Sains Malaysiana 41(7)(2012): 911–919

Spatial Analysis of Environmental Factors Influencing Typhoid

Endemicity in Kelantan, Malaysia

(Analisis Reruang Faktor Persekitaran yang Mempengaruhi Keendemikan Tifoid

di Kelantan, Malaysia)

Shamsul Azhar Shah¹*, Hiroshi Suzuki², Mohd Rohaizat Hassan¹, Teiko Saito³, Nazarudin Safian¹ & Shahrudin Idrus⁴

¹Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia

Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur Malaysia

²Department of Nursing, Niigata Seiryo University, Niigata, Japan

³Department of Infectious Disease Control and International Medicine Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

⁴Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia

43600 UKM, Bangi, Selangor D. E., Malaysia

Received: 3 August 2011 / Accepted: 21 February 2012

ABSTRACT

The determination of the high-risk area and clusters of typhoid cases is critical in typhoid control. The purpose of this study was to identify and describe the epidemiology and spatial distribution of typhoid in four selected districts in Kelantan using GIS (geographical information system). A total of 1215 (99%) of the cases were coordinated with GPS (global positioning system) and mapping was done using ArcGIS 9.2. Spatial analysis was performed to determine the cluster and high-risk area of typhoid. Results showed that typhoid incidence was not associated with race and sex. Most affected were from the age group of 5-14 followed by 15-24 year olds. Nine sub-districts were categorized as highly endemic. In addition typhoid has shown a significant tendency to cluster and a total of 22 hotspots were found in Kota Bharu, Bachok and Tumpat with a few sub districts identified as high risk for typhoid. No significant relationships between the treated water ratio and flood risk area were found with the cluster of cases. The cluster of typhoid cases in the endemic area did not appear to be related to environmental risk factors. Understanding the characteristics of these clusters would enable the prevention of typhoid disease in the future.

Keywords: Environmental factors; high-risk; typhoid cluster

ABSTRAK

Penentuan kawasan berisiko tinggi dan kelompok kes-kes tifoid adalah penting bagi pengawalannya. Tujuan kajian ini adalah untuk mengenalpasti dan menghuraikan epidemiologi dan taburan reruang tifoid di empat daerah terpilih di Kelantan menggunakan GIS. Sebanyak 1215 (99%) lokasi kes ditentukan dengan GPS dan pemetaan dibuat menggunakan ArcGIS 9.2. Analisis reruang dilakukan untuk penentuan kelompok dan kawasan berisiko tinggi tifoid. Hasil kajian menunjukkan insiden tifoid tiada kaitan dengan bangsa dan seks, Kebanyakan daripada mereka adalah daripada kumpulan umur 5 – 14 tahun diikuti dengan 15 – 24 tahun. Sembilan mukim dikategori sebagai endemik tinggi. Tifoid menunjukkan kecenderungan untuk berkelompok yang signifikan dan 22 kelompok panas ditemui di Kota Bharu, Bachok dan Tumpat dengan beberapa mukim dikenalpasti kawasan berisiko tinggi. Tiada hubungan yang signifikan di antara nisbah air terawat dan kawasan risiko banjir dengan kelompok kes. Kelompok kes tifoid dalam kawasan endemik kelihatan tiada kaitan dengan faktor risiko persekitaran. Pemahaman sifat-sifat kelompok ini boleh membantu dalam pencegahan penyakit tifoid pada masa akan datang.

Kata kunci: Faktor persekitaran; kelompok tifoid; risiko tinggi

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*Corresponding author; email: shamsulazharshah@yahoo.com