Ashraf Dewan|Robert J. Corner|Masahiro Hashizume|Emmanuel T. Ongee
Typhoid Fever and Its Association with Environmental Factors in the Dhaka Metropolitan Area of Bangladesh: A Spatial and Time-Series Approach
Curtin University|Curtin University|Nagasaki University|Curtin University
typhoid fever major cause death worldwide major part disease burden developing regions indian subcontinent bangladesh part highly endemic region yet little known spatial temporal distribution disease regional scale research used geographic information system explore spatially temporally prevalence typhoid dhaka metropolitan area dma bangladesh period 20059 paper provides first study spatiotemporal epidemiology typhoid region aims study analyse epidemiology cases 2005 2009 ii identify spatial patterns infection based two spatial hypotheses iii determine hydroclimatological factors associated typhoid prevalence case occurrences data collected 11 major hospitals dma geocoded census tract level used spatiotemporal analysis range demographic environmental meteorological variables analyses revealed distinct seasonality well age gender differences males young children disproportionately infected malefemale ratio typhoid cases found 136 median age cases 14 years typhoid incidence higher male population female 2 588 p005 agespecific incidence rate highest 04 years age group 277 cases followed 60 years age group 51 cases 45 cases 1517 years 37 cases 1834 years 34 cases 3539 years 11 cases 1014 years per 100000 people monsoon months highest disease occurrences 4462 followed premonsoon 3054 postmonsoon 2485 season students test revealed significant difference occurrence typhoid urban rural environments p005 statistically significant inverse association found typhoid incidence distance major waterbodies spatial pattern analysis showed significant clustering typhoid distribution study area morans highest 0879 p001 2008 lowest 0075 p005 2009 incidence rates found form three large multicentred spatial clusters significant difference urban rural rates temporally typhoid incidence seen increase temperature rainfall river level time lags ranging three five weeks example 01 metre rise river levels number typhoid cases increased 46 95 ci 2428 threshold 40 metres 95 ci 2443 hand 1 c rise temperature number typhoid cases could increase 142 95 ci 44250