<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112023000100210</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2023.102288</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Epidemiología de la leptospirosis en los humedales del sur de España]]></article-title>
<article-title xml:lang="en"><![CDATA[Epidemiology of leptospirosis in the wetlands of Southern Spain]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Martín]]></surname>
<given-names><![CDATA[María Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Benjumeda]]></surname>
<given-names><![CDATA[Luis Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[de Eguilior-Mestre]]></surname>
<given-names><![CDATA[María Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lozano-Domínguez]]></surname>
<given-names><![CDATA[María Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Luque-Márquez]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jódar-Sánchez]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aznar-Martín]]></surname>
<given-names><![CDATA[Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A7"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Donaire-Granado]]></surname>
<given-names><![CDATA[José Augusto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Luque-Romero]]></surname>
<given-names><![CDATA[Luis Gabriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Servicio Andaluz de Salud Distrito Sanitario Aljarafe-Sevilla Norte Centro de Salud Ciudad Expo, Unidad de Protección de la Salud]]></institution>
<addr-line><![CDATA[Mairena del Aljarafe Sevilla]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Servicio Andaluz de Salud Distrito Sanitario Aljarafe-Sevilla Norte Centro de Salud Ciudad Expo, Unidad de Prevención, Promoción y Vigilancia de la Salud]]></institution>
<addr-line><![CDATA[Mairena del Aljarafe Sevilla]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Servicio Andaluz de Salud Distrito Sanitario Aljarafe-Sevilla Norte Centro de Salud Blas Infante, Unidad de Gestión Clínica de Coria del Río]]></institution>
<addr-line><![CDATA[Coria del Río Sevilla]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Servicio Andaluz de Salud Hospital Universitario Virgen del Rocío Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Málaga Facultad de Ciencias Económicas y Empresariales Departamento de Economía Aplicada]]></institution>
<addr-line><![CDATA[Málaga ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Instituto de Investigaciones Biomédicas de Sevilla  ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidad de Sevilla Facultad de Medicina Departamento de Microbiología]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Servicio Andaluz de Salud Distrito Sanitario Aljarafe-Sevilla Norte Unidad de Investigación]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Universidad de Sevilla Facultad de Medicina Departamento de Citología e Histología Normal y Patológica]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>37</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112023000100210&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112023000100210&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112023000100210&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Conocer si la incidencia de leptospirosis en los capturadores de cangrejo rojo durante el periodo de captura es superior a la de la población general, así como identificar factores de riesgo y estimar los costes sanitarios directos e indirectos asociados a los casos de seroconversión de dicha enfermedad.  Método: Este estudio se realizó desde el 1 de julio de 2017 hasta el 31 de marzo de 2018. Se llevó a cabo un estudio de cohortes prospectivo (población expuesta: capturadores de cangrejo rojo; población no expuesta: población general) en el municipio de Isla Mayor (Sevilla, España). Previo consentimiento informado, se invitó a la población al estudio de prevalencia mediante la técnica cualitativa ELISA. Los que tuvieron serología negativa fueron incluidos en el estudio de cohortes. Ambas cohortes se siguieron clínicamente y a los casos sintomáticos se les realizó serología. A los capturadores de cangrejo rojo se les tomó una segunda muestra de suero al final del seguimiento para detectar asintomáticos. La serovariedad se confirmó mediante aglutinación microscópica. Se realizó un análisis descriptivo bivariado y se calcularon la incidencia acumulada y el riesgo relativo. La serología positiva se tomó como variable dependiente.  Resultados: Se incluyeron en el estudio 278 personas, de las que 92 constituían la cohorte de capturadores y 186 la de población general. El 46,8% de la muestra eran mujeres, aunque entre los capturadores de cangrejo rojo estas solo representaban el 29,3%. La edad media de la muestra fue de 45,1 (± 16,4) años. Se detectaron nueve seroconversiones: ocho en capturadores de cangrejo rojo y una en población general. Por lo tanto, la incidencia acumulada fue de 8,7% en capturadores de cangrejo rojo y de 0,5% en población general, siendo el riesgo relativo de 16,2 (intervalo de confianza del 95%: 2,1-127,4). El coste total de la asistencia sanitaria y de las pérdidas por enfermedad asociadas a la leptospirosis fue de 1568 &#8364; por caso.  Conclusiones: La leptospirosis en Isla Mayor está fuertemente asociada a la captura del cangrejo rojo. La incidencia es muy superior a la encontrada en estudios publicados en otros países.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: To find out whether the leptospirosis incidence rate among red swamp crayfish collectors in the harvesting season is higher than in the general population, and to identify risk factors and assess the direct and indirect health costs associated with leptospirosis seroconversion.  Method: This study was carried out between 1 July 2017 and 31 March 2018 in the municipality of Isla Mayor (Seville, Spain). It took the form of a prospective cohort study (exposed population: swamp crayfish collectors; non-exposed population: general population). The population was invited to take part in a prevalence study to be conducted using the ELISA qualitative technique, and informed consent was obtained from those who agreed. Negative serology cases were then included in the cohort study. Both cohorts were monitored clinically and symptomatic cases were serology tested. A second serum sample was taken from the swamp crayfish collectors at the end of the monitoring period to detect asymptomatic cases. Serovars were confirmed by microscopic agglutination testing. A bivariate descriptive analysis was carried out and cumulative incidence and relative risk were calculated, with positive serology being taken as the dependent variable.  Results: A total of 278 people were included in the study, of whom 92 made up the swamp crayfish collectors cohort and 186 the general population cohort. Women made up 46.8% of the sample, but only 29.3% of the collectors cohort. The mean age was 45.1 (±16.4) years. Nine cases of seroconversion were detected: eight among swamp crayfish collectors and one in the general population. Overall cumulative incidence was therefore 3.2%: 8.7% in the exposed group and 0.5% in the non-exposed group. Relative risk was 16.2% (95% confidence interval: 2.1-127.4). The total cost of medical assistance and illness-related losses associated with leptospirosis was 1568&#8364;/case.  Conclusions: Leptospirosis in Isla Mayor is strongly associated with red swamp crayfish collecting. It's incidence here is much higher than that reported in studies published in other countries.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Leptospirosis]]></kwd>
<kwd lng="es"><![CDATA[Incidencia]]></kwd>
<kwd lng="es"><![CDATA[Exposición profesional]]></kwd>
<kwd lng="es"><![CDATA[Procambarus clarkii]]></kwd>
<kwd lng="en"><![CDATA[Leptospirosis]]></kwd>
<kwd lng="en"><![CDATA[Incidence]]></kwd>
<kwd lng="en"><![CDATA[Occupational exposure]]></kwd>
<kwd lng="en"><![CDATA[Procambarus clarkii]]></kwd>
</kwd-group>
</article-meta>
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