{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:03:14Z","timestamp":1792677794834,"version":"4.5.0"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2014,8,15]],"date-time":"2014-08-15T00:00:00Z","timestamp":1408060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis. The objectives of this study were to explore possible socioeconomic variables related to leptospirosis critical areas and to construct and validate a vulnerability index based on municipal socioeconomic indicators. Municipalities with lower socioeconomic status (greater unsatisfied basic needs for quality of the household and for sanitary services, and higher extreme poverty and illiteracy rates) were identified with the highest leptospirosis rates. The municipalities with highest local vulnerability index should be the priority for intervention. A distinction between risk given by environmental factors and vulnerability to risk given by socioeconomic conditions was shown as important, which also applies to the \u201ccauses of outbreaks\u201d and \u201ccauses of cases\u201d.<\/jats:p>","DOI":"10.3390\/ijerph110808301","type":"journal-article","created":{"date-parts":[[2014,8,15]],"date-time":"2014-08-15T11:25:11Z","timestamp":1408101911000},"page":"8301-8318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua"],"prefix":"10.3390","volume":"11","author":[{"given":"Jorge","family":"Bacallao","sequence":"first","affiliation":[{"name":"University of Medical Sciences of Habana, Havana Atherosclerosis Research and Reference Center, Policl\u00ednico 19 de Abril, Tulip\u00e1n y Panorama, Nuevo Velado, Plaza de la Revoluci\u00f3n, La Habana 10600, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Schneider","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Department of Communicable Diseases and Health Analysis, 525 23rd. St. NW, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4778","authenticated-orcid":false,"given":"Patricia","family":"Najera","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Department of Communicable Diseases and Health Analysis, 525 23rd. St. NW, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Aldighieri","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Department of Communicable Diseases and Health Analysis, 525 23rd. St. NW, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Soto","sequence":"additional","affiliation":[{"name":"Pan American Health Organization Nicaragua, P.O. Box 1309, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilmer","family":"Marqui\u00f1o","sequence":"additional","affiliation":[{"name":"Pan American Health Organization Nicaragua, P.O. Box 1309, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"S\u00e1enz","sequence":"additional","affiliation":[{"name":"Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, P.O. Box 107, Managua, Postal Sector 15AB, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, P.O. Box 107, Managua, Postal Sector 15AB, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Moreno","sequence":"additional","affiliation":[{"name":"Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, P.O. Box 107, Managua, Postal Sector 15AB, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavio","family":"Ch\u00e1vez","sequence":"additional","affiliation":[{"name":"Ministry of Health of Nicaragua, Costado Oeste Colonia Primero de Mayo, P.O. Box 107, Managua, Postal Sector 15AB, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deise","family":"Galan","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Department of Communicable Diseases and Health Analysis, 525 23rd. St. NW, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Espinal","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Department of Communicable Diseases and Health Analysis, 525 23rd. St. NW, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2014,8,15]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2010). Report of the First Meeting of the Leptospirosis Burden Epidemiology Reference Group, WHO."},{"key":"ref_2","unstructured":"World Health Organization (2003). 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