{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T18:43:37Z","timestamp":1793904217571,"version":"4.8.0"},"reference-count":84,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leptospirosis is one of the most widespread zoonosis in the world and Brazil has the highest number of cases in Latin America. Transmission occurs mainly through exposure to water and soil contaminated by the urine of infected animals. The goals of this study are to describe the geographic distribution, demographic characteristics and exposure factors of urban and rural cases of leptospirosis, and identify spatial clusters in urban and rural areas of Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods\/results<\/jats:title>\n                    <jats:p>A retrospective epidemiological study was carried out using 16 years (2000\u20132015) of surveillance data from the Brazilian Ministry of Health. Cases were described by age, sex and race, and exposure factors were characterized in urban and rural areas. A spatial autocorrelation analysis was conducted using local Moran\u2019s I to identify urban and rural clusters of disease. On average 3,810 leptospirosis cases were reported annually with higher numbers in urban areas. National urban and rural incidence rates were the same (1.9 cases\/100,000 population), however, regional differences were observed. Urban incidence rates were higher in the North and Northeast regions, while rural incidence rates were higher in the Southeast and South. The main exposure factor reported in urban and rural areas was exposure to places with signs of rodents, followed by flood in urban areas and agriculture and animal farming in rural areas. Clusters of leptospirosis were identified in densely populated urban areas of the North, Southeast and South regions, while rural clusters were concentrated in of the Southern region with large agriculture and animal farming practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights that leptospirosis is an important public health problem in both urban and rural areas of Brazil. The results provide decision-makers with detailed information about where disease incidence is high and can be used in the development of prevention and control strategies for priority areas and risk groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0247763","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T13:34:53Z","timestamp":1614864893000},"page":"e0247763","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":81,"title":["Epidemiology of human leptospirosis in urban and rural areas of Brazil, 2000\u20132015"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2580-1360","authenticated-orcid":true,"given":"Deise I.","family":"Galan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira A.","family":"Roess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone Val\u00e9ria Costa","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8575-8002","authenticated-orcid":true,"given":"Maria Cristina","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"issue":"9","key":"pone.0247763.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0003898","article-title":"Global Morbidity and Mortality of Leptospirosis: A Systematic Review","volume":"9","author":"F Costa","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"pone.0247763.ref002","doi-asserted-by":"crossref","first-page":"7229","DOI":"10.3390\/ijerph10127229","article-title":"Leptospirosis: A Silent Epidemic Disease","volume":"10","author":"MC Schneider","year":"2013","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"9","key":"pone.0247763.ref003","doi-asserted-by":"crossref","first-page":"e300","DOI":"10.1371\/journal.pntd.0000300","article-title":"The neglected tropical diseases of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination","volume":"2","author":"PJ Hotez","year":"2008","journal-title":"PLoS Negl Trop Dis"},{"issue":"29","key":"pone.0247763.ref004","first-page":"237","article-title":"Leptospirosis worldwide, 1999","volume":"74","author":"World Health Organization","year":"1999","journal-title":"Releve epidemiologique hebdomadaire"},{"issue":"2","key":"pone.0247763.ref005","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1128\/CMR.14.2.296-326.2001","article-title":"Leptospirosis","volume":"14","author":"PN Levett","year":"2001","journal-title":"Clinical microbiology reviews"},{"issue":"10","key":"pone.0247763.ref006","doi-asserted-by":"crossref","first-page":"e0004122","DOI":"10.1371\/journal.pntd.0004122","article-title":"Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years","volume":"9","author":"PR Torgerson","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"pone.0247763.ref007","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.26633\/RPSP.2017.81","article-title":"Leptospirosis in Latin America: exploring the first set of regional data","volume":"41","author":"MC Schneider","year":"2017","journal-title":"Revista Panamericana de Salud P\u00fablica"},{"issue":"9181","key":"pone.0247763.ref008","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0140-6736(99)80012-9","article-title":"Urban epidemic of severe leptospirosis in Brazil","volume":"354","author":"AI Ko","year":"1999","journal-title":"The Lancet"},{"issue":"11","key":"pone.0247763.ref009","doi-asserted-by":"crossref","first-page":"3883","DOI":"10.3390\/ijerph9113883","article-title":"Leptospirosis Outbreaks in Nicaragua: Identifying Critical Areas and Exploring Drivers for Evidence-Based Planning.","volume":"9","author":"MC Schneider","year":"2012","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"1","key":"pone.0247763.ref010","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1371\/journal.pntd.0000154","article-title":"Household transmission of Leptospira infection in urban slum communities","volume":"2","author":"EA Maciel","year":"2008","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pone.0247763.ref011","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4269\/ajtmh.2012.11-0398","article-title":"Leptospirosis in American Samoa 2010: epidemiology, environmental drivers, and the management of emergence","volume":"86","author":"CL Lau","year":"2012","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"3","key":"pone.0247763.ref012","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1179\/136485908X278784","article-title":"Leptospirosis: case reports of an outbreak in Guyana","volume":"102","author":"J Liverpool","year":"2008","journal-title":"Annals of tropical medicine and parasitology"},{"issue":"4","key":"pone.0247763.ref013","doi-asserted-by":"crossref","first-page":"337","DOI":"10.4103\/0255-0857.29413","article-title":"Leptospirosis in Mumbai: post-deluge outbreak 2005","volume":"24","author":"M Maskey","year":"2006","journal-title":"Indian journal of medical microbiology"},{"issue":"1","key":"pone.0247763.ref014","first-page":"1","article-title":"Leptospirosis in the Asia Pacific region","volume":"9","author":"AFB Victoriano","year":"2009","journal-title":"BMC infectious diseases"},{"issue":"5","key":"pone.0247763.ref015","first-page":"453","article-title":"Leptospirosis following a flood in the Veneto area, North-east Italy","volume":"18","author":"P Pellizzer","year":"2006","journal-title":"Annali di igiene: medicina preventiva e di comunita"},{"issue":"1","key":"pone.0247763.ref016","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3201\/eid1801.101892","article-title":"Outbreak of leptospirosis after flood, the Philippines, 2009","volume":"18","author":"AS Amilasan","year":"2012","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"pone.0247763.ref017","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.4269\/ajtmh.16-0922","article-title":"Leptospirosis Outbreak After the 2014 Major Flooding Event in Kelantan, Malaysia: A Spatial-Temporal Analysis","volume":"98","author":"MF Mohd Radi","year":"2018","journal-title":"The American journal of tropical medicine and hygiene"},{"key":"pone.0247763.ref018","first-page":"e78","article-title":"A systematic literature review of leptospirosis outbreaks worldwide, 1970\u20132012","volume":"44","author":"C Munoz-Zanzi","year":"2020","journal-title":"Revista panamericana de salud publica = Pan American journal of public health"},{"issue":"3","key":"pone.0247763.ref019","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.actatropica.2008.06.007","article-title":"Clinical characteristics and risk factors of human leptospirosis in Argentina (1999\u20132005)","volume":"107","author":"NB Vanasco","year":"2008","journal-title":"Acta Trop"},{"issue":"11","key":"pone.0247763.ref020","doi-asserted-by":"crossref","first-page":"e0004095","DOI":"10.1371\/journal.pntd.0004095","article-title":"Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface","volume":"9","author":"MC Schneider","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"pone.0247763.ref021","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/j.trstmh.2008.05.010","article-title":"Leptospirosis in a subsistence farming community in Brazil","volume":"102","author":"HG Lacerda","year":"2008","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"8","key":"pone.0247763.ref022","doi-asserted-by":"crossref","first-page":"8301","DOI":"10.3390\/ijerph110808301","article-title":"Socioeconomic factors and vulnerability to outbreaks of leptospirosis in Nicaragua","volume":"11","author":"J Bacallao","year":"2014","journal-title":"International journal of environmental research and public health"},{"issue":"1","key":"pone.0247763.ref023","doi-asserted-by":"crossref","first-page":"e579","DOI":"10.1371\/journal.pntd.0000579","article-title":"Increasing trends of leptospirosis in northern India: a clinico-epidemiological study","volume":"4","author":"S Sethi","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pone.0247763.ref024","doi-asserted-by":"crossref","first-page":"957","DOI":"10.4269\/ajtmh.2008.78.957","article-title":"Seroprevalence of leptospirosis and risk factor analysis in flood-prone rural areas in Lao PDR","volume":"78","author":"L Kawaguchi","year":"2008","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pone.0247763.ref025","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1017\/S0950268801006392","article-title":"Changing epidemiology of human leptospirosis in New Zealand","volume":"128","author":"CN Thornley","year":"2002","journal-title":"Epidemiol Infect"},{"issue":"3","key":"pone.0247763.ref026","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1017\/S0950268803001201","article-title":"Risk factors and the prevalence of leptospirosis infection in a rural community of Chiapas, Mexico","volume":"131","author":"C Leal-Castellanos","year":"2003","journal-title":"Epidemiology & Infection"},{"issue":"4","key":"pone.0247763.ref027","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1017\/S0950268811001014","article-title":"Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka","volume":"140","author":"C Robertson","year":"2012","journal-title":"Epidemiol Infect"},{"key":"pone.0247763.ref028","year":"2017","journal-title":"Guia de Vigil\u00e2ncia em Sa\u00fade"},{"key":"pone.0247763.ref029","article-title":"Epidemiological surveillance of Leptospirosis in Brazil","author":"E. Caldas","year":"2015"},{"issue":"1","key":"pone.0247763.ref030","doi-asserted-by":"crossref","first-page":"15170","DOI":"10.1038\/s41598-018-33381-3","article-title":"Spatiotemporal dynamics and risk factors for human Leptospirosis in Brazil","volume":"8","author":"OS Baquero","year":"2018","journal-title":"Scientific Reports"},{"issue":"3","key":"pone.0247763.ref031","article-title":"Leptospirosis\u2019s Trend and Seasonality in Brazil: Statistical Analysis of Notified Cases Between 2008 and 2012\/Tend\u00eancia e Sazonalidade da Leptospirose no Brasil: An\u00e1lise Estat\u00edstica dos Casos Notificados entre 2008 e 2012","volume":"7","author":"CAR Pereira","year":"2014","journal-title":"Sa\u00fade e Pesquisa"},{"issue":"6","key":"pone.0247763.ref032","first-page":"1001","article-title":"Years of potential life lost and hospitalization costs associated with leptospirosis in Brazil","volume":"45","author":"VMMd Souza","year":"2011","journal-title":"Revista de Sa\u00fade P\u00fablica"},{"issue":"4","key":"pone.0247763.ref033","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/j.1365-3156.2008.02028.x","article-title":"Detection and modelling of case clusters for urban leptospirosis.","volume":"13","author":"WS Tassinari","year":"2008","journal-title":"Tropical Medicine & International Health"},{"issue":"4","key":"pone.0247763.ref034","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1371\/journal.pntd.0000228","article-title":"Impact of environment and social gradient on Leptospira infection in urban slums.","volume":"2","author":"RB Reis","year":"2008","journal-title":"PLoS Neglected Tropical Diseases [electronic resource]"},{"issue":"2","key":"pone.0247763.ref035","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00484-011-0419-4","article-title":"The impact of climate on Leptospirosis in Sao Paulo, Brazil","volume":"56","author":"MS Coelho","year":"2012","journal-title":"International journal of biometeorology"},{"key":"pone.0247763.ref036","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1590\/S0102-311X2001000700014","article-title":"The place behind the case: leptospirosis risks and associated environmental conditions in a flood-related outbreak in Rio de Janeiro","volume":"17","author":"C Barcellos","year":"2001","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"5","key":"pone.0247763.ref037","first-page":"e2927","article-title":"Prospective study of leptospirosis transmission in an urban slum community: role of poor environment in repeated exposures to the Leptospira agent. PLoS Neglected Tropical Diseases [electronic resource]","volume":"8","author":"RD Felzemburgh","year":"2014"},{"issue":"12","key":"pone.0247763.ref038","doi-asserted-by":"crossref","first-page":"e3338","DOI":"10.1371\/journal.pntd.0003338","article-title":"Influence of household rat infestation on leptospira transmission in the urban slum environment","volume":"8","author":"F Costa","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pone.0247763.ref039","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1179\/136485909X398221","article-title":"The socio-demographic, environmental and reservoir factors associated with leptospirosis in an urban area of north-eastern Brazil","volume":"103","author":"DS Oliveira","year":"2009","journal-title":"Ann Trop Med Parasitol"},{"issue":"3","key":"pone.0247763.ref040","doi-asserted-by":"crossref","first-page":"505","DOI":"10.3201\/eid1403.071064","article-title":"Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil","volume":"14","author":"EL Gouveia","year":"2008","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"pone.0247763.ref041","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1590\/S0102-311X2003000500007","article-title":"Spatial distribution of leptospirosis in Rio Grande do Sul, Brazil: recovering the ecology of ecological studies","volume":"19","author":"C Barcellos","year":"2003","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"1","key":"pone.0247763.ref042","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1590\/S1517-83822007000100019","article-title":"Anti-Leptospira spp and anti-Brucella spp antibodies in humans from rural area of Monte Negro municipality, state of Rond\u00f4nia, Brazilian Western Amazon","volume":"38","author":"DM Aguiar","year":"2007","journal-title":"Brazilian Journal of Microbiology"},{"key":"pone.0247763.ref043","unstructured":"The World Bank. Brazil 2016 [cited 2016 06 November]. Available from: http:\/\/data.worldbank.org\/country\/brazil."},{"key":"pone.0247763.ref044","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE). Censo Demogr\u00e1fico 2010 2010 [cited 2016 15 August]. Available from: http:\/\/www.ibge.gov.br\/home\/estatistica\/populacao\/censo2010\/default.shtm."},{"key":"pone.0247763.ref045","unstructured":"Ministry of the Environment of Brazil. Biomas 2016 [cited 2016 05 November]. Available from: http:\/\/www.mma.gov.br\/biomas."},{"key":"pone.0247763.ref046","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE). Economia 2016 [cited 2016 15 August]. Available from: http:\/\/www.ibge.gov.br\/home\/mapa_site\/mapa_site.php#economia."},{"key":"pone.0247763.ref047","unstructured":"Ministry of Health of Brazil. Sistema de Informa\u00e7\u00f5es ao Cidad\u00e3o (SIC) [Internet]. [cited 2015 23 October]. Available from: http:\/\/portalsaude.saude.gov.br\/index.php\/acesso-a-informacao."},{"key":"pone.0247763.ref048","unstructured":"Ministry of Health of Brazil. Ficha de Investiga\u00e7\u00e3o de Leptospirosis [Internet]. 2007 [updated 02 February 2007; cited 2018 November 25]. Available from: http:\/\/portalsinan.saude.gov.br\/images\/documentos\/Agravos\/Leptospirose\/Ficha_Leptospirose.pdf."},{"key":"pone.0247763.ref049","unstructured":"UCLA Institute for Digital Research and Education. Chi-square Test 2016 [cited 2016 18 July]. Available from: http:\/\/www.ats.ucla.edu\/stat\/sas\/whatstat\/whatstat.htm#chisq."},{"key":"pone.0247763.ref050","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/00001648-199411000-00010","article-title":"Empirical Bayes methods for stabilizing incidence rates before mapping","author":"OJ Devine","year":"1994","journal-title":"Epidemiology"},{"issue":"2","key":"pone.0247763.ref051","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1538-4632.1995.tb00338.x","article-title":"Local indicators of spatial association\u2014LISA","volume":"27","author":"L. Anselin","year":"1995","journal-title":"Geographical analysis"},{"key":"pone.0247763.ref052","volume-title":"Secretaria de Aten\u00e7\u00e3o \u00e0 Sa\u00fade. Departamento de Aten\u00e7\u00e3o B\u00e1sica. Vigil\u00e2ncia em sa\u00fade: zoonoses","author":"Ministry of Health of Brazil","year":"2009"},{"issue":"9","key":"pone.0247763.ref053","doi-asserted-by":"crossref","first-page":"e0003843","DOI":"10.1371\/journal.pntd.0003843","article-title":"Environmental and Behavioural Determinants of Leptospirosis Transmission: A Systematic Review.","volume":"9","author":"MA Mwachui","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"pone.0247763.ref054","doi-asserted-by":"crossref","first-page":"565","DOI":"10.5123\/S1679-49742011000400016","article-title":"Revis\u00e3o sistem\u00e1tica dos fatores associados \u00e0 leptospirose no Brasil, 2000\u20132009","volume":"20","author":"DM Pelissari","year":"2011","journal-title":"Epidemiologia e Servi\u00e7os de Sa\u00fade"},{"issue":"1","key":"pone.0247763.ref055","doi-asserted-by":"crossref","first-page":"e0004275","DOI":"10.1371\/journal.pntd.0004275","article-title":"Spatiotemporal determinants of urban leptospirosis transmission: four-year prospective cohort study of slum residents in Brazil","volume":"10","author":"JE Hagan","year":"2016","journal-title":"PLoS neglected tropical diseases"},{"issue":"10","key":"pone.0247763.ref056","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.trstmh.2010.07.002","article-title":"Climate change, flooding, urbanisation and leptospirosis: fuelling the fire?","volume":"104","author":"CL Lau","year":"2010","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"issue":"5","key":"pone.0247763.ref057","doi-asserted-by":"crossref","first-page":"e00039216","DOI":"10.1590\/0102-311x00039216","article-title":"Seroprevalence and factors associated with Leptospira infection in an urban district of Cali, Colombia","volume":"33","author":"K Escand\u00f3n-Vargas","year":"2017","journal-title":"Cad Saude Publica"},{"issue":"11","key":"pone.0247763.ref058","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4103\/0019-5359.48454","article-title":"A case control study to explore the risk factors for acquisition of leptospirosis in Surat city, after flood","volume":"62","author":"P Bhardwaj","year":"2008","journal-title":"Indian J Med Sci"},{"issue":"5\u20136","key":"pone.0247763.ref059","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.cimid.2007.05.003","article-title":"Current status of leptospirosis in Japan and Philippines","volume":"30","author":"Y Yanagihara","year":"2007","journal-title":"Comp Immunol Microbiol Infect Dis"},{"issue":"1","key":"pone.0247763.ref060","doi-asserted-by":"crossref","first-page":"16650","DOI":"10.1038\/s41598-018-35074-3","article-title":"Geographical and temporal distribution of the residual clusters of human leptospirosis in China, 2005\u20132016","volume":"8","author":"PW Dhewantara","year":"2018","journal-title":"Sci Rep"},{"issue":"7","key":"pone.0247763.ref061","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1093\/trstmh\/trz124","article-title":"Spatial patterns of leptospirosis in Ecuador, 2013\u20132018","volume":"114","author":"S N\u00fa\u00f1ez-Gonz\u00e1lez","year":"2020","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"1","key":"pone.0247763.ref062","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4269\/ajtmh.14-0465","article-title":"Characteristics of Rural Leptospirosis Patients Admitted to Referral Hospitals during the 2008 Leptospirosis Outbreak in Sri Lanka: Implications for Developing Public Health Control Measures","volume":"92","author":"SB Agampodi","year":"2015","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"4","key":"pone.0247763.ref063","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s10389-014-0611-1","article-title":"Risk factors associated with rural and urban epidemics of leptospirosis in Tiruchirappalli District of Tamilnadu","volume":"22","author":"SG Prabhakaran","year":"2014","journal-title":"India. Journal of Public Health"},{"key":"pone.0247763.ref064","unstructured":"Ministry of Health of Brazil. Leptospirose: an\u00e1lise dos dados epidemiol\u00f3gicos de 2010 a 2014 [Internet]. 2016 [updated May 2016; cited 2018 November 23]. Available from: http:\/\/portalarquivos2.saude.gov.br\/images\/pdf\/2016\/maio\/20\/Informe-epidemiol\u2014gico-leptospirose.pdf."},{"key":"pone.0247763.ref065","article-title":"Portrait of leptospirosis in the State of Acre, Brazil","volume":"10","author":"EMDdMGL Cirilo Costa","year":"2017","journal-title":"International Archives of Medicine"},{"key":"pone.0247763.ref066","volume-title":"Boletim Epidemiol\u00f3gico","author":"Ministry of Health of Brazil","year":"2018"},{"issue":"4","key":"pone.0247763.ref067","doi-asserted-by":"crossref","first-page":"94","DOI":"10.18561\/2179-5746\/biotaamazonia.v6n4p94-99","article-title":"Epidemiology of Leptospirosis: Cases from 2011 to 2015 in the Brazilian Northern Region","volume":"6","author":"R Segatti Rezende","year":"2016","journal-title":"Biota Amaz\u00f4nia"},{"issue":"2","key":"pone.0247763.ref068","first-page":"16","article-title":"\u00d3bitos por leptospirose em per\u00edodos com e sem enchentes no ano de 2014, na regi\u00e3o Norte do Brasil. AMAZ\u00d4NIA:","volume":"6","author":"FV Pinna","year":"2018","journal-title":"SCIENCE & HEALTH"},{"key":"pone.0247763.ref069","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1590\/s1678-9946201860039","article-title":"Temporal analysis of the relationship between leptospirosis, rainfall levels and seasonality, Santa Catarina, Brazil, 2005\u20132015","volume":"60","author":"J Ghizzo Filho","year":"2018","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"pone.0247763.ref070","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE). Censo Agropecu\u00e1rio 2017 2017 [cited 2020 12 August]. Available from: https:\/\/censos.ibge.gov.br\/agro\/2017\/."},{"key":"pone.0247763.ref071","first-page":"49","volume":"7","author":"C. Goarant","year":"2016","journal-title":"Leptospirosis: risk factors and management challenges in developing countries. Research and reports in tropical medicine"},{"issue":"4","key":"pone.0247763.ref072","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1111\/j.1469-0691.2011.03474.x","article-title":"Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world","volume":"17","author":"RA Hartskeerl","year":"2011","journal-title":"Clinical Microbiology and Infection"},{"key":"pone.0247763.ref073","volume-title":"Natural Disasters in Latin America and the Caribbean, 2000\u20132019","author":"UN Office for the Coordination of Humanitarian Affairs","year":"2020"},{"issue":"2","key":"pone.0247763.ref074","first-page":"283","article-title":"Spatial and seasonal analysis on leptospirosis in the municipality of Sao Paulo, Southeastern Brazil, 1998 to 2006","volume":"44","author":"TSM Soares","year":"2010","journal-title":"Revista de saude publica"},{"issue":"5","key":"pone.0247763.ref075","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1590\/S0036-46652003000500002","article-title":"Human leptospirosis: a twenty-nine-year serological study in S\u00e3o Paulo, Brazil","volume":"45","author":"EC Romero","year":"2003","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"pone.0247763.ref076","volume-title":"As enchentes em Santa Catarina e o aprendizado em pol\u00edticas p\u00fablicas","author":"PCV Guimar\u00e3es","year":"2012"},{"key":"pone.0247763.ref077","author":"A Busch","year":"2011"},{"issue":"5426","key":"pone.0247763.ref078","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1126\/science.285.5426.347","article-title":"Climate and health","volume":"285","author":"PR Epstein","year":"1999","journal-title":"Science"},{"issue":"7066","key":"pone.0247763.ref079","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/nature04188","article-title":"Impact of regional climate change on human health","volume":"438","author":"JA Patz","year":"2005","journal-title":"Nature"},{"issue":"2","key":"pone.0247763.ref080","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4269\/ajtmh.2012.12-0245","article-title":"Knowledge, attitudes, and practices related to Leptospirosis among urban slum residents in Brazil","volume":"88","author":"W Navegantes de Ara\u00fajo","year":"2013","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0247763.ref081","first-page":"190","article-title":"Epidemiological aspects in leptospirosis. Research of anti-Leptospira spp antibodies, isolation and biomolecular research in bovines, rodents and workers in rural properties from Botucatu, SP","author":"H Langoni","year":"2008","journal-title":"Brazil. Brazilian Journal of Veterinary Research and Animal Science"},{"key":"pone.0247763.ref082","volume-title":"\u201cOne Health\u201d From Concept to Application in the Global WorldOxford University Press","author":"MC Schneider","year":"2019"},{"key":"pone.0247763.ref083","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1590\/S1020-49892012000900001","article-title":"Surveillance for leptospirosis in the Americas, 1996\u20132005: a review of data from ministries of health","volume":"32","author":"F Costa","year":"2012","journal-title":"Revista Panamericana de Salud P\u00fablica"},{"key":"pone.0247763.ref084","first-page":"e131","article-title":"A road map for leptospirosis research and health policies based on country needs in Latin America","volume":"41","author":"MM Pereira","year":"2018","journal-title":"Revista panamericana de salud publica = Pan American journal of public health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T13:36:31Z","timestamp":1614864991000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247763"}},"subtitle":[],"editor":[{"given":"Ulrike Gertrud","family":"Munderloh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,4]]},"references-count":84,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0247763","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,4]]}}}