Spatial and Statistical Analysis of Leptospirosis in Guilan Province, Iran

The most underdiagnosed water-borne bacterial zoonosis in the world is Leptospirosis which especially impacts tropical and humid regions. According to World Health Organization (WHO), the number of human cases is not known precisely. Available reports showed that worldwide incidences vary from 0.1-1 per 100 000 per year in temperate climates to 10-100 per 100 000 in the humid tropics. Pathogenic bacteria that is spread by the urines of rats is the main reason of water and soil infections. Rice field farmers who are in contact with infected water or soil, contain the most burden of leptospirosis prevalence. In recent years, this zoonotic disease have been occurred in north of Iran endemically. Guilan as the second rice production province (average=750 000 000 Kg, 40% of country production) after Mazandaran, has one of the most rural population (Male=487 679, Female=496 022) and rice workers (47 621 insured workers) among Iran provinces. The main objectives of this study were to analyse yearly spatial distribution and the possible spatial clusters of leptospirosis to better understand epidemiological aspects of them in the province. Survey was performed during the period of 2009-2013 at rural district level throughout the study area. Global clustering methods including the average nearest neighbour distance, Moran's I and General G indices were utilized to investigate the annual spatial distribution of diseases. At the end, significant spatial clusters have been detected with the objective of informing priority areas for public health planning and resource allocation.