Leptospirosis incidence in a state capital in the Western Brazilian Amazon and its relationship with climate and environmental variability, 2008-2013

Duarte, Juliana Lúcia; Giatti, Leandro Luiz

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100009 copy

Leptospirosis incidence in a state capital in the Western Brazilian Amazon and its relationship with climate and environmental variability, 2008-2013^* * Article derived from the Doctoral thesis entitled ‘Influence of climate variability and environmental alterations on the occurrence of climate-sensitive diseases in a state capital in the Western Brazilian Amazon’, defended in 2017 by Juliana Lúcia Duarte at the University of São Paulo Faculty of Public Health (FSP/USP) and Federal University of Acre (UFAC) Inter-Institutional Public Health Doctoral Degree Program.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze association between environmental variables and leptospirosis incidence in the municipality of Rio Branco, Acre, Brazil, 2008-2013.

Methods:

this was an ecological study of association between monthly average environmental variables and monthly leptospirosis incidence, according to generalized autoregressive score models and moving averages.

Results:

increases in the monthly average levels of the River Acre and days of precipitation per month were associated with a 7% increase (incidence rate ratio [RR] 1.07 - 95%CI 1.02;1.14) and a 4% increase (RR 1.04 - 95%CI 1,00;1,07) in the monthly incidence of leptospirosis, respectively; in 2013 leptospirosis incidence in the municipality was 8 times higher than in 2008 (RR 8.00 - 95%CI 4.07;15.71).

Conclusion:

this study showed a strong increase in leptospirosis incidence, over the years studied, and positive associations with environmental variables.

Keywords:
Leptospirosis; Climate; Environmental Health; Floods; Climate Change

Variable	Bivariate model	Multiple variable model
Variable	RR^a (95%CI^b), p-value^c	RR^a (95%CI^b), p-value^c
Year
2008	Intercept	Intercept
2009	1.21 (0.57;2.58), 0.624	1.26 (0.60;2.65), 0.540
2010	0.97 (0.41;2.30), 0.948	0.97 (0.45;2.09), 0.929
2011	1.88 (0.86;4.12), 0.116	2.16 (1.06;4.42), 0.035
2012	4.36 (1.87;10.17), <0.001	4.22 (2.11;8.45), <0.001
2013	7.39 (3.11;17.55), <0.001	8.00 (4.07;15.71), <0.001
River level (in meters)	1.10 (1.03;1.17), 0.003	1.07 (1.02;1.14), 0.012
Number of days of precipitation per month	1.07 (1.00;1.15), 0.049	1.04 (1.00;1.07), 0.026
Total precipitation	0.76 (0.58;1.00), 0.047	-
Compensated humidity	0.98 (0.86;1.12), 0.757	-
Minimum temperature	1.25 (0.54;2.92), 0.604	-
Compensated temperature	0.73 (0.20;2.64), 0.628	-
Maximum temperature	1.10 (0.68;1.79), 0.689	-
Q ^d	0.19 (p=0.050)	0.19 (p=0.022)
s ^e	0.16 (p=0.002)	0.18 (p=0.001)
AIC ^f		399.50

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Juliana Lúcia Duarte - Rua Nilo Peçanha, No. 797, Apto. 22, Bairro Estrela, Ponta Grossa, PR, Brazil. Postcode: 84040-040. E-mail: jluciaduarte@usp.br