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Human Leptospirosis infection in Fiji: An eco-epidemiological approach to identifying risk factors and environmental drivers for transmission

Lau, Colleen, L. and Watson, Conall H. and Lowry, John and David, Michael C. and Craig, Scott B. and Wynwood, Sarah J. and Kama, Mike and Nilles, Eric J. (2016) Human Leptospirosis infection in Fiji: An eco-epidemiological approach to identifying risk factors and environmental drivers for transmission. PLoS: Neglected Tropical Diseases, 10 (1). pp. 1-25. ISSN 1935-2727

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    Abstract

    Leptospirosis is an important zoonotic disease in the Pacific Islands. In Fiji, two successive cyclones and severe flooding in 2012 resulted in outbreaks with 576 reported cases and 7% case-fatality. We conducted a cross-sectional seroprevalence study and used an eco-epidemiological approach to characterize risk factors and drivers for human leptospirosis infection in Fiji, and aimed to provide an evidence base for improving the effectiveness of public health mitigation and intervention strategies. Antibodies indicative of previous or recent infection were found in 19.4% of 2152 participants (81 communities on the 3 main islands). Questionnaires and geographic information systems data were used to assess variables related to demographics, individual behaviour, contact with animals, socioeconomics, living conditions, land use, and the natural environment. On multivariable logistic regression analysis, variables associated with the presence of Leptospira antibodies included male gender (OR 1.55), iTaukei ethnicity (OR 3.51), living in villages (OR 1.64), lack of treated water at home (OR 1.52), working outdoors (1.64), living in rural areas (OR 1.43), high poverty rate (OR 1.74), living <100m from a major river (OR 1.41), pigs in the community (OR 1.54), high cattle density in the district (OR 1.04 per head/sqkm), and high maximum rainfall in the wettest month (OR 1.003 per mm). Risk factors and drivers for human leptospirosis infection in Fiji are complex and multifactorial, with environmental factors playing crucial roles. With global climate change, severe weather events and flooding are expected to intensify in the South Pacific. Population growth could also lead to more intensive livestock farming; and urbanization in developing countries is often associated with urban and peri-urban slums where diseases of poverty proliferate. Climate change, flooding, population growth, PLOS Neglected Tropical Diseases | DOI:10.1371/journal.pntd.0004405 January 28, 2016 1 / 25 OPEN ACCESS Citation: Lau CL, Watson CH, Lowry JH, David MC, Craig SB, Wynwood SJ, et al. (2016) Human Leptospirosis Infection in Fiji: An Eco-epidemiological Approach to Identifying Risk Factors and Environmental Drivers for Transmission. PLoS Negl Trop Dis 10(1): e0004405. doi:10.1371/journal. pntd.0004405 Editor: Mathieu Picardeau, Institut Pasteur, FRANCE Received: September 21, 2015 Accepted: January 4, 2016 Published: January 28, 2016 Copyright: © 2016 Lau et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The study was conducted in small communities in Fiji, and participants could potentially be re-identifiable if the study data were fully available, e.g. by diagnosis of leptospirosis, demographics, occupation, and household GPS locations. Public deposition of the data would compromise participant privacy, and therefore breach compliance with the protocol approved by the research ethics committees. Data can be requested via The University of Queensland's Human Research Ethics Committee for researchers who meet the criteria for access to confidential data. urbanization, poverty and agricultural intensification are important drivers of zoonotic disease transmission; these factors may independently, or potentially synergistically, lead to enhanced leptospirosis transmission in Fiji and other similar settings.

    Item Type: Journal Article
    Subjects: G Geography. Anthropology. Recreation > GF Human ecology. Anthropogeography
    R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
    Divisions: Faculty of Science, Technology and Environment (FSTE) > School of Geography, Earth Science and Environment
    Depositing User: John Lowry
    Date Deposited: 13 Apr 2016 10:33
    Last Modified: 17 Feb 2017 12:27
    URI: http://repository.usp.ac.fj/id/eprint/8812
    UNSPECIFIED

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