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We sought to combine sentinel surveillance with community behavioural surveillance to estimate leptospirosis incidence. We administered a questionnaire gathering responses on established locally relevant leptospirosis risk factors and recent fever to livestock\u2010owning community members across six districts in northern Tanzania and applied a logistic regression model predicting leptospirosis risk on the basis of behavioural factors that had been previously developed among patients with fever in Moshi Municipal and Moshi Rural Districts. We aggregated probability of leptospirosis by district and estimated incidence in each district by standardizing probabilities to those previously estimated for Moshi Districts. We recruited 286 community participants: Hai District (<jats:italic>n<\/jats:italic>\u00a0=\u00a011), Longido District (59), Monduli District (56), Moshi Municipal District (103), Moshi Rural District (44) and Rombo District (13). The mean predicted probability of leptospirosis by district was Hai 0.029 (0.005, 0.095), Longido 0.071 (0.009, 0.235), Monduli 0.055 (0.009, 0.206), Moshi Rural 0.014 (0.002, 0.049), Moshi Municipal 0.015 (0.004, 0.048) and Rombo 0.031 (0.006, 0.121). We estimated the annual incidence (upper and lower bounds of estimate) per 100,000 people of human leptospirosis among livestock owners by district as Hai 35 (6, 114), Longido 85 (11, 282), Monduli 66 (11, 247), Moshi Rural 17 (2, 59), Moshi Municipal 18 (5, 58) and Rombo 47 (7, 145). Use of community behavioural surveillance may be a useful tool for extrapolating disease incidence beyond sentinel surveillance sites.<\/jats:p>","DOI":"10.1111\/zph.12712","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T12:09:14Z","timestamp":1588766954000},"page":"496-505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Estimating acute human leptospirosis incidence in northern Tanzania using sentinel site and community behavioural surveillance"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-1508","authenticated-orcid":false,"given":"Michael J.","family":"Maze","sequence":"first","affiliation":[{"name":"Centre for International Health University of Otago Dunedin New Zealand"},{"name":"Department of Medicine University of Otago Christchurch New Zealand"},{"name":"Kilimanjaro Christian Medical Centre Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina J.","family":"Sharples","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics University of Otago Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn J.","family":"Allan","sequence":"additional","affiliation":[{"name":"Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly M.","family":"Biggs","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Duke University Medical Center Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shama","family":"Cash\u2010Goldwasser","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute Duke University Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee L.","family":"Galloway","sequence":"additional","affiliation":[{"name":"Bacterial Special Pathogens Branch Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"de Glanville","sequence":"additional","affiliation":[{"name":"Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo E. B.","family":"Halliday","sequence":"additional","affiliation":[{"name":"Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudovick R.","family":"Kazwala","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine and Public Health Sokoine University of Agriculture Morogoro Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tito","family":"Kibona","sequence":"additional","affiliation":[{"name":"Nelson Mandela African Institution for Science and Technology Arusha Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-1916","authenticated-orcid":false,"given":"Blandina T.","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre Moshi Tanzania"},{"name":"Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venance P.","family":"Maro","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre Moshi Tanzania"},{"name":"Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"Rubach","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre Moshi Tanzania"},{"name":"Division of Infectious Diseases Duke University Medical Center Durham NC USA"},{"name":"Duke Global Health Institute Duke University Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Cleaveland","sequence":"additional","affiliation":[{"name":"Boyd Orr Centre for Population and Ecosystem Health Institute of Biodiversity, Animal Health and Comparative Medicine University of Glasgow Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Crump","sequence":"additional","affiliation":[{"name":"Centre for International Health University of Otago Dunedin New Zealand"},{"name":"Kilimanjaro Christian Medical Centre Moshi Tanzania"},{"name":"Division of Infectious Diseases Duke University Medical Center Durham NC USA"},{"name":"Duke Global Health Institute Duke University Durham NC USA"},{"name":"Kilimanjaro Christian Medical University College Moshi Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Retrieved from National Bureau of Statistics (Tanzania), Dar es Salaam, Tanzania","author":"2012 Population and Housing Census","year":"2013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003899"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2000.63.249"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002589"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/28.3.583"},{"key":"e_1_2_9_7_1","volume-title":"Leptospirosis (Leptospira interrogans) 2013 case definition","author":"Centers for Disease Control and Prevention","year":"2013"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003898"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002324"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1015509105668"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.06.013"},{"key":"e_1_2_9_12_1","first-page":"65","article-title":"Leptospirosis in humans","volume":"387","author":"Haake D. 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