Spatiotemporal epidemiology of cryptosporidiosis in the Republic of Ireland, 2008--2017: development of a space--time “cluster recurrence” index

Abstract

Background: Ireland frequently reports the highest annual Crude Incidence Rates (CIRs) of cryptosporidiosis in the
EU, with national CIRs up to ten times the EU average. Accordingly, the current study sought to examine the spatiotemporal trends associated with this potentially severe protozoan infection.
Methods: Overall, 4509 cases of infection from January 2008 to December 2017 were geo-referenced to a Census
Small Area (SA), with an ensemble of geo-statistical approaches including seasonal decomposition, Local Moran’s I,
and space–time scanning used to elucidate spatiotemporal patterns of infection.
Results: One or more confrmed cases were notifed in 3413 of 18,641 Census SAs (18.3%), with highest case numbers occurring in the 0–5-year range (n=2672, 59.3%). Sporadic cases were more likely male (OR 1.4) and rural (OR
2.4), with outbreak-related cases more likely female (OR 1.4) and urban (OR 1.5). Altogether, 55 space–time clusters
(≥10 confrmed cases) of sporadic infection were detected, with three “high recurrence” regions identifed; no large
urban conurbations were present within recurrent clusters.
Conclusions: Spatiotemporal analysis represents an important indicator of infection patterns, enabling targeted
epidemiological intervention and surveillance. Presented results may also be used to further understand the sources,
pathways, receptors, and thus mechanisms of cryptosporidiosis in Ireland

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ORCID for Eimear Cleary: orcid.org/0000-0003-2549-8565

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