• 1.

    Azlee A, 2015. Worst floods in Kelantan, confirms NSC. Available at: http://www.themalaymailonline.com/print/malaysia/worst-floods-in-kelantan-confirms-nsc. Accessed March 4, 2015.

  • 2.

    WHO, 2014. Leptospirosis. Excerpt from “WHO Recommended Standards and Strategies for Surveillance, Prevention and Control of Communicable Diseases,” 14. Geneva, Switzerland: World Health Organization.

  • 3.

    WHO, 2003. Human Leptospirosis: Guidance for Diagnosis, Surveillance and Control. Geneva, Switzerland: World Health Organization.

  • 4.

    Lau C, 2009. Urbanisation, Climate Change, and Leptospirosis: Environmental Drivers of Infectious Disease Emergence. Universitas 21 International Graduate Research Conference: Sustainable Cities for the Future, 8387. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Urbanisation+,+climate+change+,+and+leptospirosis+:+environmental+drivers+of+infectious+disease+emergence#0. Accessed May 24, 2016.

  • 5.

    Wahab ZA, 2015. Epidemiology and Current Situation of Leptospirosis in Malaysia. Persidangan Kesihatan Persekitaran Pihak Berkuasa Tempatan 2015, September 8–9, 2015, 167.

  • 6.

    Nations U, 2015. Sendai Framework for Disaster Risk Reduction 2015–2030. United Nations, Adopted 15. Third UN World Conference on Disaster Risk Reduction. March 14–18, 2015, Miyagi, Japan, 137.

  • 7.

    WHO, 1999. WHO Recommended Surveillance Standards WHO/CDS/CSR/ISR/99.2. Geneva, Switzerland: World Health Organization, 1144.

  • 8.

    Ministry of Health Malaysia, 2011. Guideline for the Diagnosis, Management, Prevention and Control of Leptospirosis in Malaysia. Putrajaya, Malaysia: Ministry of Health.

  • 9.

    Pradhan B, Youssef AM, 2011. A 100-year maximum flood susceptibility mapping using integrated hydrological and hydrodynamic models: Kelantan River Corridor, Malaysia. J Flood Risk Manag 4: 189202.

    • Search Google Scholar
    • Export Citation
  • 10.

    Anselin L, 1995. Local indicators of spatial association—LISA. Geogr Anal 27: 93115.

  • 11.

    Nur Fajriyah S, Udiyono A, Saraswati LD, 2017. Environmental and risk factors of leptospirosis: a spatial analysis in Semarang City. OP Conf. Ser.: Earth Environ. Sci. 55: 012013.

    • Search Google Scholar
    • Export Citation
  • 12.

    Dewan AM, Corner R, Hashizume M, Ongee ET, 2013. Typhoid fever and its association with environmental factors in the Dhaka metropolitan area of Bangladesh: a spatial and time-series approach. PLoS Negl Trop Dis 7: 1215.

    • Search Google Scholar
    • Export Citation
  • 13.

    El-Fadel M, Ghanimeh S, Maroun R, Alameddine I, 2012. Climate change and temperature rise: implications on food- and water-borne diseases. Sci Total Environ 437: 1521.

    • Search Google Scholar
    • Export Citation
  • 14.

    IRT Group, 2015. SPSS Data Analysis Examples Negative Binomial Regression. Available at: Http://www.ats.ucla.edu/stat/spss/dae/neg_binom.htm, 17. Accessed May 24, 2016.

  • 15.

    Virtual Atlast of the Terrestrial Birds of Spain, 2002. The Negative Binomial Model, Stat 544, Lecture 17. Available at: avesbiodiv.mncn.csic.es/estadistica/negbin.pdf. Accessed May 24, 2016.

  • 16.

    Lord D, Park BJ, 2012. Negative Binomial Regression Models and Estimation Methods. Probability density and likelihood functions, 115.

  • 17.

    Dechet AM et al. 2012. Leptospirosis outbreak following severe flooding: a rapid assessment and mass prophylaxis campaign; Guyana, January–February 2005. PLoS One 7: e39672, 1–7.

    • Search Google Scholar
    • Export Citation
  • 18.

    Amilasan AST et al. 2012. Outbreak of leptospirosis after flood, the Philippines, 2009. Emerg Infect Dis 18: 9194.

  • 19.

    Agampodi SB et al. 2014. Regional differences of leptospirosis in Sri Lanka: observations from a flood-associated outbreak in 2011. PLoS Negl Trop Dis 8: e2626.

    • Search Google Scholar
    • Export Citation
  • 20.

    Kost GJ, Katip P, Vinitwatanakhun C, 2012. Diagnostic testing strategies for health care delivery during the great Bangkok flood and other weather disasters. Point Care 11: 191199.

    • Search Google Scholar
    • Export Citation
  • 21.

    Vijayachari P, Sugunan AP, Murhekar MV, Sharma S, Sehgal SC, 2004. Leptospirosis among schoolchildren of the Andaman & Nicobar Islands, India: low levels of morbidity and mortality among pre-exposed children during an epidemic. Epidemiol Infect 132: 11151120.

    • Search Google Scholar
    • Export Citation
  • 22.

    Pappas G, Papadimitriou P, Siozopoulou V, Christou L, Akritidis N, 2008. The globalization of leptospirosis: worldwide incidence trends. Int J Infect Dis 12: 351357.

    • Search Google Scholar
    • Export Citation
  • 23.

    Chiu CH, Wang YC, Yang YS, Chang FY, 2009. Leptospirosis after typhoon in Taiwan. J Med Sci 29: 131134.

  • 24.

    Gaynor K, Katz AR, Park SY, Nakata M, Clark TA, Effler PV, 2007. Leptospirosis on oahu: an outbreak associated with flooding of a university campus. Am J Trop Med Hyg 76: 882885.

    • Search Google Scholar
    • Export Citation
  • 25.

    Smith JKG, Young MM, Wilson KL, Craig SB, 2013. Leptospirosis following a major flood in Central Queensland, Australia. Epidemiol Infect 141: 585590.

    • Search Google Scholar
    • Export Citation
  • 26.

    Bhardwaj P, Kosambiya JK, Desai VK, 2008. A case control study to explore the risk factors for acquisition of leptospirosis in Surat City, after flood. Indian J Med Sci 62: 431438.

    • Search Google Scholar
    • Export Citation
  • 27.

    Reis RB et al. 2008. Impact of environment and social gradient on Leptospira infection in urban slums. PLoS Negl Trop Dis 2: e228.

  • 28.

    Al-Robasi AA, Rohaim WD, Al-Danani DA, 2015. Seroprevalence of leptospira antibodies among populations at risk. J Microbiol Infect Dis 5: 14.

    • Search Google Scholar
    • Export Citation
  • 29.

    Gancheva GI, 2013. Leptospirosis in elderly patients. Braz J Infect Dis 17: 592595.

  • 30.

    Barcellos C, Sabroza PC, 2000. Socio-environmental determinants of the leptospirosis outbreak of 1996 in western Rio de Janeiro: a geographical approach. Int J Environ Health Res 10: 301313.

    • Search Google Scholar
    • Export Citation
  • 31.

    Lau CL, Smythe LD, Craig SB, Weinstein P, 2010. Climate change, flooding, urbanisation and leptospirosis: fuelling the fire? Trans R Soc Trop Med Hyg 104: 631638.

    • Search Google Scholar
    • Export Citation
  • 32.

    Lau CL, Clements ACA, Skelly C, Dobson AJ, Smythe LD, Weinstein P, 2012. Leptospirosis in American Samoa—estimating and mapping risk using environmental data. PLoS Negl Trop Dis 6: e1669.

    • Search Google Scholar
    • Export Citation
  • 33.

    Robertson C, Nelson TA, Stephen C, 2012. Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka. Epidemiol Infect 140: 731743.

    • Search Google Scholar
    • Export Citation
  • 34.

    Sarkar U et al. 2002. Population-based case-control investigation of risk factors for leptospirosis during an urban epidemic. Am J Trop Med Hyg 66: 605610.

    • Search Google Scholar
    • Export Citation
  • 35.

    Pappachan MJ, Sheela M, Aravindan KP, 2004. Relation of rainfall pattern and epidemic leptospirosis in the Indian state of Kerala. J Epidemiol Community Health 58: 1054.

    • Search Google Scholar
    • Export Citation
  • 36.

    Maskey M, Shastri JS, Saraswathi K, Surpam R, Vaidya N, 2006. Leptospirosis in Mumbai: post-deluge outbreak 2005. Indian J Med Microbiol 24: 337338.

    • Search Google Scholar
    • Export Citation
  • 37.

    Hashim JH, Hashim Z, 2015. Climate change, extreme weather events, and human health implications in the Asia Pacific region. Asia Pac J Public Health 28: 8S14S.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Leptospirosis Outbreak After the 2014 Major Flooding Event in Kelantan, Malaysia: A Spatial-Temporal Analysis

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  • 1 Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia;
  • | 2 United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia;
  • | 3 School of Medicine, Taylor’s University, Subang Jaya, Selangor, Malaysia;
  • | 4 Kelantan State Health Department, Kota Bharu, Kelantan, Malaysia
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Severe floods increase the risk of leptospirosis outbreaks in endemic areas. This study determines the spatial-temporal distribution of leptospirosis in relation to environmental factors after a major flooding event in Kelantan, Malaysia. We conducted an observational ecological study involving incident leptospirosis cases, from the 3 months before, during, and three months after flood, in reference to the severe 2014 Kelantan flooding event. Geographical information system was used to determine the spatial distribution while climatic factors that influenced the cases were also analyzed. A total of 1,229 leptospirosis cases were notified within the three study periods where incidence doubled in the postflood period. Twelve of 66 subdistricts recorded incidence rates of over 100 per 100,000 population in the postflood period, in comparison with only four subdistricts in the preflooding period. Average nearest neighborhood analysis indicated that the cases were more clustered in the postflood period as compared with the preflood period, with observed mean distance of 1,139 meters and 1,666 meters, respectively (both at P < 0.01). Global Moran’s I was higher in the postflood period (0.19; P < 0.01) as compared with the preflood period (0.06; P < 0.01). Geographic weighted regression showed that living close to water bodies increased the risk of contracting the disease. Postflooding hotspots were concentrated in areas where garbage cleanup occurred and the incidence was significantly associated with temperature, humidity, rainfall, and river levels. Postflooding leptospirosis outbreak was associated with several factors. Understanding the spatial distribution and associated factors of leptospirosis can help improve future disease outbreak management after the floods.

Author Notes

Address correspondence to Jamal Hisham Hashim, United Nations University-International Institute for Global Health (UNU-IIGH), UKM Medical Center, Jalan Yaacob Latiff, 56000 Kuala Lumpur, Malaysia. E-mail: jamalhas@hotmail.com

Authors’ addresses: Mohd Firdaus Mohd Radi, Mohd Hasni Jaafar, Rozita Hod, Norfazilah Ahmad, Azmawati Mohammed Nawi, and Nur Izzah Farakhin Ayub, Department of Community Health, National University of Malaysia, Cheras, W.P. Kuala Lumpur, Malaysia, E-mails: firdausradi@yahoo.com, drmhasni65@hotmail.com, gieto1@gmail.com, ah.fazilah@gmail.com, azmawati@ppukm.ukm.edu.my, and izzahayub@yahoo.com. Jamal Hisham Hashim, International Institute for Global Heatlh, United Nations University, Cheras, Kuala Lumpur, W.P. Kuala Lumpur, Malaysia, E-mail: jamalhas@hotmail.com. Gul Muhammad Baloch, School of Medicine, Taylor’s University, Subang Jaya, Selangor, Malaysia, E-mail: gulmuhammad.baloch@taylors.edu.my. Rohaida Ismail, Ministry of Health, Kelantan State Health Department, Kota Bharu, Kelantan, Malaysia, E-mail: rohaidadr@moh.gov.my.

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