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

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 conduc...

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Main Authors: Fabiana Almerinda G. Palma, Federico Costa, Ricardo Lustosa, Hammed O. Mogaji, Daiana Santos de Oliveira, Fábio Neves Souza, Mitermayer G. Reis, Albert I. Ko, Michael Begon, Hussein Khalil
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022107/?tool=EBI
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author Fabiana Almerinda G. Palma
Federico Costa
Ricardo Lustosa
Hammed O. Mogaji
Daiana Santos de Oliveira
Fábio Neves Souza
Mitermayer G. Reis
Albert I. Ko
Michael Begon
Hussein Khalil
author_facet Fabiana Almerinda G. Palma
Federico Costa
Ricardo Lustosa
Hammed O. Mogaji
Daiana Santos de Oliveira
Fábio Neves Souza
Mitermayer G. Reis
Albert I. Ko
Michael Begon
Hussein Khalil
author_sort Fabiana Almerinda G. Palma
collection DOAJ
description 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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spelling doaj.art-a679fb35138e416da8aedeb4739211da2023-09-03T13:44:29ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01212Why 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, BrazilFabiana Almerinda G. PalmaFederico CostaRicardo LustosaHammed O. MogajiDaiana Santos de OliveiraFábio Neves SouzaMitermayer G. ReisAlbert I. KoMichael BegonHussein KhalilSeveral 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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022107/?tool=EBI
spellingShingle Fabiana Almerinda G. Palma
Federico Costa
Ricardo Lustosa
Hammed O. Mogaji
Daiana Santos de Oliveira
Fábio Neves Souza
Mitermayer G. Reis
Albert I. Ko
Michael Begon
Hussein Khalil
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
PLOS Global Public Health
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022107/?tool=EBI
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