Dog bite Emergency department presentations in Brisbane metro south: Epidemiology and exploratory medical geography for targeted interventions.

Dog bites are a recognized public health issue due to their impact on human and animal health/welfare. This study aimed to investigate demographic and geographic disparities in the epidemiology of dog bites presentations reported to the emergency departments of the four main public hospitals in the Metro South region of Brisbane, Queensland, Australia. Dog bite patient hospitalization data geolocated to the street address were collected from clinical records management systems from the four main public hospitals in the Metro South Hospital Health Service region of Queensland for a 5-year period (ie. 01/07/2013 to 30/06/2017). We investigated the epidemiology of three clinical outcomes including probability of paediatric cases (paediatric vs. adult), probability of dog bites to the head (head injury vs. other injury), and probability of re-presentation to the ED following their initial dog bite (yes or no) by way of univariable then multivariable Bernoulli logistic regression models including patient postcode as a random effect. Residual semivariograms were created to identify spatial trends in the medical geography of dog bites and binomial geostatistical models were created to predict the probability of the outcomes of interest in Brisbane Metro south and surrounding suburbs. Our results demonstrate that compared to adult dog bite cases, paediatric dog bite cases were significantly associated with bites to the head or face or neck (OR 14.65,  < 0.001), bites to the lower body (OR 4.95,  = 0.035) and larger dogs (OR 0.25,  = 0.030 for small dogs). The probability of head injuries was greater in younger age groups (17-39 OR 0.25,  = 0.001; 40-64 OR 0.15,  = 0.001; 65-above OR 0.14,  = 0.029). Attacks by small dogs were more likely to inflict head wounds than large dogs (OR 6.12,  < 0.001). The probability of re-presentation was lower in patients bitten by medium sized dogs (OR 0.29,  = 0.027) than larger dogs. Our predictive maps showed significant clustering of paediatric case probability in the Logan city and Redlands councils associated with socioeconomic status of the places of residence. In conclusion, our findings demonstrate significant demographic and geographic heterogeneity in dog bite ED presentations. Public health interventions to reduce the burden of dog bites should be targeted to the populations most at-risk in the areas identified in this study.