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Leptospirosis Outbreaks in Nicaragua: Identifying Critical Areas and Exploring Drivers for Evidence-Based Planning

Author

Listed:
  • Maria Cristina Schneider

    (Pan American Health Organization, Health Surveillance and Disease Prevention and Control, 525 23rd. St. NW, Washington, DC 20037, USA)

  • Patricia Nájera

    (Pan American Health Organization, Health Surveillance and Disease Prevention and Control, 525 23rd. St. NW, Washington, DC 20037, USA)

  • Sylvain Aldighieri

    (Pan American Health Organization, Health Surveillance and Disease Prevention and Control, 525 23rd. St. NW, Washington, DC 20037, USA)

  • Jorge Bacallao

    (University of Medical Sciences of Habana, Research and Reference Center of Atherosclerosis of Havana, Universidad de Ciencias Médicas de La Habana, Tulipán y Panorama, Plaza, La Habana, Cuba)

  • Aida Soto

    (Pan American Health Organization Nicaragua, PO Box 1309, Managua, Nicaragua)

  • Wilmer Marquiño

    (Pan American Health Organization Nicaragua, PO Box 1309, Managua, Nicaragua)

  • Lesbia Altamirano

    (Pan American Health Organization Nicaragua, PO Box 1309, Managua, Nicaragua)

  • Carlos Saenz

    (Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, PO Box 107, Managua, Nicaragua)

  • Jesus Marin

    (Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, PO Box 107, Managua, Nicaragua)

  • Eduardo Jimenez

    (Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, PO Box 107, Managua, Nicaragua)

  • Matthew Moynihan

    (Pan American Health Organization, Health Surveillance and Disease Prevention and Control, 525 23rd. St. NW, Washington, DC 20037, USA)

  • Marcos Espinal

    (Pan American Health Organization, Health Surveillance and Disease Prevention and Control, 525 23rd. St. NW, Washington, DC 20037, USA)

Abstract

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide. In Central America, leptospirosis outbreaks have been reported in almost all countries; Nicaragua in particular has faced several outbreaks. The objective of this study was to stratify the risk and identify “critical areas” for leptospirosis outbreaks in Nicaragua, and to perform an exploratory analysis of potential “drivers”. This ecological study includes the entire country (153 municipalities). Cases from 2004 to 2010 were obtained from the country’s health information system, demographic and socioeconomic variables from its Census, and environmental data from external sources. Criteria for risk stratification of leptospirosis were defined. Nicaragua reported 1,980 cases of leptospirosis during this period, with the highest percentage of cases (26.36%) in León, followed by Chinandega (15.35%). Among the 153 municipalities, 48 were considered critical areas, 85 were endemic and 20 silent. Using spatial and statistical analysis, the variable presenting the most evident pattern of association with critical areas defined by top quintile of incidence rate is the percentage of municipal surface occupied by the soil combination of cambisol (over pyroclastic and lava bedrock) and andosol (over a volcanic ashes foundation). Precipitation and percentage of rural population are also associated with critical areas. This methodology and findings could be used for Nicaragua’s Leptospirosis Intersectoral Plan, and to identify possible risk areas in other countries with similar drivers.

Suggested Citation

  • Maria Cristina Schneider & Patricia Nájera & Sylvain Aldighieri & Jorge Bacallao & Aida Soto & Wilmer Marquiño & Lesbia Altamirano & Carlos Saenz & Jesus Marin & Eduardo Jimenez & Matthew Moynihan & M, 2012. "Leptospirosis Outbreaks in Nicaragua: Identifying Critical Areas and Exploring Drivers for Evidence-Based Planning," IJERPH, MDPI, vol. 9(11), pages 1-28, October.
    • Handle: RePEc:gam:jijerp:v:9:y:2012:i:11:p:3883-3910:d:20997
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    References listed on IDEAS

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    Cited by:

    1. Jessica Petrakovsky & Alejandra Bianchi & Helen Fisun & Patricia Nájera-Aguilar & Martha Maria Pereira, 2014. "Animal Leptospirosis in Latin America and the Caribbean Countries: Reported Outbreaks and Literature Review (2002–2014)," IJERPH, MDPI, vol. 11(10), pages 1-20, October.
    2. Kara N. Durski & Michel Jancloes & Tej Chowdhary & Eric Bertherat, 2014. "A Global, Multi-Disciplinary, Multi-Sectorial Initiative to Combat Leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN)," IJERPH, MDPI, vol. 11(6), pages 1-9, June.
    3. Jorge Bacallao & Maria Cristina Schneider & Patricia Najera & Sylvain Aldighieri & Aida Soto & Wilmer Marquiño & Carlos Sáenz & Eduardo Jiménez & Gilberto Moreno & Octavio Chávez & Deise I. Galan & Ma, 2014. "Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua," IJERPH, MDPI, vol. 11(8), pages 1-18, August.

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