Research article · 2020 · Full text
International Journal of Geography Geology and EnvironmentSpatial temporal variation of leptospirosis disease in Madurai city – Medico-geographical analysis
Volume 2(1) · Pages 21–27
Research areasLeptospirosis research and findingsViral Infections and Vectors
Abstract
Author-writtenLeptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. The bacteria are typically found in animals, including rodents, farm animals, and dogs. Humans become infected when water or soil contaminated with the bacteria come into contact with their eyes, mouth, nose, or open cuts on the skin. It is also possible to be infected through rodent bites and drinking contaminated water. Leptospirosis it continues to remain as an important public health problem in Madurai city. The study area, Madurai is the oldest and second largest city in Tamil Nadu situated on the banks of river Vaigai in south central part of Tamil Nadu, India. It is located on 90 30’ and 100 30’ longitudes and between 770 00’and 780 30 latitudes. The broader objective of this study is to analyse the spatio temporal variation noticed between different unit areas of study area. The collected data includes both primary and secondary source. Standard score (Z-score) technique, is used to synthese the relationship between the sets of variables and total conditions of selected urban environmental variables. It includes mapping of the disease using the GIS software of Arc GIS. The study’s social aspect of leptospirosis with reference to selected socio-economic determinants and suggests suitable preventive measures.
Summary
Source-checkedPlain-language reading of the full paper, prepared with AI and checked against the text. Each point links to the authors' own words.
Why it matters
- Leptospirosis is a zoonotic disease caused by Leptospira bacteria, which are commonly found in animals such as dogs, farm animals, and rodents. View evidence ↗
- Human infection occurs through contact with contaminated soil or water via the mouth, nose, eyes, or skin abrasions. View evidence ↗
- Leptospirosis remains a significant public health issue within Madurai city. View evidence ↗
The question
- The study aims to analyze the geographical distribution of leptospirosis in Madurai city and how it relates to medical, behavioral, environmental, and socio-economic factors. View evidence ↗
What they did
- Primary data was gathered from 300 samples using stratified random sampling across various sexes and age groups. View evidence ↗
- Secondary data on ward-wise zoonotic and vector-borne diseases from 2014 to 2018 were obtained from the leptospirosis clinic (ECO) and the health department. View evidence ↗
- The researchers used Arc GIS 9.3 for mapping and the Z-score statistical technique to analyze disease distribution and its relationship with health centers. View evidence ↗
What they found
- Among the sampled population, females were more widely affected by leptospirosis, representing 73.3% of cases compared to 26.7% for males. View evidence ↗
- The number of leptospirosis cases declined over time, from a high of 139 in 2014 to 49 in 2016, 46 in 2017, and 21 in 2018. View evidence ↗
- By 2018, the number of affected wards decreased to 13, with Ellisnagar remaining heavily affected. View evidence ↗
What it means
- The authors conclude that the disease is most prevalent in the Western and South Western parts of Madurai City, linked to slums, poor hygiene, and low socio-economic status. View evidence ↗
- The authors state that the gradual reduction in leptospirosis incidence is a result of proper management and planning in the area. View evidence ↗
Visual summary
2 visualsIllustrations explain the paper; charts are replotted from the paper's own table values.
Transmission Cycle of Leptospirosis
AI-generated conceptual illustration (rodents, dogs, livestock, and humans in an urban environment). It explains the idea and does not show study data.
View source evidence ↗
Responses In%: Male vs Female
Replotted from Table 1 (page 3) of the original paper. Every bar is the paper's own table value.
View source evidence ↗Figures & tables
From the original paper
Figure 1
Table 2
Table 3
Table 1
Table 3
Figure 2
Table 4
Figure 3Introduction
Leptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira [1] It is most commonly spread via water contaminated with urine from infected animals, but contaminated food or soil can also act as vehicles for the disease [2] . The main animal reservoirs are rodents, livestock and dogs. The patients suffer from fever, swelling of legs, and sever body pain. Some severe complications include kidney damage, liver failure, respiratory distress, meningitis and death [3] . Leptospirosis is most common in urban slum areas, where there is inadequate sewage disposal and water treatment [4] . It can also be an occupational hazard for those working outdoors or with animals and a recreational hazard for those participating in water related activities. 5 Epidemics are typically seen during flooding. Changing environmental trends, with extreme weather patterns, may perpetuate these epidemics [6] . Transmission of the disease in humans occurs by either direct or indirect contact with the urine, blood, or tissue of an infected animal. Animals known to spread leptospirosis to humans include cattle, pigs, dogs, reptiles and amphibians, rats and other rodents, which are the most important sources for human infection [7,8] . The urine of infected animals or healthy carriers, which may contaminated soil, pasture, drinking water and food, is the main source of infection. In the case of leptospira abortion, infection can spread through the aborted fetus and uterine discharges [9] . Humans are accidental hosts and acquire infection due to several occupational and recreational hazards associated with leptospirosis. Butchers, veterinarians, farmers and rodent control workers are at increased risk [10] . Outbreaks associated with recreational exposure to water have been reported from several countries [11] . Leptospirosis has been recognized as a potential hazard of water sports, swimming in the river and other recreational activities that expose people to possible contaminated waters. Direct transmission between humans is not indicated. They are not proven to be important epidemiological source of transmission although the excretion of leptospirosis in human urine occurs for months after recovery has been recorded [12,13] .
Medical geography is a multidimensional body of knowledge and at the same time a multifaceted approach is geared towards understanding the spatial aspects of health problems [14,15,16,17,18] . Epidemiology is a branch of medical science that deals with the incidence, distribution, and control of disease in a population [19,20,21,22] . It also deals with the sum of the factors controlling the presence or absence of a disease or pathogen [23,24,25,26,27] . All the studies in medical geography are concerned with the description of spatial and temporal variations of a particular disease and are attempted at the regional level but limited with respect to micro level [28,29,30] . Hence the present study has focused its importance at micro level to study the spatial distribution of Leptospirosis in Madurai city. The purpose of this study is to analyze the geographical distribution of vector borne disease in Madurai city especially Leptospirosis and its association with selected socio economic, environmental, behavioral and Medical aspects. The present study will identify the existing morbidity condition of population and health status prevailing in Madurai City. This offers a wide scope to find out the environmental conditions for both health and disease and stress the need for better environmental planning [31,32] . In addition, it helps to provide the most appropriate description for its present standard of diagnosis and remedy [33,34] .
Study Area
Madurai city is situated in south central part of Tamilnadu on 9 0 55"N Latitude and 78 0 07"E Longitude at a distance of nearly 500 km from Chennai. (Fig 1 ) It is bounded on north by districts namely Dindigul, Tiruchirappalli, and on the east by Sivagangai and on the west by Theni and south by Virudhunagar. The city has grown on both sides of river Vaigai and lies at a low altitude being only about 100 mts above the mean sea level. Madurai city has an area of 52sq.km with an urban area now extending over at much as 130 sq.km.
Aims and objectives
The aims and objectives of the present sutdy are as follows;
To analyse the ward wise spatial distribution of leptospirosis in Madurai City.
To analyse the spatio temporal variation noticed between different years of study area.
To analyse the inter relationship between the prevalence rate of leptospirosis and selected environmental, socio economic and health care variables.
Methodology
To fulfill the above objectives, the information was collected from both primary and secondary sources. The most important tool of analysis for geographers is cartographic interpretation and analysis of data with the help of maps.
Primary Data
The primary data is collected in the form of sample questionnaire survey in selected ward of the study area. The data collected were taken by using the method of stratified random sampling and a total of 300 samples were collected from the study is area with reference to different age groups and sex. The primary data in the present study based on direct personal interview which is selected as sampling units. Leptospirosis awareness of the public identified in Madurai city.
4.2Secondary Data
The main sources of secondary data are available at health department (Viswanatha puram) and leptospirosis clinic (ECO) in West Zone. The data collected from the above institution are ward wisevector borne disease and zoonotic disease 2014-2018. The rainfall and ward wise population data was collected from Assistant director of statistic in Madurai. The information about vectors was collected from respected health centers in Madurai. Census was collected from Madurai corporation office. Other socioeconomic particulars were collected from the respective offices. The Study area maps and related information were obtained from the Town Planning office in Madurai Corporation.
Techniques Used
Two important techniques are used in the present study. They are statistical techniques and Cartographic interpretations. It includes mapping of the study area using the GIS software of Arc GIS 9.3. The primary survey is based on the method of stratified random sampling. Apart from this, the 'Z' score statistical techniques and used to find the major disease distribution and interrelationship between patients and health care centres.
'Z' Score Method
A 'Z' score is a statistical measurement of a score's relationship to the mean in group scores. A 'z' score can be positive or negative indicating whether it is above or below the mean and standard deviation [35] . 'z' score can also be explained as in addition of showing a score's relationship to the mean. 'z' scores also allow analyst to convert scores from different data sets into scores that can be accurately concerned to each other. In order to use a z-score, we need to know the mean μ (mu) and the population standard deviation σ. The z-score is calculated using the following formula by SPSS (Statistical package Social Sciences)
Where: X= Raw score µ= mean of the given population sample σ = standard deviation of given population sample.
Results and Discussion
Results and Discussion
Gender Classification
Analysis of sex ratio is one of the important aspects of Leptospirosis study. In the sample population Females are more (73.3%) when compared to males (26.7%). In Madurai city Females are widely affected by Leptospirosis. Hence awareness about Leptospirosis is needed amongst them (Table 1)
| Gender | Responses In% |
|---|---|
| Male | 26.7 |
| Female | 73.3 |
Table text extracted from the original PDF; superscript letters are shown inline. The original table image is below.
View original table image
Spatial temporal variation of Leptospirosis In Madurai City
In 2014 people affected is very high (139). In 2016 affected 49 people. In 2017 it affected few people i.e 46. (Table 3)
| Ward No | Ward Name | Leptospirosis in Percentage | Leptospirosis ‘Z’Score Value | Ward No | Ward Name | Leptospirosis in Percentage | Leptospirosis ‘Z’Score Value |
|---|---|---|---|---|---|---|---|
| 8 | Vilaivgudi | 1.44 | -0.439 | 47 | Reserve Line | 2.15 | -0.203 |
| 11 | Ponnaharm | 1.44 | -0.439 | 50 | Swami Sannidhi | 7.91 | 1.687 |
| 12 | Chokkikulam | 0.72 | -0.676 | 57 | Anuppanadi | 3.59 | 0.269 |
| 13 | Azhagaradi | 1.44 | -0.439 | 64 | Keeraithurai | 2.87 | 0.032 |
| 14 | Viswasapuri | 0.72 | -0.676 | 65 | Sappani Kovil | 0.72 | -0.676 |
| 16 | Railway colony | 5.04 | 0.742 | 70 | Kamaraj Puram | 0.72 | -0.676 |
| 17 | Ellisnager | 11.51 | 2.869 | 76 | Pazhhagaanathm | 3.59 | 0.269 |
| 18 | S.S. Colony | 2.15 | -0.203 | 77 | Sundaraja Puram | 5.03 | 0.742 |
| 19 | Ponmeni | 8.63 | 1.924 | 78 | MaduraiBaskaradass Nagar | 1.44 | -0.439 |
| 20 | Arasaradi Othakadai | 2.15 | -0.203 | 79 | Perumal Theppakulam | 3.59 | 0.269 |
| 21 | Bethaniya Puram | 0.72 | -0.676 | 80 | Krishnaraya Theppakulam | 0.72 | -0.676 |
| 22 | Kochadai | 2.87 | 0.032 | 81 | Tamil Sangam | 0.72 | -0.676 |
| 34 | Arigar Anna Nager | 0.72 | -0.676 | 86 | Kaajimar Street | 4.32 | 0.505 |
| 36 | Aazhwar Puram | 0.72 | -0.676 | 88 | Solai Azhagupuram | 0.72 | -0.676 |
| 39 | Goripalayam | 2.15 | -0.203 | 90 | Veerakali Amman Kovil | 12.95 | 3.342 |
| 42 | Chokki Kulam | 0.72 | -0.676 | 91 | Thennaharam | 1.44 | -0.439 |
| 43 | Thallakulam | 1.44 | -0.439 | 93 | T.V.S. Nagar | 1.44 | -0.439 |
| 45 | K.Pudur | 0.72 | -0.676 | 100 | Muthramalinga Puram | 0.72 | -0.676 |
Table text extracted from the original PDF; superscript letters are shown inline. The original table image is below.
View original table image
The number of in cases 2018 is only 21. The bacteria can get into a person's body through eating or drinking food or water with these bacteria, through a cut in the skin, or through mucous membranes (eyes, nose, mouth, or anus).
Significant variation of Leptospirosis in Madurai City 2014-2018
Madurai city was highly affected by leptospirosis in 2014 when compared to 2018. The major reasons are polluted water, solid waste management, and socio economic background of people.People can also get this disease through direct or indirect contact with the infected urine of people or animals. The bacteria can get into a person's body through eating or drinking food or water with these bacteria, through a cut in the skin, or through mucous membranes (eyes, nose, mouth, or anus).The most people affected in leptospirosis the government hospital. The mazimum affected areas are Anuppanadi, Ellisnagar.
Conclusions
Spatial distribution of this disease observed to be high in the Western part of Madurai City. The prevalence rate was very high in south western part of the city. This area has a slum, poor water supply, poor and low socio-economic status of people and personal hygienic etc,. Moderate prevalence rate is noticed in southern part. Low prevalence rate is found Leptospirosis in Northern area the city. The disease mostly affected women and children. The present study will identify the existing morbidity condition of population and health status prevailing in Madurai City. This offers a wide scope to find out the environmental conditions to both health and disease and stress the need for better environmental planning. In addition, it helps to provide the most appropriate description for its present standard of diagnosis and remedy. The work also helps to plan for minimum essential health facilities needed for the people of Madurai city. The study has its own value if this subjective impression revealed from the maps, could be reinforced by objective. Hence the present study has made an attempt to throw light on specific environment and geographical pathology particularly with physical health with reference to selected environmental indicators of Madurai city. The study highlights that incidence rate of Leptospirosis has gradually reduced due to proper planning and management system of the study area.
Figures and tables from the paper
| Age Group | Responses In% |
|---|---|
| <15 | 02 |
| 15-30 | 29 |
| 30-45 | 43 |
| 45-60 | 16 |
| >60 | 10 |
Table text extracted from the original PDF; superscript letters are shown inline. The original table image is below.
View original table image
| Ward No | Ward Name | Leptospirosis in% | Leptospirosis ‘Z’Score Value | Ward No | Ward Name | Leptospirosis in% | Leptospirosis ‘Z’Score Value |
|---|---|---|---|---|---|---|---|
| 3 | Anaiyur | 5.56 | -.414 | 57 | Anuppanadi | 5.56 | -.414 |
| 15 | Melapponnaharm | 5.56 | -.414 | 61 | Vellapurm,Pudhu Nagar | 5.56 | -.414 |
| 17 | Eillnager | 22.22 | 3.03 | 63 | Villaapuram | 11.11 | .662 |
| 18 | S.S Colony | 5.56 | -.4.14 | 78 | MaduraiBaskaradass Nagar | 5.56 | -.414 |
| 21 | Bethaniya Puram | 5.56 | -.4.14 | 87 | Subramaniym Puram | 5.56 | -.144 |
| 31 | Tahsildhar Nager | 5.56 | -4.14 | 95 | T.V.S. Nagar | 11.11 | .662 |
| 54 | Mariamman Theppakulam | 5.56 | -4.14 | Mean Value::7.923 Std.Deviation:4.645 |
Table text extracted from the original PDF; superscript letters are shown inline. The original table image is below.
View original table image
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