The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas
Vibrio cholerae remains a notable public health challenge across Malaysia. Although the Malaysian state of Sabah is considered a cholera-affected area, gaps remain in understanding the epidemiological trends and spatial distribution of outbreaks. Therefore, to determine longitudinal and spatial tren...
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| Format: | Article |
| Language: | English English |
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PLOS
2024
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| Online Access: | https://eprints.ums.edu.my/id/eprint/41902/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/41902/2/FULL%20TEXT.pdf |
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| author | Marilyn Charlene Montini Maluda Emilia Johnson Fredie Robinson Muhammad Jikal Siat, Yee Fong Mohammad Saffree Jeffree Kimberly M. Fornace Kamruddin Ahmed |
| author_facet | Marilyn Charlene Montini Maluda Emilia Johnson Fredie Robinson Muhammad Jikal Siat, Yee Fong Mohammad Saffree Jeffree Kimberly M. Fornace Kamruddin Ahmed |
| author_sort | Marilyn Charlene Montini Maluda |
| collection | UMS |
| description | Vibrio cholerae remains a notable public health challenge across Malaysia. Although the Malaysian state of Sabah is considered a cholera-affected area, gaps remain in understanding the epidemiological trends and spatial distribution of outbreaks. Therefore, to determine longitudinal and spatial trends in cholera cases data were obtained from the Sabah State Health Department for all notified cases of cholera between 2005–2020. A cholera outbreak is defined as one or more confirmed cases in a single locality with the evidence of local transmission. All records were geolocated to village level. Satellite-derived data and generalised linearized models were used to assess potential risk factors, including population density, elevation, and distance to the sea. Spatiotemporal clustering of reported cholera cases and zones of increased cholera risk were evaluated using the tau statistic (τ) at 550m, 5km and 10km distances. Over a 15-year period between 2005–2020, 2865 cholera cases were recorded in Sabah, with a mean incidence rate of 5.6 cases per 100,000 (95% CI: 3.4–7.9). From 2015–2020, 705 symptomatic cases and 727 asymptomatic cases were reported. Symptomatic cases primarily occurred in local Malaysian populations (62.6%, 441/705) and in children and adolescents under 15-years old (49.4%, 348/705). On average, cases were reported in areas with low population density (19.45 persons/km2), low elevations (19.45m) and near coastal areas. Spatiotemporal clustering of cholera cases was identified up to 3.5km, with increased village-level cholera risk within 500m and 5 days of initial case presentation to a health facility (Risk Ratio = 9.7, 95% CI: 7.5–12.4). Cholera incidence has high spatial and temporal heterogeneity within Sabah, with some districts experiencing repeated outbreaks. Cholera cases clustered across space and time, with village-level risk of cholera highest within 5 days and within close proximity to primary case villages, suggesting local transmission. |
| first_indexed | 2024-12-09T00:53:53Z |
| format | Article |
| id | ums.eprints-41902 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2024-12-09T00:53:53Z |
| publishDate | 2024 |
| publisher | PLOS |
| record_format | dspace |
| spelling | ums.eprints-419022024-11-16T06:57:41Z https://eprints.ums.edu.my/id/eprint/41902/ The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas Marilyn Charlene Montini Maluda Emilia Johnson Fredie Robinson Muhammad Jikal Siat, Yee Fong Mohammad Saffree Jeffree Kimberly M. Fornace Kamruddin Ahmed RA421-790.95 Public health. Hygiene. Preventive medicine RC109-216 Infectious and parasitic diseases Vibrio cholerae remains a notable public health challenge across Malaysia. Although the Malaysian state of Sabah is considered a cholera-affected area, gaps remain in understanding the epidemiological trends and spatial distribution of outbreaks. Therefore, to determine longitudinal and spatial trends in cholera cases data were obtained from the Sabah State Health Department for all notified cases of cholera between 2005–2020. A cholera outbreak is defined as one or more confirmed cases in a single locality with the evidence of local transmission. All records were geolocated to village level. Satellite-derived data and generalised linearized models were used to assess potential risk factors, including population density, elevation, and distance to the sea. Spatiotemporal clustering of reported cholera cases and zones of increased cholera risk were evaluated using the tau statistic (τ) at 550m, 5km and 10km distances. Over a 15-year period between 2005–2020, 2865 cholera cases were recorded in Sabah, with a mean incidence rate of 5.6 cases per 100,000 (95% CI: 3.4–7.9). From 2015–2020, 705 symptomatic cases and 727 asymptomatic cases were reported. Symptomatic cases primarily occurred in local Malaysian populations (62.6%, 441/705) and in children and adolescents under 15-years old (49.4%, 348/705). On average, cases were reported in areas with low population density (19.45 persons/km2), low elevations (19.45m) and near coastal areas. Spatiotemporal clustering of cholera cases was identified up to 3.5km, with increased village-level cholera risk within 500m and 5 days of initial case presentation to a health facility (Risk Ratio = 9.7, 95% CI: 7.5–12.4). Cholera incidence has high spatial and temporal heterogeneity within Sabah, with some districts experiencing repeated outbreaks. Cholera cases clustered across space and time, with village-level risk of cholera highest within 5 days and within close proximity to primary case villages, suggesting local transmission. PLOS 2024 Article NonPeerReviewed text en https://eprints.ums.edu.my/id/eprint/41902/1/ABSTRACT.pdf text en https://eprints.ums.edu.my/id/eprint/41902/2/FULL%20TEXT.pdf Marilyn Charlene Montini Maluda and Emilia Johnson and Fredie Robinson and Muhammad Jikal and Siat, Yee Fong and Mohammad Saffree Jeffree and Kimberly M. Fornace and Kamruddin Ahmed (2024) The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas. PLOS Glob Public Health, 4. pp. 1-16. ISSN 2767-3375 https://doi.org/10.1371/journal.pgph.0002861 |
| spellingShingle | RA421-790.95 Public health. Hygiene. Preventive medicine RC109-216 Infectious and parasitic diseases Marilyn Charlene Montini Maluda Emilia Johnson Fredie Robinson Muhammad Jikal Siat, Yee Fong Mohammad Saffree Jeffree Kimberly M. Fornace Kamruddin Ahmed The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title | The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title_full | The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title_fullStr | The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title_full_unstemmed | The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title_short | The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas |
| title_sort | incidence and spatial trends of cholera in sabah over 15 years repeated outbreaks in coastal areas |
| topic | RA421-790.95 Public health. Hygiene. Preventive medicine RC109-216 Infectious and parasitic diseases |
| url | https://eprints.ums.edu.my/id/eprint/41902/1/ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/41902/2/FULL%20TEXT.pdf |
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