03681nas a2200301   4500000000100000008004100001260004400042653002400086653005700110653002100167653002100188653002700209653002700236653002600263653001300289100001800302700001500320700001500335700001500350700002000365700002300385245009300408856010400501300000900605490000700614520274400621022001403365       2023                            d  bSpringer Science and Business Media LLC10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10a Disease ecology10aEcological niche model10aSocioecological system10aVector borne diseases10aZoonosis1 aMagalhães AR1 aCodeço CT1 aSvenning J1 aEscobar LE1 aVan de Vuurst P1 aGonçalves-Souza T00aNeglected tropical diseases risk correlates with poverty and early ecosystem destruction  uhttps://idpjournal.biomedcentral.com/counter/pdf/10.1186/s40249-023-01084-1.pdf?pdf=button%20sticky  a1-150 v123 a<p><strong>Background:</strong> Neglected tropical diseases affect the most vulnerable populations and cause chronic and debilitating disorders. Socioeconomic vulnerability is a well-known and important determinant of neglected tropical diseases. For example, poverty and sanitation could influence parasite transmission. Nevertheless, the quantitative impact of socioeconomic conditions on disease transmission risk remains poorly explored.</p>

<p><strong>Methods:</strong> This study investigated the role of socioeconomic variables in the predictive capacity of risk models of neglected tropical zoonoses using a decade of epidemiological data (2007–2018) from Brazil. Vector-borne diseases investigated in this study included dengue, malaria, Chagas disease, leishmaniasis, and Brazilian spotted fever, while directly-transmitted zoonotic diseases included schistosomiasis, leptospirosis, and hantaviruses. Environmental and socioeconomic predictors were combined with infectious disease data to build environmental and socioenvironmental sets of ecological niche models and their performances were compared.</p>

<p><strong>Results:</strong> Socioeconomic variables were found to be as important as environmental variables in influencing the estimated likelihood of disease transmission across large spatial scales. The combination of socioeconomic and environmental variables improved overall model accuracy (or predictive power) by 10% on average (P &lt; 0.01), reaching a maximum of 18% in the case of dengue fever. Gross domestic product was the most important socioeconomic variable (37% relative variable importance, all individual models exhibited P &lt; 0.00), showing a decreasing relationship with disease indicating poverty as a major factor for disease transmission. Loss of natural vegetation cover between 2008 and 2018 was the most important environmental variable (42% relative variable importance, P &lt; 0.05) among environmental models, exhibiting a decreasing relationship with disease probability, showing that these diseases are especially prevalent in areas where natural ecosystem destruction is on its initial stages and lower when ecosystem destruction is on more advanced stages.</p>

<p><strong>Conclusions:&nbsp;</strong>Destruction of natural ecosystems coupled with low income explain macro-scale neglected tropical and zoonotic disease probability in Brazil. Addition of socioeconomic variables improves transmission risk forecasts on tandem with environmental variables. Our results highlight that to efficiently address neglected tropical diseases, public health strategies must target both reduction of poverty and cessation of destruction of natural forests and savannas.</p>
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