BACKGROUND: There is a higher case-detection rate for leprosy among spatially proximate contacts such as household members and neighbors. Spatial information regarding the clustering of leprosy can be used to improve intervention strategies. Identifying high-risk areas within villages around known cases can be helpful in finding new cases. METHODS: Using geographic information systems, we created digital maps of four villages in a highly endemic area in northwest Bangladesh. The villages were surveyed three times over four years. The spatial pattern of the compounds--a small group of houses--was analyzed, and we looked for spatial clusters of leprosy cases. RESULTS: The four villages had a total population of 4,123. There were 14 previously treated patients and we identified 19 new leprosy patients during the observation period. However, we found no spatial clusters with a probability significantly different from the null hypothesis of random occurrence. CONCLUSION: Spatial analysis at the microlevel of villages in highly endemic areas does not appear to be useful for identifying clusters of patients. The search for clustering should be extended to a higher aggregation level, such as the subdistrict or regional level. Additionally, in highly endemic areas, it appears to be more effective to target complete villages for contact tracing, rather than narrowly defined contact groups such as households.
BACKGROUND: There is a higher case-detection rate for leprosy among spatially proximate contacts such as household members and neighbors. Spatial information regarding the clustering of leprosy can be used to improve intervention strategies. Identifying high-risk areas within villages around known cases can be helpful in finding new cases. METHODS: Using geographic information systems, we created digital maps of four villages in a highly endemic area in northwest Bangladesh. The villages were surveyed three times over four years. The spatial pattern of the compounds--a small group of houses--was analyzed, and we looked for spatial clusters of leprosy cases. RESULTS: The four villages had a total population of 4,123. There were 14 previously treated patients and we identified 19 new leprosypatients during the observation period. However, we found no spatial clusters with a probability significantly different from the null hypothesis of random occurrence. CONCLUSION: Spatial analysis at the microlevel of villages in highly endemic areas does not appear to be useful for identifying clusters of patients. The search for clustering should be extended to a higher aggregation level, such as the subdistrict or regional level. Additionally, in highly endemic areas, it appears to be more effective to target complete villages for contact tracing, rather than narrowly defined contact groups such as households.
Authors: Mirjam I Bakker; Mochammad Hatta; Agnes Kwenang; Birgit H B Van Benthem; Stella M Van Beers; Paul R Klatser; Linda Oskam Journal: Am J Trop Med Hyg Date: 2005-04 Impact factor: 2.345
Authors: Mirjam I Bakker; Mochammad Hatta; Agnes Kwenang; William R Faber; Stella M van Beers; Paul R Klatser; Linda Oskam Journal: Int J Epidemiol Date: 2004-07-15 Impact factor: 7.196
Authors: R V Cellona; G P Walsh; T T Fajardo; R M Abalos; E C dela Cruz; L Guido-Villahermosa; M V Felicio-Balagon; G J Steenbergen; J T Douglas Journal: Int J Lepr Other Mycobact Dis Date: 1993-06
Authors: Mirjam I Bakker; Linda May; Mochammad Hatta; Agnes Kwenang; Paul R Klatser; Linda Oskam; Jeanine J Houwing-Duistermaat Journal: BMC Med Genet Date: 2005-11-24 Impact factor: 2.103
Authors: J Gaines Wilson; Jessica Ballou; Chris Yan; Susan P Fisher-Hoch; Belinda Reininger; Jennifer Gay; Jennifer Salinas; Pablo Sanchez; Yvette Salinas; Fidel Calvillo; Leonel Lopez; Ionara P Delima; Joseph B McCormick Journal: Health Place Date: 2010-08-14 Impact factor: 4.078
Authors: Antônio Carlos Vieira Ramos; Mellina Yamamura; Luiz Henrique Arroyo; Marcela Paschoal Popolin; Francisco Chiaravalloti Neto; Pedro Fredemir Palha; Severina Alice da Costa Uchoa; Flávia Meneguetti Pieri; Ione Carvalho Pinto; Regina Célia Fiorati; Ana Angélica Rêgo de Queiroz; Aylana de Souza Belchior; Danielle Talita Dos Santos; Maria Concebida da Cunha Garcia; Juliane de Almeida Crispim; Luana Seles Alves; Thaís Zamboni Berra; Ricardo Alexandre Arcêncio Journal: PLoS Negl Trop Dis Date: 2017-02-27
Authors: Márcio Bezerra Santos; Allan Dantas Dos Santos; Aline Silva Barreto; Mariana do Rosário Souza; Marco Aurélio de Oliveira Goes; José Antônio Barreto Alves; Ikaro Daniel Carvalho Barreto; José-Rodrigo S Silva; Daniela Teles de Oliveira; Karina C G Machado de Araújo; Malcolm S Duthie; Amélia Ribeiro de Jesus Journal: BMJ Open Date: 2019-07-27 Impact factor: 2.692
Authors: Charlotte Gilkison; Stephen Chambers; David J Blok; Jan Hendrik Richardus; Eretii Timeon; Erei Rimon; Patricia Priest Journal: PLoS Negl Trop Dis Date: 2019-09-20