Colombia

The Amazon Basin stretches across numerous countries within South America, providing a suitable environment for not only Leptospirosis but many diseases and bacterium that impact communities within and surrounding the Basin. Every year the Amazon Basin is subjected to damage from illegal mining sites, urbanization, and population changes. All of which leave marginalized communities within the area of risk of contracting the pathogens that are normally maintained within the natural ecosystem of the jungle. 

A study on the trend of epidemiological data of Leptospirosis in Colombia showed higher incidence rates among communities living in proximity to contaminated water or those without adequate water or sanitation systems. As of  2015 it was found that 14% of people living in rural communities do not have access to clean drinking water, even though 30% of Colombia’s population reside in rural areas. From 1994 to 2004, Colombia invested in improved water and sanitations within medium and large cities but failed to include smaller communities including those in rural areas. The Planes Departamentales de Agua (Department Plans of Water), PDA,  were created to oversee the issues governmental offices faced when allocating funds and time to properly dispersing water systems throughout all socioeconomic levels in Colombia. There was a lack of coordination between municipality supply and the centralization of power for PDAs meaning the project was bound to fail. With a lack of control from superior governmental offices the municipal public works departments cannot be the only one at fault for failure to provide all communities with access to water and sanitation systems. Currently the fate of access to water and sanitation systems in communities is the responsibility of local governments. Municipalities currently face financial and collaboration problems when trying to create solutions for implementation of community systems. 

Along with access  access to water and sanitation, the healthcare system itself in Colombia has limitation for all socioeconomic levels. In 2000, one trillion twenty five billion pesos that was allocated to the health care system was never seen. A one trillion dollar deficit was placed on hospitals due to governmental departments only giving them funds for bills and services rendered leaving 33,000 healthcare facilities at risk of closing. 

At health care facilities,  Leptospirosis tests are done with either the Microscopic agglutination test (MAT) or through the detection of immunoglobulin M IGM antibodies. Leptospirosis requires access to viable bacteria, however in Latin America there is typically no viable bacteria requiring shipment from elsewhere. This shipment is recent years has increased in price and the lack of interest from the healthcare community for funding is making it quite difficult to receive these materials. Clinics and facilities hope to see the data move to a more portable form reducing or eliminating the need for shipped samples.  LeptoNet, Leptospirosis Database that was created to encourage health care professionals to participate in national surveillance however it was stated that little to very low interest arose from the community. 

Within Colombia it is important to consider the political conflict, pollution, and environmental damage that affect rural communities. For instance within the same communities where Leptospirosis incidence rates are higher, their water is contaminated with metals and chemicals from illegal mining in the area. A combination of conflicts from multiple levels of government in conflict contribute to the spread of a bacterial zoonoses such as Leptospirosis. Moving forward finding solutions to providing isolated communities with laboratory facilities for detection, relooking financial aid for water and sanitation systems, along with understanding and limiting the damaging effects of the human industrial system on the ecosystem should be of priority.

Brazil

In 2015 it was found that Leptospirosis was endemic all year round throughout all municipalities in Brazil. Incidence rates tended to be higher after floods in poorer communities. Among surveys for Leptospirosis detection, it was found that rural communities were not well represented. The communities with the highest rates of seropositivity were communities in the South and Western parts of Manus that sit on two river basins for the São Raimundo and Educandos rivers. The São Raimundo river is known for its pollution and its ability to invoke nausea by the smell of it. The ends of the river basins are filled with trash from a lack of sanitary systems in place along the river. Many urban sanitation systems leak sewage waste into the river. During flooding season both rivers are known to flood. One study done on Leptospirosis incidence in Brazil, found that with improved sanitation and garbage systems this incidence rate decreased.