Spatio-temporal risk prediction of leptospirosis: A machine-learning-based approach.

backgroundLeptospirosis is a neglected zoonotic disease prevalent worldwide, particularly in tropical regions experiencing frequent rainfall and severe cyclones, which are further aggravated by climate change. This bacterial zoonosis, caused by the Leptospira genus, can be transmitted through contaminated water and soil. The Pacific islands bear a high burden of leptospirosis, making it crucial to identify key factors influencing its distribution. Understanding these factors is vital for developing targeted policy decisions to mitigate the spread of Leptospira. METHODOLOGY/PRINCIPAL

findingsThis study aims to establish a precise spatio-temporal risk map of leptospirosis at a national scale, using binarized incidence rates as the variable to predict. The spatial analysis was conducted at a finer resolution than the city level, while the temporal analysis was performed on a monthly basis from 2011 to 2022. Our approach utilized a comprehensive strategy combining machine learning models trained on binarized incidences, along with descriptive techniques for identifying key factors. The analysis encompasses a broad spectrum of variables, including meteorological, topographic, and socio-demographic factors. The strategy achieved a concordance metric of 83.29%, indicating a strong ability to predict the presence of contamination risk, with a sensitivity of 83.93%. Key findings included the identification of seasonal patterns, such as the impact of the El Niño Southern Oscillation, and the determination that rainfall and humidity with a one-month lag are significant contributors to Leptospira contamination. Conversely, soil types rich in organic matter may reduce bacterial presence and survival. CONCLUSIONS/SIGNIFICANCE: The study highlights the significant influence of environmental factors on the seasonal spread of Leptospira, particularly in tropical and subtropical regions. These findings are crucial for public health planning, providing insights for targeted policies to reduce leptospirosis, while advanced machine learning models serve as a robust tool for improving disease surveillance, and risk assessment, which ultimately supports the development of an early warning system.