A framework for assessing and predicting the environmental health impact of infectious diseases: a case study of leptospirosis.

This article demonstrates the practical application of an integrated environmental health impact assessment (IEHIA)methodology to investigate an infectious disease (leptospirosis)and the value of using such an approach to estimate future health impact. The assessment described the current health impact (using leptospirosis seroprevalence as a proxy measure)and estimated the future health impact based on scenarios that included indicators of different risk factors. The application of an IEHIA methodology to assess the health impact of an infectious disease was shown to enhance the ability to quantify associations between a disease agent and its health impact by taking into account the environmental drivers of transmission, human behaviour, socio economic factors, and the multiple pathways through which exposure and infection could occur.