Background: Land use and land cover (LULC) change is one anthropogenic
disturbance linked to infectious disease emergence. Current research has
focused largely on wildlife and vector-borne zoonotic diseases, neglecting
to investigate landscape disturbance and environmental bacterial
infections. One example is Buruli ulcer (BU) disease, a necrotizing skin
disease caused by the environmental pathogen Mycobacterium ulcerans (MU).
Empirical and anecdotal observations have linked BU incidence to landscape
disturbance, but potential relationships have not been quantified as they
relate to land cover configurations. Methodology/Principal Findings: A
landscape ecological approach utilizing Bayesian hierarchical models with
spatial random effects was used to test study hypotheses that land cover
configurations indicative of anthropogenic disturbance were related to
Buruli ulcer (BU) disease in southern Benin, and that a spatial structure
existed for drivers of BU case distribution in the region. A final
objective was to generate a continuous, risk map across the study region.
Results suggested that villages surrounded by naturally shaped, or
undisturbed rather than disturbed, wetland patches at a distance within
1200m were at a higher risk for BU, and study outcomes supported the
hypothesis that a spatial structure exists for the drivers behind BU risk
in the region. The risk surface corresponded to known BU endemicity in
Benin and identified moderate risk areas within the boundary of Togo.
Conclusions/Significance: This study was a first attempt to link land
cover configurations representative of anthropogenic disturbances to BU
prevalence. Study results identified several significant variables,
including the presence of natural wetland areas, warranting future
investigations into these factors at additional spatial and temporal
scales. A major contribution of this study included the incorporation of a
spatial modeling component that predicted BU rates to new locations
without strong knowledge of environmental factors contributing to disease
distribution. BU_dataGeographic coordinates, numbers of cases, and community population used in this analysis. Land use land cover classification at 30 m resolution in .img format. Values corresponding to land cover classes available in the ReadMe file.manuscript_data.zip