging Infectious Diseases, 2012
- Seasonality of Human Leptospirosis in Reunion Island (Indian Ocean) and Its Association with Meteorological DataPLOS ONE, 2011
- Importance of animal/human health interface in potential Public Health Emergencies of International Concern in the AmericasRevista Panamericana de Salud Pública, 2011
- Impact of Environment and Social Gradient on Leptospira Infection in Urban SlumsPLoS Neglected Tropical Diseases, 2008
- Global trends in emerging infectious diseasesNature, 2008
- Household Transmission of Leptospira Infection in Urban Slum CommunitiesPLoS Neglected Tropical Diseases, 2008
- General deterrent effects of police patrol in crime “hot spots”: A randomized, controlled trialJustice Quarterly, 1995
- A twelve-year study of leptospirosis on BarbadosEuropean Journal of Epidemiology, 1995