Spatial and temporal dynamics of pathogenic Leptospira in surface waters from the urban slum environment

被引:57
作者
Casanovas-Massana, Arnau [1 ]
Costa, Federico [1 ,2 ,3 ]
Riediger, Irina N. [2 ,4 ,5 ]
Cunha, Marcelo [6 ]
de Oliveira, Daiana [2 ]
Mota, Diogenes C. [2 ]
Sousa, Erica [2 ]
Querino, Vladimir A. [2 ]
Nery, Nivisson, Jr. [2 ]
Reis, Mitermayer G. [1 ,2 ]
Wunder, Elsio A., Jr. [1 ]
Diggle, Peter J. [7 ]
Ko, Albert I. [1 ,2 ]
机构
[1] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06520 USA
[2] Minist Saude, Fundacao Oswaldo Cruz, Ctr Pesquisas Goncalo Moniz, Rua Waldemar Falcao 121, Salvador, BA, Brazil
[3] Univ Fed Bahia, Inst Saude Colet, Rua Basilio da Gama S-N,Campus Univ Canela, Salvador, BA, Brazil
[4] Lab Cent Estado Parana, Curitiba, Parana, Brazil
[5] Rua Sebastiana Santana Fraga 1001, Sao Jose Dos Pinhais, Parana, Brazil
[6] Fundacao Oswaldo Cruz, Escola Nacl Saude Publ, Rua Leopoldo Bulhoes 1480, Manguinho, RJ, Brazil
[7] Univ Lancaster, Fac Hlth & Med, Lancaster LA1 4YG, England
基金
美国国家卫生研究院;
关键词
Leptospira; Leptospirosis; Surface water; Public health; Sewage; Urban slum; REAL-TIME PCR; RISK-FACTORS; INTERROGANS; OUTBREAK; INFECTION; FLOOD; DISSEMINATION; PHILIPPINES; EPIDEMIC; SURVIVAL;
D O I
10.1016/j.watres.2017.11.068
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Leptospirosis has emerged as an important urban health problem as slum settlements have expanded worldwide. Yet the dynamics of the environmentally transmitted Leptospira pathogen has not been well characterized in these settings. We used a stratified dense sampling scheme to study the dynamics of Leptospira abundance in surface waters from a Brazilian urban slum community. We collected surface water samples during the dry, intermediate and rainy seasons within a seven-month period and quantified pathogenic Leptospira by quantitative PCR (qPCR). We used logistic and linear mixed models to identify factors that explained variation for the presence and concentration of Leptospira DNA. Among 335 sewage and 250 standing water samples, Leptospira DNA were detected in 36% and 34%, respectively. Among the 236 samples with positive results geometric mean Leptospira concentrations were 152 GEq/ mL The probability of finding Leptospira DNA was higher in sewage samples collected during the rainy season when increased leptospirosis incidence occurred, than during the dry season (47.2% vs 12.5%, respectively, p = 0.0002). There was a marked spatial and temporal heterogeneity in Leptospira DNA distribution, for which type of water, elevation, and time of day that samples were collected, in addition to season, were significant predictors. Together, these findings indicate that Leptospira are ubiquitous in the slum environment and that the water-related risk to which inhabitants are exposed is low. Seasonal increases in Leptospira presence may explain the timing of leptospirosis outbreaks. Effective prevention wilt need to consider the spatial and temporal dynamics of pathogenic Leptospira in surface waters to reduce the burden of the disease. (C) 2017 Elsevier Ltd. All rights reserved.
引用
收藏
页码:176 / 184
页数:9
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