Determination of high risk regions of cutaneous leishmaniasis in Turkey using spatial analysis.

The aim of this study was to use geographical analysis to determine the distribution of cutaneous leishmaniasis among the provinces of Turkey, as well as detection of the presence of any regional clustering in Turkey using spatial analyses. Geographic information systems based spatial analyses were performed on cutaneous leishmaniasis cases recorded by the Turkish Ministry of Health during the period from 1988-2006. Spatial analyses, including local and global spatial autocorrelation methods and clustering analysis were performed on the cutaneous leishmaniasis cases (1996-2006), to detect any trend or cluster and any particular province. The spatial distribution of cutaneous leishmaniasis cases was nonrandom and found to be clustered significantly (p < 0.05). There is a clear trend toward the southeast region. Regions with high concentration of cutaneous leishmaniasis are located in the southeast region (p < 0.05). This study shows that cutaneous leishmaniasis is a serious public health concern in the southeast region of Turkey, and that region should have a priority in the implement of precautionary measures. It also shows that spatial analyses and statistics can contribute to the understanding of the epidemiology of diseases and in identification of high rate disease locations.