Leptospirosis disease mapping with standardized morbidity ratio and Poisson-Gamma model: An analysis of Leptospirosis disease in Kelantan, Malaysia

Abstract

Leptospirosis is a disease caused by the infection of pathogenic species from the genus of Leptospira. Human can be infected by the leptospirosis from direct or indirect exposure to the urine of infected animals. The excretion of urine from the animal host that carries pathogenic Leptospira causes the soil or water to be contaminated. Therefore, people can become infected when they are exposed to contaminated soil and water by cut on the skin as well as open wound. It also can enter the human body by mucous membrane such nose, eyes and mouth, for example by splashing contaminated water or urine into the eyes or swallowing contaminated water or food. Currently, there is no vaccine available for the prevention or treatment of leptospirosis disease but this disease can be treated if it is diagnosed early to avoid any complication. The disease risk mapping is important in a way to control and prevention of disease. Using a good choice of statistical model will produce a good disease risk map. Therefore, the aim of this study is to estimate the relative risk for leptospirosis disease based initially on the most common statistic used in disease mapping called Standardized Morbidity Ratio (SMR) and Poisson-gamma model. This paper begins by providing a review of the SMR method and Poisson-gamma model, which we then applied to leptospirosis data of Kelantan, Malaysia. Both results are displayed and compared using graph, tables and maps. The result shows that the second method Poisson-gamma model produces better relative risk estimates compared to the SMR method. This is because the Poisson-gamma model can overcome the drawback of SMR where the relative risk will become zero when there is no observed leptospirosis case in certain regions. However, the Poisson-gamma model also faced problems where the covariate adjustment for this model is difficult and no possibility for allowing spatial correlation between risks in neighbouring areas. The problems of this model have motivated many researchers to introduce other alternative methods for estimating the risk.