title: Model of cholera dissemination using geographic information systems and fuzzy clustering means: case study, Chabahar, Iran.
abstract: OBJECTIVE
  Cholera is spread by drinking water or eating food that is contaminated by bacteria, and is related to climate changes. Several epidemics have occurred in Iran, the most recent of which was in 2005 with 1133 cases and 12 deaths. This study investigated the incidence of cholera over a 10-year period in Chabahar district, a region with one of the highest incidence rates of cholera in Iran.
  
  
  METHODS
  Descriptive retrospective study on data of patients with Eltor and NAG cholera reported to the Iranian Centre of Disease Control between 1997 and 2006.
  
  
  METHODS
  Data on the prevalence of cholera were gathered through a surveillance system, and a spatial database was developed using geographic information systems (GIS) to describe the relation of spatial and climate variables to cholera incidences. Fuzzy clustering (fuzzy C) method and statistical analysis based on logistic regression were used to develop a model of cholera dissemination. The variables were demographic characteristics, specifications of cholera infection, climate conditions and some geographical parameters.
  
  
  RESULTS
  The incidence of cholera was found to be significantly related to higher temperature and humidity, lower precipitation, shorter distance to the eastern border of Iran and local health centres, and longer distance to the district health centre. The fuzzy C means algorithm showed that clusters were geographically distributed in distinct regions.
  
  
  CONCLUSIONS
  In order to plan, manage and monitor any public health programme, GIS provide ideal platforms for the convergence of disease-specific information, analysis and computation of new data for statistical analysis.
authors.affiliation: Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Pezeshki
authors.forename: M
authors.initials: M
authors.lastname: Tafazzoli-Shadpour
authors.forename: A
authors.initials: A
authors.lastname: Mansourian
authors.forename: B
authors.initials: B
authors.lastname: Eshrati
authors.forename: E
authors.initials: E
authors.lastname: Omidi
authors.forename: I
authors.initials: I
authors.lastname: Nejadqoli
mesh_terms: D000293:Adolescent; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology*; D002980:Climate; D016000:Cluster Analysis; D005260:Female; D017143:Fuzzy Logic; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008962:Models, Theoretical; D012189:Retrospective Studies; D012307:Risk Factors