Social and environmental determinants of leptospirosis exposure in primary care: a cross-sectional study at the 24 de Mayo Health Center, Ecuador

This study aimed to analyze these determinants associated with exposure among users of the 24 de Mayo Health Center, located in the rural parish of Portoviejo, Ecuador. A descriptive cross-sectional study was conducted with 50 participants (>18 years), selected through non-probabilistic sampling. Data were collected using a structured survey that assessed sociodemographic variables, occupation, knowledge about the disease, and exposure risks (contact with animals, contaminated water, and rodents), and were analyzed using descriptive statistics. Of the participants, 60% were aged 20–50 years, and 56% were male. The most common occupation was agriculture (36%), followed by homemaking (22%) and livestock farming (18%). Overall, 58% of respondents were unaware of the disease; among the 42% who had some knowledge, 43% identified contaminated water as the main transmission route, while only 29% mentioned animal urine. Additionally, 24% reported previous community cases, and 8% reported cases within their own family. Exposure associated with agricultural activities and a knowledge deficit were evident, highlighting the need for health education, active surveillance, and improvements in sanitation from the first level of care.