Leptospirosis in American Samoa 2010: epidemiology, environmental drivers, and the management of emergence.
Leptospirosis has recently been reported as an emerging disease worldwide, and a seroprevalence study was undertaken in American Samoa to better understand the drivers of transmission. Antibodies indicative of previous exposure to leptospirosis were found in 15.5% of 807 participants, predominantly against three serovars that were not previously known to occur in American Samoa. Questionnaires and geographic information systems data were used to assess behavioral factors and environmental determinants of disease transmission, and logistic regression was used to identify factors associated with infection. Many statistically significant factors were consistent with previous studies, but we also showed a significant association with living at lower altitudes (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.03-2.28), and having higher numbers of piggeries around the home (OR = 2.63, 95% CI: 1.52-4.40). Our findings support a multifaceted approach to combating the emergence of leptospirosis, including modification of individual behavior, but importantly also managing the evolving environmental drivers of risk.
School of Population Health, The University of Queensland, Brisbane, Queensland, Australia. colleen.lau@uqconnect.edu.au
Colleen L
CL
Lau
Annette J
AJ
Dobson
Lee D
LD
Smythe
Emily J
EJ
Fearnley
Chris
C
Skelly
Archie C A
AC
Clements
Scott B
SB
Craig
Saipale D
SD
Fuimaono
Philip
P
Weinstein
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018948:American Samoa / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D007922:Leptospirosis / Q000188:drug therapy* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D055815:Young Adult