Determining the spatial distribution of environmental and socio-economic suitability for human leptospirosis in the face of limited epidemiological data

CRISTALDI, MAXIMILIANO; HERBRETEAU, VINCENT; POTTIER, AURÉA; PREVITALI, ANDREA; JACOB, PAULINA; THIBAULT, CATRY; ROUX, EMMANUEL

Infectious Diseases of Poverty

Springer Nature

Año: 2022

2049-9957

BackgroundLeptospirosis is among the leading zoonotic causes of morbidity and mortality worldwide. Knowledge about spatial patterns of diseases and their underlying processes have the potential to guide intervention efforts. However, leptospirosis is often an underreported and misdiagnosed disease and consequently, spatial patterns of the disease remain unclear. In the absence of accurate epidemiological data in the Urban Agglomeration of Santa Fe, we used a knowledge-based index and cluster analysis to identify spatial patterns of environmental and socioeconomic suitability for the disease and potential underlying processes that shape them.MethodsWe geocoded confirmed and probable human leptospirosis cases derived from the Argentinian surveillance system. Environmental and socioeconomic databases were obtained from satellite images and publicly available platforms on the web. Two sets of human leptospirosis determinants (?scenarios?) were considered according to the level of their support by the literature and expert knowledge. We used the Zonation algorithm to build a knowledge-based index and the combination of Principal Component, Hierarchical and partitioning algorithms for clustering. Comparisons between index, clusters and the incidence of the disease in the study area were performed in terms of spatial similarity and correlations. Results According to the knowledge-based index, the suitability for the human leptospirosis in the UA Santa Fe increased from downtown areas of the largest cities towards peri-urban and suburban areas. Downtown areas were characterized by higher levels of education and better housing conditions. Peri-urban and suburban areas encompassed two clusters which differed in terms of environmental determinants. When non-highly supported determinants were considered, we identified areas with suitable environmental conditions for the disease that were inhabited by advantaged socioeconomic groups. The highest incidence rates overlapped areas where the highest suitability scores were found. ConclusionsWe present a method to analyze the environmental and socioeconomic suitability for human leptospirosis based on literature and expert knowledge. The methodology can be thought as an evolutive and perfectible scheme as more studies are performed in the area and novel information regarding determinants of the disease become available. Our approach can be a valuable tool for decision-makers since it can serve as a baseline to plan intervention measures.