Bowel disorders and its spatial trend in Manitoba, Canada

Area of Science:

• Spatial epidemiology
• Public health research
• Disease cluster analysis

Background:

• Bowel disorders significantly impact patients' social and mental well-being, with increased risk of incontinence in older populations.
• An elevated incidence of inflammatory bowel disease in Manitoba, Canada, necessitates epidemiological investigation.
• Identifying trends in bowel disorders is crucial for understanding risk factors and disease patterns.

Purpose of the Study:

• To identify potential clusters of bowel disorders in Manitoba, Canada, using spatial epidemiology techniques.
• To compare the effectiveness of different cluster detection methods in identifying disease hotspots.
• To inform further epidemiological studies on the risk factors and causes of bowel disorders.

Main Methods:

• Employed spatial scan statistics (circular and flexible) and Bayesian disease mapping (BYM) for cluster detection.
• Utilized a frequentist approach based on maximum likelihood estimation (MLE).
• Analyzed a dataset of bowel disorders in Manitoba from 2001 to 2010.

Main Results:

• Circular spatial scan statistic (CSS) identified fewer southern regions as clusters compared to flexible spatial scan statistic (FSS).
• Bayesian disease mapping (BYM) and maximum likelihood estimation (MLE) identified similar regions as potential bowel disorder clusters, with minor differences in significance.
• Most identified cluster regions were consistently detected across multiple methods (CSS, FSS, BYM, MLE).

Conclusions:

• Recommends BYM and MLE for cluster detection in regions with similar population and structure to Manitoba.
• Potential bowel disorder clusters are predominantly located in southern Manitoba, including eastern Winnipeg.
• Findings may indicate genuine increases in bowel disorders or unadjusted covariates, warranting further investigation.