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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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000408&type=printable |
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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. |
| format | Article |
| id | doaj-art-aae7bba8a4684e8ebca8e2299034dbf1 |
| institution | OA Journals |
| issn | 2767-3375 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-aae7bba8a4684e8ebca8e2299034dbf12025-08-20T02:23:19ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01212e000040810.1371/journal.pgph.0000408Why 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.Fabiana 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://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000408&type=printable |
| 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://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000408&type=printable |
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