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: | 12 Apr 2016 22:33 |
| Last Modified: | 17 Feb 2017 00:27 |
| URI: | https://repository.usp.ac.fj/id/eprint/8812 |
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