GIS based spatial pattern analysis: Children with Hepatitis A in Turkey.

This study aimed to provide an insight into the geographic distribution of Hepatitis A incidence considering their temporal distribution, spatial patterns, hot spots and clusters identification in three different age-group (0-4, 5-9 and 10-14) in Turkey. Province based tabular data, including monthly numbers of Hepatitis A cases in children, and the populations from 2001 to 2011 were used as the basic input of the study. Time series maps were created using Geographic Information Systems (GIS) to introduce the temporal changes in the morbidity rates of Hepatitis A. The spatial variation of Hepatitis A was measured using Moran's I at the global level and the local indicators of spatial associations (LISAs) Moran's I and Getis-Ord G *(d) in order to identify influential locations through clusters and hot spots detection of Hepatitis A cases. The morbidity rates in children under the age of 5 were found significantly lower than the other age-groups, whereas the age-group 5-9 revealed the highest morbidity rates in the study area. The morbidity of Hepatitis A was detected very high for the years 2001, and 2005-2007. The identification of the highly vulnerable provinces was conducted using local Moran's I and local Getis-Ord G *(d). The majority of clusters and hot spots were detected to be agglomerated in the Eastern Mediterranean and South-Eastern Anatolian Regions and Ceyhan, Asi and Southeast part of Firat-Dicle river basins in Turkey.