Emanuele Giorgi1, Federico Costa1,2,3,4, Max T Eyre1,5, Fábio N Souza2, Ticiana S A Carvalho-Pereira2, Nivison Nery2, Daiana de Oliveira2, Jaqueline S Cruz2, Gielson A Sacramento2, Hussein Khalil2,6, Elsio A Wunder3,4, Kathryn P Hacker7, José E Hagan8, James E Childs3,4, Mitermayer G Reis2,3, Mike Begon9, Peter J Diggle1, Albert I Ko3,4. 1. Centre for Health Informatics, Computing, and Statistics, Lancaster University Medical School, Lancaster, United Kingdom. 2. Institute of Collective Health, Federal University of Bahia, Salvador, Brazil. 3. Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil. 4. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States. 5. Liverpool School of Tropical Medicine, Liverpool, United Kingdom. 6. Swedish University of Agricultural Sciences, Umeå, Sweden. 7. University of Pennsylvania, Philadelphia, United States. 8. World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark. 9. Department of Evolution, Ecology and Behaviour, University of Liverpool, Liverpool, United Kingdom.
Abstract
Background: Zoonotic spillover from animal reservoirs is responsible for a significant global public health burden, but the processes that promote spillover events are poorly understood in complex urban settings. Endemic transmission of Leptospira, the agent of leptospirosis, in marginalised urban communities occurs through human exposure to an environment contaminated by bacteria shed in the urine of the rat reservoir. However, it is unclear to what extent transmission is driven by variation in the distribution of rats or by the dispersal of bacteria in rainwater runoff and overflow from open sewer systems. Methods: We conducted an eco-epidemiological study in a high-risk community in Salvador, Brazil, by prospectively following a cohort of 1401 residents to ascertain serological evidence for leptospiral infections. A concurrent rat ecology study was used to collect information on the fine-scale spatial distribution of 'rattiness', our proxy for rat abundance and exposure of interest. We developed and applied a novel geostatistical framework for joint spatial modelling of multiple indices of disease reservoir abundance and human infection risk. Results: The estimated infection rate was 51.4 (95%CI 40.4, 64.2) infections per 1000 follow-up events. Infection risk increased with age until 30 years of age and was associated with male gender. Rattiness was positively associated with infection risk for residents across the entire study area, but this effect was stronger in higher elevation areas (OR 3.27 95% CI 1.68, 19.07) than in lower elevation areas (OR 1.14 95% CI 1.05, 1.53). Conclusions: These findings suggest that, while frequent flooding events may disperse bacteria in regions of low elevation, environmental risk in higher elevation areas is more localised and directly driven by the distribution of local rat populations. The modelling framework developed may have broad applications in delineating complex animal-environment-human interactions during zoonotic spillover and identifying opportunities for public health intervention. Funding: This work was supported by the Oswaldo Cruz Foundation and Secretariat of Health Surveillance, Brazilian Ministry of Health, the National Institutes of Health of the United States (grant numbers F31 AI114245, R01 AI052473, U01 AI088752, R01 TW009504 and R25 TW009338); the Wellcome Trust (102330/Z/13/Z), and by the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB/JCB0020/2016). MTE was supported by a Medical Research UK doctorate studentship. FBS participated in this study under a FAPESB doctorate scholarship.
Background: Zoonotic spillover from animal reservoirs is responsible for a significant global public health burden, but the processes that promote spillover events are poorly understood in complex urban settings. Endemic transmission of Leptospira, the agent of leptospirosis, in marginalised urban communities occurs through human exposure to an environment contaminated by bacteria shed in the urine of the rat reservoir. However, it is unclear to what extent transmission is driven by variation in the distribution of rats or by the dispersal of bacteria in rainwater runoff and overflow from open sewer systems. Methods: We conducted an eco-epidemiological study in a high-risk community in Salvador, Brazil, by prospectively following a cohort of 1401 residents to ascertain serological evidence for leptospiral infections. A concurrent rat ecology study was used to collect information on the fine-scale spatial distribution of 'rattiness', our proxy for rat abundance and exposure of interest. We developed and applied a novel geostatistical framework for joint spatial modelling of multiple indices of disease reservoir abundance and human infection risk. Results: The estimated infection rate was 51.4 (95%CI 40.4, 64.2) infections per 1000 follow-up events. Infection risk increased with age until 30 years of age and was associated with male gender. Rattiness was positively associated with infection risk for residents across the entire study area, but this effect was stronger in higher elevation areas (OR 3.27 95% CI 1.68, 19.07) than in lower elevation areas (OR 1.14 95% CI 1.05, 1.53). Conclusions: These findings suggest that, while frequent flooding events may disperse bacteria in regions of low elevation, environmental risk in higher elevation areas is more localised and directly driven by the distribution of local rat populations. The modelling framework developed may have broad applications in delineating complex animal-environment-human interactions during zoonotic spillover and identifying opportunities for public health intervention. Funding: This work was supported by the Oswaldo Cruz Foundation and Secretariat of Health Surveillance, Brazilian Ministry of Health, the National Institutes of Health of the United States (grant numbers F31 AI114245, R01 AI052473, U01 AI088752, R01 TW009504 and R25 TW009338); the Wellcome Trust (102330/Z/13/Z), and by the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB/JCB0020/2016). MTE was supported by a Medical Research UK doctorate studentship. FBS participated in this study under a FAPESB doctorate scholarship.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Federico Costa; Fleur Helena Porter; Gorete Rodrigues; Helena Farias; Marcus Tucunduva de Faria; Elsio A Wunder; Lynn M Osikowicz; Michael Y Kosoy; Mitermayer Galvão Reis; Albert I Ko; James E Childs Journal: Vector Borne Zoonotic Dis Date: 2013-12-20 Impact factor: 2.133
Authors: Max T Eyre; Ticiana S A Carvalho-Pereira; Fábio N Souza; Hussein Khalil; Kathryn P Hacker; Soledad Serrano; Joshua P Taylor; Mitermayer G Reis; Albert I Ko; Mike Begon; Peter J Diggle; Federico Costa; Emanuele Giorgi Journal: J R Soc Interface Date: 2020-09-02 Impact factor: 4.118
Authors: Federico Costa; Elsio A Wunder; Daiana De Oliveira; Vimla Bisht; Gorete Rodrigues; Mitermayer G Reis; Albert I Ko; Mike Begon; James E Childs Journal: PLoS Negl Trop Dis Date: 2015-06-05
Authors: Daniel J Becker; Alex D Washburne; Christina L Faust; Juliet R C Pulliam; Erin A Mordecai; James O Lloyd-Smith; Raina K Plowright Journal: Philos Trans R Soc Lond B Biol Sci Date: 2019-08-12 Impact factor: 6.237
Authors: Emanuele Giorgi; Federico Costa; Max T Eyre; Fábio N Souza; Ticiana S A Carvalho-Pereira; Nivison Nery; Daiana de Oliveira; Jaqueline S Cruz; Gielson A Sacramento; Hussein Khalil; Elsio A Wunder; Kathryn P Hacker; José E Hagan; James E Childs; Mitermayer G Reis; Mike Begon; Peter J Diggle; Albert I Ko Journal: Elife Date: 2022-09-16 Impact factor: 8.713