| Summary: | Background. Human and wild rodent infection rates with <i>Leishmania</i> (<i>Viannia</i>) <i>braziliensis</i> are needed to differentiate transmission pathways in anthropogenically altered habitats. Methods. Human participants in northeast Brazil were tested by the leishmanin skin test (LST) and inspected for lesions/scars characteristic of American clinical leishmaniasis (ACL). Molecular (PCR/qPCR) test records of free-ranging rodents were available from a concurrent capture–mark–recapture study. Force of Infection (λ) and recovery (ρ) rates were estimated from cross-sectional and longitudinal datasets. Results. Cumulative prevalences of human LST+ves and ACL scar+ves were 0.343–0.563 (<i>n</i> = 503 participants) and 0.122–0.475 (<i>n</i> = 503), respectively. Active ACL lesions were not detected. Annual rates of LST conversions were λ = 0.03–0.15 and ρ = 0.02–0.07. The probability of infection was independent of sex and associated with increasing age in addition to the period of exposure. Rodents (<i>n</i> = 596 individuals of 6 species) showed high rates of exclusively asymptomatic infection (λ = 0.222/month) and potential infectiousness to the sand fly vector. Spatially concurrent rodent and household human infection prevalences were correlated. Conclusions. Human exposure to <i>L.</i> (<i>V.</i>) <i>braziliensis</i> continues to be high despite the substantial drop in reported ACL cases in recent years. Spill-over transmission risk to humans from rodents in peridomestic habitats is likely supported by a rodent infection/transmission corridor linking houses, plantations, and the Atlantic Forest.
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