"Flooding, sanitation, and water exposure as key risk factors for leptospirosis in Krakitan village"

inggris

Abstract

ABSTRACT Leptospirosis is a zoonotic disease caused by Leptospira bacteria, with manifestations ranging from mild infection to severe multi-organ disease. Transmission is closely linked to environmental exposure, particularly contact with water, mud, or floodwater contaminated by the urine of reservoir animals such as rats, especially in the presence of skin wounds or mucosal exposure. Krakitan Village, Bayat Subdistrict, Klaten Regency, was selected as the study site to generate local evidence on the environmental and behavioral factors contributing to leptospirosis transmission, given its recurrent flooding and reported cases in the area. This study aimed to analyze the environmental and behavioral risk factors associated with the incidence of leptospirosis in Krakitan Village.

Methods: This study employed a quantitative observational analytic approach with an unmatched case-control design. A total of 140 respondents were recruited, comprising 70 confirmed leptospirosis cases and 70 controls from the general population of Krakitan Village. Exposure variables assessed included flooding/standing water, drainage condition, presence of rats, sanitation/waste management, exposure to risky water/mud/river sources, use of personal protective equipment, high-risk occupation, history of wounds, and contact with animals, while age and sex were treated as potential confounders. Data were collected through structured interviews and environmental observation, then analyzed using bivariate analysis (chi-square/odds ratio) followed by multivariate binary logistic regression to identify factors independently associated with leptospirosis incidence.

Results: Bivariate analysis showed five factors significantly associated with leptospirosis: flooding/standing water (OR=3.24; 95% CI 1.59–6.60; p=0.001), presence of rats (OR=2.15; 95% CI 1.09–4.25; p=0.027), exposure to risky water/mud/river (OR=2.70; 95% CI 1.36–5.34; p=0.004), high-risk occupation (OR=2.01; 95% CI 1.02–3.95; p=0.042), and history of wounds (OR=2.97; 95% CI 1.47–5.98; p=0.002). After adjusting for age and sex through multivariate logistic regression, five factors remained significant: flooding/standing water (aOR=4.60; 95% CI 1.93–10.97), history of wounds (aOR=4.61; 95% CI 1.96–10.84), exposure to risky water/mud/river (aOR=3.77; 95% CI 1.62–8.78), poor sanitation/waste management (aOR=2.38; 95% CI 1.05–5.41), and high-risk occupation (aOR=2.32; 95% CI 1.02–5.28), with a classification accuracy of 74.30%. These findings indicate that a combination of environmental factors (flooding, sanitation, water/mud exposure) and behavioral/occupational factors (wound history, high-risk occupation) jointly contributes to leptospirosis incidence in Krakitan Village. Interventions should prioritize drainage and sanitation improvement, rat control, education on protective equipment use, and wound care for high-risk groups.

Conclusion: These findings indicate that environmental factors, particularly flooding, poor sanitation, and exposure to contaminated water or mud, combined with behavioral and occupational factors such as wound history and high-risk occupation, jointly contribute to the incidence of leptospirosis in Krakitan Village. This underscores the need for integrated prevention strategies, including improvement of drainage and environmental sanitation, rat population control, community education on the use of personal protective equipment, and prompt wound care for individuals in high-risk occupations. These measures should be prioritized by local health authorities and village governments to reduce leptospirosis transmission risk in flood-prone rural areas.

KEYWORDS

Leptospirosis, risk factors, environmental sanitation, flooding, case-control study