Improved sanitation interventions to prevent urban leptospirosis transmission

Leptospirosis is a zoonotic bacterial disease that affects vulnerable populations such as rural subsistence farmers and urban slum dwellers causing one million cases and ~60.000 deaths each year worldwide. Our findings suggest that the main risk factor for infection in urban slums is the open sewer environment. Indeed, the disease has been declining in the city of Salvador, Brazil with the increase of sewer systems coverage. However, conventional closed sewer networks in these settings is not foreseeable in the near future because fo high costs and condominial sewer coverage has emerged as a feasible and economic sanitation alternative. As part of this proposal, we will evaluate whether implementation of conventional and condominial sanitation program is effective in decreasing the direct contact with open sewage, bacterial contamination in the environment and subsequently the risk of Leptospira infection and severe leptospirosis.