Abstract ID: 251
Authors:
Muhamad Fadhil Mohd Pua’at Zuzaki
Bala Murali Sundram
Aimee Halim
Nur Anisah Mohamed
Muhamad Alfatih Pahrol
Rohaida Ismail
Affiliations:
Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya; Department of Geography, Faculty of Arts and Social Sciences, Universiti Malaya; Institute of Mathematical Sciences, Faculty of Science, Universiti Malaya; Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health.
Abstract:Background: Leptospirosis remains a significant zoonotic disease in Malaysia, where climatic and environmental factors influence transmission dynamics. However, comprehensive national analyses of spatiotemporal patterns and their relationship to climate remain limited. Objectives: To describe the demographic and spatial patterns of leptospirosis cases (2012-2022), identify spatial hotspots and coldspots, and determine the association between climatic conditions and state-level incidence. Materials and Methods: A retrospective ecological study was conducted using 51,564 leptospirosis cases reported across Malaysia from 2012 to 2022. Demographic and temporal patterns were summarised. Spatial clustering and hotspots were identified using NNI, Moran’s I, LISA, and Getis-Ord Gi* statistics. The impact of temperature, rainfall, humidity, and flooding on annual state-level cases was assessed using a generalised linear mixed model. Results: Most cases were in males (68.1%) and Malay Bumiputera (62.6%), with a median age of 30 years. Case numbers peaked in 2014, 2016, and 2022, especially in Selangor and Sarawak. Strong spatial clustering was seen every year (NNI 0.19 0.28; Moran’s I 0.24 0.51, p<0.001). LISA found persistent hotspots in Hulu Selangor, Gombak, Klang (Selangor), Kinta and Batang Padang (Perak), and Kota Bharu (Kelantan), and consistent coldspots in Kuala Lumpur, Johor Bahru, and the southern region, with spatial outliers being rare. Getis-Ord Gi* confirmed the persistence and spread of these high-risk areas, especially during years with higher case numbers. Higher temperature was linked to reduced leptospirosis risk (IRR=0.84, 95% CI: 0.71 0.99), while rainfall, humidity, and flooding were not significant. Conclusions: Leptospirosis in Malaysia is strongly shaped by local climate and geography, with some districts consistently experiencing higher risk. Focusing prevention efforts in these hotspots, while considering ongoing changes in climate and land use, can improve disease control. These strategies may also be useful for managing leptospirosis and similar diseases in other countries with changing environments.
Keywords: Climate Change and Planetary Health, Leptospirosis, Hotspots, Clustering, Climate, Malaysia
