Quantifying spatial variation in environmental and sociodemographic drivers of leptospirosis in the Dominican Republic using a geographically weighted regression model

Spatial variation in drivers of leptospirosis transmission in the Dominican Republic is poorly understood. To inform targeted public health interventions, we aimed to identify household-level variations in leptospirosis drivers. We analysed data from 2078 participants in two provinces, Espaillat and San Pedro de Macoris (SPM), collected from a 2021 cross-sectional survey. We used geographically weighted regression to quantify associations between leptospirosis seropositivity and spatial environmental and sociodemographic data. In Espaillat, higher odds of seropositivity were associated with exposure to freshwater (OR 12.92;95%CI 1.36-122.29), a higher percentage of bare ground (OR 1.21;1.01–1.46) and river density (OR 1.53;1.14–2.06) surrounding the household. In SPM, rat exposure was associated with higher odds of seropositivity (OR 2.41;1.33–2.89). Higher community-level gross domestic product was associated with lower odds of seropositivity in both provinces. By identifying locally important drivers of transmission, our study provides evidence to support more tailored public health interventions to optimise the control and prevention of leptospirosis.