title: Spatial Analysis of Anthropogenic Landscape Disturbance and Buruli Ulcer Disease in Benin.
abstract: BACKGROUND
  Land use and land cover (LULC) change is one anthropogenic disturbance linked to infectious disease emergence. Current research has focused largely on wildlife and vector-borne zoonotic diseases, neglecting to investigate landscape disturbance and environmental bacterial infections. One example is Buruli ulcer (BU) disease, a necrotizing skin disease caused by the environmental pathogen Mycobacterium ulcerans (MU). Empirical and anecdotal observations have linked BU incidence to landscape disturbance, but potential relationships have not been quantified as they relate to land cover configurations.
  
  
  RESULTS
  A landscape ecological approach utilizing Bayesian hierarchical models with spatial random effects was used to test study hypotheses that land cover configurations indicative of anthropogenic disturbance were related to Buruli ulcer (BU) disease in southern Benin, and that a spatial structure existed for drivers of BU case distribution in the region. A final objective was to generate a continuous, risk map across the study region. Results suggested that villages surrounded by naturally shaped, or undisturbed rather than disturbed, wetland patches at a distance within 1200 m were at a higher risk for BU, and study outcomes supported the hypothesis that a spatial structure exists for the drivers behind BU risk in the region. The risk surface corresponded to known BU endemicity in Benin and identified moderate risk areas within the boundary of Togo.
  
  
  CONCLUSIONS
  This study was a first attempt to link land cover configurations representative of anthropogenic disturbances to BU prevalence. Study results identified several significant variables, including the presence of natural wetland areas, warranting future investigations into these factors at additional spatial and temporal scales. A major contribution of this study included the incorporation of a spatial modeling component that predicted BU rates to new locations without strong knowledge of environmental factors contributing to disease distribution.
authors.affiliation: Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, Kansas, United States of America; Biodiversity Institute, University of Kansas, Lawrence, Kansas, United States of America.
authors.forename: Lindsay P
authors.initials: LP
authors.lastname: Campbell
authors.affiliation: Department of Forestry, Michigan State University, East Lansing, Michigan, United States of America; Department of Geography, Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Finley
authors.affiliation: Department of Entomology, University of Michigan State University, East Lansing, Michigan, United States of America; Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: M Eric
authors.initials: ME
authors.lastname: Benbow
authors.affiliation: Center for Global Change and Earth Observations, Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: Jenni
authors.initials: J
authors.lastname: Gronseth
authors.affiliation: Department of Microbiology, University of Tennessee, Knoxville, Tennessee, United States of America.
authors.forename: Pamela
authors.initials: P
authors.lastname: Small
authors.affiliation: Programme National de Lutte contre la Lèpre et l'ulcère de Buruli, Cotonou, Benin.
authors.forename: Roch Christian
authors.initials: RC
authors.lastname: Johnson
authors.affiliation: Institut régional de santé publique, université d'Abomey-calavi, Ouidah, Bénin.
authors.forename: Ghislain E
authors.initials: GE
authors.lastname: Sopoh
authors.affiliation: Department of Entomology, University of Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Merritt
authors.affiliation: Department of Biological Sciences, Mississippi State University, Starkville, Mississippi, United States of America.
authors.forename: Heather
authors.initials: H
authors.lastname: Williamson
authors.affiliation: Department of Geography, Michigan State University, East Lansing, Michigan, United States of America; Center for Global Change and Earth Observations, Michigan State University, East Lansing, Michigan, United States of America.
authors.forename: Jiaguo
authors.initials: J
authors.lastname: Qi
mesh_terms: D001541:Benin / Q000453:epidemiology; D054312:Buruli Ulcer / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D006802:Human Activities; D006801:Humans; D019911:Mycobacterium ulcerans / Q000302:isolation & purification*; D018570:Risk Assessment; D062206:Spatial Analysis; D019371:Topography, Medical