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R. Soc. Interface."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Leptospirosis is a zoonotic disease with a high burden in Latin America, including northeastern Argentina, where flooding events linked to El Ni\u00f1o are associated with leptospirosis outbreaks. The aim of this study was to evaluate the value of using hydrometeorological indicators to predict leptospirosis outbreaks in this region. We quantified the effects of El Ni\u00f1o, precipitation, and river height on leptospirosis risk in Santa Fe and Entre R\u00edos provinces between 2009 and 2020, using a Bayesian modelling framework. Based on several goodness of fit statistics, we selected candidate models using a long-lead El Ni\u00f1o 3.4 index and shorter lead local climate variables. We then tested predictive performance to detect leptospirosis outbreaks using a two-stage early warning approach. Three-month lagged Ni\u00f1o 3.4 index and one-month lagged precipitation and river height were positively associated with an increase in leptospirosis cases in both provinces. El Ni\u00f1o models correctly detected 89% of outbreaks, while short-lead local models gave similar detection rates with a lower number of false positives. Our results show that climatic events are strong drivers of leptospirosis incidence in northeastern Argentina. Therefore, a leptospirosis outbreak prediction tool driven by hydrometeorological indicators could form part of an early warning and response system in the region.<\/jats:p>","DOI":"10.1098\/rsif.2023.0069","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T07:11:42Z","timestamp":1684307502000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Towards a leptospirosis early warning system in northeastern Argentina"],"prefix":"10.1098","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9437-5270","authenticated-orcid":false,"given":"Mart\u00edn","family":"Lotto Batista","sequence":"first","affiliation":[{"name":"Department for Epidemiology, Helmholtz Centre for Infection Research, 38124 Brunswick, Germany"},{"name":"Barcelona Supercomputing Center (BSC), 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-2795","authenticated-orcid":false,"given":"Eleanor M.","family":"Rees","sequence":"additional","affiliation":[{"name":"Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9724-2847","authenticated-orcid":false,"given":"Andrea","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Centre for Studies of Climate Variability and Climate Change (CEVARCAM), National University of Litoral (UNL), S3000 Santa Fe, Argentina"},{"name":"National Council for Scientific and Technical Research (CONICET), C1425FQB Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-0577","authenticated-orcid":false,"given":"Soledad","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Centre for Studies of Climate Variability and Climate Change (CEVARCAM), National University of Litoral (UNL), S3000 Santa Fe, Argentina"},{"name":"National Council for Scientific and Technical Research (CONICET), C1425FQB Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1762-8462","authenticated-orcid":false,"given":"Stefanie","family":"Castell","sequence":"additional","affiliation":[{"name":"Department for Epidemiology, Helmholtz Centre for Infection Research, 38124 Brunswick, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-9421","authenticated-orcid":false,"given":"Adam J.","family":"Kucharski","sequence":"additional","affiliation":[{"name":"Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3911-9573","authenticated-orcid":false,"given":"St\u00e9phane","family":"Ghozzi","sequence":"additional","affiliation":[{"name":"Department for Epidemiology, Helmholtz Centre for Infection Research, 38124 Brunswick, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-9089","authenticated-orcid":false,"given":"Gabriela V.","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Centre for Studies of Climate Variability and Climate Change (CEVARCAM), National University of Litoral (UNL), S3000 Santa Fe, Argentina"},{"name":"National Council for Scientific and Technical Research (CONICET), C1425FQB Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-7343","authenticated-orcid":false,"given":"Rachel","family":"Lowe","sequence":"additional","affiliation":[{"name":"Barcelona Supercomputing Center (BSC), 08034 Barcelona, Spain"},{"name":"Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Catalan Institution for Research and Advanced Studies (ICREA), 08010 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003898"},{"key":"e_1_3_5_3_2","unstructured":"PLoS ONE. 2022 Neglected tropical diseases. 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