Spatial patterns of leptospirosis in Ecuador, 2013-2018.

Background: Leptospirosis is a zoonotic disease that is considered an important public health problem in tropical regions and the world's poorest countries.

Methods: In this ecological study, we included cases of leptospirosis reported in Ecuador from 2013 to 2018. Spatial autocorrelation was evaluated through the global Moran I index and spatial-temporal scan statistics were used to identify high-risk clusters.

Results: In Ecuador, the leptospirosis incidence rates decreased from 3.3 cases per 100 000 population in 2013 to 0.8 cases per 100 000 population in 2018. The global Moran I index for the study period showed a positive spatial autocorrelation (0.68; p=0.001). We identified three significant spatial-temporal clusters for a high occurrence of leptospirosis incidence located in cantons of the Coast and Amazon regions.

Conclusions: The clusters identified could be targeted by policymakers and stakeholders in order to direct surveillance and understand the dynamics of the distribution of leptospirosis in Ecuador.