Hot-spot and cluster analysis on legal and illegal dumping sites as the contributors of leptospirosis in a flood hazard area in Pahang, Malaysia

Leptospirosis is one of the zoonotic diseases which pose majorpublic health issues worldwide. The spread of leptospirosis depends on the climate conditions as well as environmental conditions.Methods: The cases of leptospirosis were determinedby using database obtained from Ministryof Health, Malaysia. Case cluster and hot spotanalysis within Geographical Information System (GIS) were done using ArcGIS version 9.3. Level of significance was setat alpha= 0.05. Results: Most of the cases were at the centrePahang located along the flood hazard stream. Cluster analysis indicated that cases were mostlyclusterednear illegal and legal dumping sites. The outliers were Jerantut, Maran, Pekan, andRompin in both maps (p<0.05).The hot spot analysis obtained an obvioustrend in the legal dumping compared to the illegaldumping. The hotspot area was foundin the middle of Pahang such as in Jerantut, Temerloh, Maran, Pekan, and Rompin. Conclusions Increasing flood risk, poor sanitation and abundanceof rats are conditions that trigger leptospirosis outbreaks. Interventions are therefore needed, targeting at environmental sources of transmission namely open legal and illegal dumping sites as well as flooding in flood hazard areas. A refinedwaste management system is neededtocontrol the spread of the disease.