ArticlePLOS global public health2022
Why is leptospirosis hard to avoid for the impoverished? Deconstructing leptospirosis transmission risk and the drivers of knowledge, attitudes, and practices in a disadvantaged community in Salvador, Brazil.
Article in PLOS global public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Detection of pathogenic leptospires in water bodies in neighborhoods vulnerable to flooding, through a participatory research approach in Santa Fe (Argentina).PLOS global public health · 2026Article
- Co-production of informal settlement health: a community based participatory research program for building healthy communities in urban informal settlements of Salvador, Brazil.Frontiers in public health · 2026Article
- Collaborative mapping: Perceived environmental risk of leptospirosis in Urban communities in Salvador, Brazil.PLOS global public health · 2026Article
- Article
- Using step selection functions to analyse human mobility using telemetry data in infectious disease epidemiology: a case study of leptospirosis.medRxiv : the preprint server for health sciences · 2025Article
- Topography and environmental deficiencies are associated with chikungunya virus exposure in urban informal settlements in Salvador, Brazil.PLoS neglected tropical diseases · 2025Article
- Increased incidence of human leptospirosis and the effect of temperature and precipitation, the Netherlands, 2005 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil.PLoS neglected tropical diseases · 2025Article
- Gender differences in Leptospira exposure risk, perceptions of disease severity, and high-risk behaviours in Salvador, Brazil: A cross-sectional study.PLOS global public health · 2025Article
- Factors associated with the presence of anti-Frontiers in public health · 2025Article
- Geospatial Analysis of Abiotic and Biotic Conditions Associated with Leptospirosis in the Klaten Regency, Central Java, Indonesia.Tropical medicine and infectious disease · 2024Article
- Gender differences in the perception of leptospirosis severity, behaviours, andmedRxiv : the preprint server for health sciences · 2024Article
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Authors and funding
10 authors.
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Abstract
Several studies have identified socioeconomic and environmental risk factors for infectious disease, but the relationship between these and knowledge, attitudes, and practices (KAP), and more importantly their web of effects on individual infection risk, have not previously been evaluated. We conducted a cross-sectional KAP survey in an urban disadvantaged community in Salvador, Brazil, leveraging on simultaneously collected fine-scale environmental and epidemiological data on leptospirosis transmission. Residents' knowledge influenced their attitudes which influenced their practices. However, different KAP variables were driven by different socioeconomic and environmental factors; and while improved KAP variables reduced risk, there were additional effects of socioeconomic and environmental factors on risk. For example, males and those of lower socioeconomic status were at greater risk, but once we controlled for KAP, male gender and lower socioeconomic status themselves were not direct drivers of seropositivity. Employment was linked to better knowledge and a less contaminated environment, and hence lower risk, but being employed was independently associated with a higher, not lower risk of leptospirosis transmission, suggesting travel to work as a high risk activity. Our results show how such complex webs of influence can be disentangled. They indicate that public health messaging and interventions should take into account this complexity and prioritize factors that limit exposure and support appropriate prevention practices.
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