Communication Breakdown - Of Disease Clusters, a Trillium and One Health.

Area of Science:

• Geographic Epidemiology
• Spatial Epidemiology
• One Health

Background:

• The term "disease cluster" lacks a consistent definition in scientific literature.
• Ambiguity in defining disease clusters hinders effective communication and application in One Health.
• Geographic epidemiology requires precise conceptualization of spatial health patterns.

Purpose of the Study:

• To clarify the concept of a "disease cluster" within geographic epidemiology.
• To differentiate "disease cluster" from related spatial epidemiology terms.
• To propose a new conceptual paradigm for analyzing spatial health patterns.

Main Methods:

• Literature review of disease cluster definitions.
• Conceptualization using the epidemiological triangle (agent, host, environment).
• Distinguishing "disease cluster" from "clustering," "high-risk area," "hot spot," and "outbreak."
• Review of statistical concepts (expectation, prediction) and outlier identification.
• Proposal of the geographic epidemiological trillium paradigm.
• Embedding the paradigm within spatial generalized linear mixed models.

Main Results:

• The study highlights the varied and often conflicting definitions of "disease cluster."
• It distinguishes "disease cluster" as a statistical outlier from related concepts.
• A new conceptual framework, the geographic epidemiological trillium, is proposed.
• The proposed model aims to clarify spatial patterns and guide research.

Conclusions:

• A clear, standardized definition of "disease cluster" is essential for advancing geographic epidemiology and One Health.
• The proposed geographic epidemiological trillium offers a robust framework for spatial pattern analysis.
• This work aims to improve epidemiological research, teaching, and science communication.