Fig 2. Final Structural equation model linking socioeconomic, environmental, exposure and demographic factors to leptospirosis sero-positivity, while accounting for the relationships among these factors.

There are 31 measured variables (in boxes) in the model (including sero-positivity), 23 of those representing 4 latent variables (in circles). Unless otherwise specified, the questions had binary responses with reference as “no”. Sanitation and peri-domestic quality score: E1 = Access to household is paved, E2 = Household floods after rain, E3 = Sewer floods, E4 = Presence of open sewer within 10 meters of the household. Socioeconomic status score: S1 = Owns a car, S2 = Owns a computer, S3 = Owns a washing machine, S4 = Food runs out before resident can afford to restock. S5 = Household ownership (reference: owned, rented), S6 = Education level (>5 years, 5–9 years, 9–12 years, >12 years of education). S7 = Maximum income in the household (in Brazilian Reais, continuous), S8 = Household has unplastered walls. Exposure score: In the past 12 months, the resident had Ex1 = Contact with sewage water, Ex2 = Contact with floodwater, Ex3 = Cleaned a sewer, Ex4 = Contact with mud. Protective measures: In the household P1 = Prevent trash accumulation, P2 = Wear shoes, P3 = Kill rats, Outside the household P4 = Clean peri-domestic area, P5 = Wear boots or gloves, P6 = Kill rats, P7 = Restructure sewer flow. One-sided arrows represents a causal influence originating from the variable at the base of the arrow, with the width of the arrow representing the strength of the relationship. Double-sided arrows represent a correlation. The small double-sided arrows and numbers next to each variable represent the error variance.