Spatiotemporal clustering of cutaneous leishmaniasis in Fars province, Iran

Abstract

Objective: To assess the spatiotemporal trait of cutaneous leishmaniasis (CL) in Fars province, Iran. Methods: Spatiotemporal cluster analysis was conducted retrospectively to find spatiotemporal clusters of CL cases. Time-series data were recorded from 29 201 cases in Fars province, Iran from 2010 to 2015, which were used to verify if the cases were distributed randomly over time and place. Then, subgroup analysis was applied to find significant sub-clusters within large clusters. Spatiotemporal permutation scans statistics in addition to subgroup analysis were implemented using SaTScan software. Results: This study resulted in statistically significant spatiotemporal clusters of CL (P < 0.05). The most likely cluster contained 350 cases from 1 July 2010 to 30 November 2010. Besides, 5 secondary clusters were detected in different periods of time. Finally, statistically significant sub-clusters were found within the three large clusters (P < 0.05). Conclusions: Transmission of CL followed spatiotemporal pattern in Fars province, Iran. This can have an important effect on future studies on prediction and prevention of CL.

Keywords

• Cutaneous leishmaniasis
• Scan statistics
• Spatiotemporal clustering
• Clusters within a cluster