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Spatial Interaction Between Leptospirosis and Enteric Fever in Kelantan, Malaysia: A 2016-2022 Notification Registry
Hazlienor Mohd Hatta1, Kamarul Imran Musa1, Nik Mohd Hafiz Mohd Fuzi2
1Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
Abstract:
Leptospirosis and enteric fever are prevalent tropical acute bacterial febrile illnesses in Kelantan, Malaysia, that exhibit overlapping features and shared transmission dynamics, yet their spatial relationship remains understudied. This study aimed to analyze their spatial distribution, investigating potential interactions and intersecting patterns. A total of 212 laboratory-confirmed cases of enteric fever and 1106 of leptospirosis between 2016 and 2022, were retrieved from the national e-Notifikasi registry. Point pattern analysis revealed clustering of both diseases in the northern region, but leptospirosis was predominant in the south, exhibiting higher spatial risk. Seven co-infection cases were identified in overlapping hotspot areas. Spatial dependence between the diseases was identified within 4 km distance on average, with varying patterns over time and regions. Recognizing spatial dependence has implications for accurate diagnosis, timely intervention, and tailored public health strategies. The findings underscore the need for multi-disease interventions to address shared risk factors and co-infections in similar geographical contexts.
Insights
Leptospirosis and enteric fever co-occur in Kelantan, Malaysia, with spatial links up to 4 km. Understanding these patterns aids targeted public health interventions for these tropical febrile illnesses.
Area of Science:
- Tropical Medicine
- Epidemiology
- Spatial Analysis
Background:
- Leptospirosis and enteric fever are common acute bacterial febrile illnesses in tropical regions.
- These diseases share overlapping clinical features and transmission routes, particularly in Kelantan, Malaysia.
- The spatial relationship and potential interactions between leptospirosis and enteric fever remain underexplored.
Purpose of the Study:
- To analyze the spatial distribution of leptospirosis and enteric fever in Kelantan.
- To investigate potential spatial interactions and co-occurrence patterns between these two diseases.
- To inform public health strategies by understanding disease clustering and spatial dependence.
Main Methods:
- Utilized laboratory-confirmed case data for enteric fever (n=212) and leptospirosis (n=1106) from 2016-2022.
- Retrieved data from the national e-Notifikasi registry.
- Employed point pattern analysis to assess spatial clustering and identify overlapping hotspots.
Main Results:
- Both diseases showed clustering in the northern region of Kelantan.
- Leptospirosis exhibited higher spatial risk and predominance in the southern region.
- Seven co-infection cases were identified in overlapping disease hotspots, with spatial dependence observed within an average distance of 4 km.
Conclusions:
- Spatial dependence exists between leptospirosis and enteric fever, with varying patterns geographically and temporally.
- Identifying these spatial relationships is crucial for accurate diagnosis and timely interventions.
- The findings support the need for integrated public health strategies addressing shared risk factors and co-infections in tropical settings.
