Risk Factors for Clinical Leptospirosis from Western Jamaica

John Keenan University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, Alabama; Western Regional Health Authority, Montego Bay, Jamaica

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Genine Ervin University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, Alabama; Western Regional Health Authority, Montego Bay, Jamaica

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Maung Aung University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, Alabama; Western Regional Health Authority, Montego Bay, Jamaica

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Gerald McGwin Jr University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, Alabama; Western Regional Health Authority, Montego Bay, Jamaica

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Pauline Jolly University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, Alabama; Western Regional Health Authority, Montego Bay, Jamaica

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A retrospective, matched case-control study was conducted in Jamaica's Western Regional Health Authority (WRHA). Forty-three individuals developing clinical leptospirosis between January 2005 and December 2007 (i.e., cases) were age and neighborhood matched to 89 controls. Odds ratios (OR) and associated 95% confidence intervals (CIs) and the relative excess risk due to interaction (RERI) were calculated. Cases had increased odds of contact with rodents OR 3.52, goats OR 3.38, and being engaged in outdoor labor OR 5.30. Knowledge of leptospirosis and indoor work was protective, OR 0.39 and OR 0.16, respectively. Positive RERI values were noted for joint exposure to rodents and goats (RERI 5.54), outdoor labor and goats (RERI 6.97), and outdoor labor and rodents (RERI 30.59). Our results suggest a synergistic effect of occupational and environmental exposures on clinical human leptospirosis from the WRHA. Knowledge of the disease and its risk factors allows for protection from the disease.

Author Notes

*Address correspondence to Pauline Jolly, University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, 1665 University Boulevard, RPHB 217, Birmingham, AL 35294-0022. E-mail: JollyP@ms.soph.uab.edu

Financial support: This study was supported by the Minority Health International Research Training (MHIRT) grant no. T37-MD001448 from the National Center on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, and the Ministry of Health, Jamaica.

Authors' addresses: John Keenan, Genine Ervin, Gerald McGwin Jr, and Pauline Jolly, University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, E-mails: gre1979@uab.edu, JKeenan@uab.edu, Gerald.McGwin@ccc.uab.edu, and JollyP@ms.soph.uab.edu. Maung Aung, Western Regional Health Authority, Montego Bay, Jamaica, E-mail: rtdwrha@gmail.com.

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