Human leptospirosis in the Federal District, Brazil, 2011-2015: eco-epidemiological characterization

Abstract INTRODUCTION: Leptospirosis is an infectious disease that affects more than 5,000 people per year in Brazil. The Federal District (FD) lacks epidemiological studies of human leptospirosis and presents concerning rates of this disease, especially considering its lethality. METHODS: Seventy-nine autochthonous human cases of leptospirosis between 2011 and 2015 were analyzed, with the probable infection location serving as a basis for the collection and analysis of the environmental and epidemiological variables. RESULTS: The incidence of the disease ranged from 0.68-13.39 per 100,000 inhabitants in 21 of the 31 administrative regions that compose the FD. The local profile of human leptospirosis was predominantly associated with urban areas during the rainy season, population access to the sewage network, the treated water network, and the public garbage collection service. The vast majority of cases had a strong association with synanthropic rodents at the infection sites. CONCLUSIONS: In order to prevent and control potentially lethal human leptospirosis infection, the eco-epidemiological characterization of this disease is a valuable tool for public policies of prevention, control, and surveillance. In addition to population awareness, the systematized control of synanthropic rodents could be the main health action to reduce the incidence of this disease in the FD.摘要：钩端螺旋体病（Leptospirosis）是一种传染性疾病，巴西每年有超过5000人罹患该病。巴西联邦区（Federal District，FD）目前尚未开展针对人类钩端螺旋体病的流行病学研究，且该疾病的发病态势令人担忧，尤其在致死率方面。方法：本研究分析了2011年至2015年间的79例人类本土钩端螺旋体病病例，以推测的感染地点为基础，收集并分析相关环境与流行病学变量。结果：在构成联邦区的31个行政辖区中，有21个辖区的该病发病率介于每10万居民0.68至13.39例之间。人类钩端螺旋体病的本地流行特征主要与雨季城区、居民接入污水管网、自来水处理管网以及公共垃圾收集服务相关。绝大多数病例与感染地点处的与人共生的啮齿动物存在显著关联。结论：为预防和控制具有潜在致死性的人类钩端螺旋体病感染，开展该疾病的生态流行病学特征表征，是制定预防、控制与监测公共卫生政策的宝贵工具。除提升人群健康认知外，对与人共生的啮齿动物实施系统化防控，或可成为降低联邦区该病发病率的核心卫生干预措施。