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BMC Public Health
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Malaria | Research

Mapping the stability of febrile illness hotspots in Punjab from 2012 to 2019- a spatial clustering and regression analysis

Authors: Madhur Verma, Shweta Panwar, Soumya Swaroop Sahoo, Gagandeep Singh Grover, Seema Aggarwal, Jaya Prasad Tripathy, Jitendra Shah, Rakesh Kakkar

Published in: BMC Public Health | Issue 1/2023

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Abstract

Introduction

Febrile illnesses (FI) represent a typical spectrum of diseases in low-resource settings, either in isolation or with other common symptoms. They contribute substantially to morbidity and mortality in India. The primary objective was to study the burden of FI based on Integrated Disease Surveillance Programme (IDSP) data in Punjab, analyze geospatial and temporal trends and patterns, and identify the potential hotspots for effective intervention.

Methods

A retrospective ecological study used the district-level IDSP reports between 2012 and 2019. Diseases responsible for FI on a large scale, like Dengue, Chikungunya, Malaria (Plasmodium Falciparum, P. Vivax), Enteric fever, and Pyrexia of Unknown Origin (PUO), were included in the analysis. The digital map of Punjab was obtained from GitHub. Spatial autocorrelation and cluster analysis were done using Moran’s I and Getis-Ord G* to determine hotspots of FI using the incidence and crude disease numbers reported under IDSP. Further, negative binomial regression was used to determine the association between Spatio-temporal and population variables per the census 2011. Stable hotspots were depicted using heat maps generated from district-wise yearly data.

Results

PUO was the highest reported FI. We observed a rising trend in the incidence of Dengue, Chikungunya, and Enteric fever, which depicted occasional spikes during the study period. FI expressed significant inter-district variations and clustering during the start of the study period, with more dispersion in the latter part of the study period. P.Vivax malaria depicted stable hotspots in southern districts of Punjab. In contrast, P. Falciparum malaria, Chikungunya, and PUO expressed no spatial patterns. Enteric Fever incidence was high in central and northeastern districts but depicted no stable spatial patterns. Certain districts were common incidence hotspots for multiple diseases. The number of cases in each district has shown over-dispersion for each disease and has little dependence on population, gender, or residence as per regression analysis.

Conclusions

The study demonstrates that information obtained through IDSP can describe the spatial epidemiology of FI at crude spatial scales and drive concerted efforts against FI by identifying actionable points.
Appendix
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Metadata
Title
Mapping the stability of febrile illness hotspots in Punjab from 2012 to 2019- a spatial clustering and regression analysis
Authors
Madhur Verma
Shweta Panwar
Soumya Swaroop Sahoo
Gagandeep Singh Grover
Seema Aggarwal
Jaya Prasad Tripathy
Jitendra Shah
Rakesh Kakkar
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-16930-y

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