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首页> 美国卫生研究院文献>PLoS Neglected Tropical Diseases >Human Leptospirosis Infection in Fiji: An Eco-epidemiological Approach to Identifying Risk Factors and Environmental Drivers for Transmission
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Human Leptospirosis Infection in Fiji: An Eco-epidemiological Approach to Identifying Risk Factors and Environmental Drivers for Transmission

机译：斐济的人类钩端螺旋体感染：一种生态流行病学方法用于识别传播的危险因素和环境驱动因素

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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, 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.
机译：钩端螺旋体病是太平洋岛屿地区的一种重要的人畜共患病。在斐济，2012年连续两次飓风和严重洪灾导致暴发，报告了576例病例，死亡率为7％。我们进行了横断面血清流行病学研究，并采用了生态流行病学方法来表征斐济人钩端螺旋体病感染的危险因素和驱动因素，旨在为改善公共卫生缓解和干预策略的有效性提供依据。在2152名参与者（3个主要岛屿上的81个社区）中，有19.4％的人发现了指示先前或近期感染的抗体。问卷和地理信息系统数据用于评估与人口统计，个人行为，与动物的接触，社会经济学，生活条件，土地利用和自然环境有关的变量。在多变量logistic回归分析中，与钩端螺旋体抗体存在相关的变量包括男性（OR 1.55），iTaukei种族（OR 3.51），居住在乡村（OR 1.64），在家中没有经过处理的水（OR 1.52），在户外工作（1.64），生活在农村地区（OR 1.43），高贫困率（OR 1.74），生活在主要河流<100m以内（OR 1.41），社区中的猪（OR 1.54），该地区的牛密度高（OR每头/平方千米1.04），并且在最湿润的月份中最高降雨量最高（或每毫米1.003）。斐济人类钩端螺旋体病感染的危险因素和驱动因素是复杂和多因素的，环境因素起着至关重要的作用。随着全球气候变化，南太平洋的恶劣天气事件和洪水预计将加剧。人口增长也可能导致集约化畜牧业的发展；发展中国家的城市化往往与城市和郊区贫民窟有关，那里的贫困疾病正在蔓延。气候变化，洪水，人口增长，城市化，贫困和农业集约化是人畜共患病传播的重要驱动力；这些因素可能独立地或潜在地协同作用，导致斐济和其他类似环境中钩端螺旋体病传播的增强。

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