Spatial analysis of influenza incidence in EMRO using flexible scan statistics

Introduction: Influenza is an infectious and severe respiratory disease. It is one of the major problems of public health. In order to determine the spatial distribution and areas with over-expected of a disease including influenza, it can be effective in identifying environmental hazards and fair distribution of health services. In this study, the geographical distribution of the influenza and the identification of the high risk clusters of this disease were investigated. Materials and Methods: In this study, the incidence information of influenza in a 21-month period (until October 2018) from eastern Mediterranean countries were used. The data were extracted from the world health organization's reports and used to determine the areas with over-expected incidence of influenza using flexible scan statistics. Results: In total, 28055 cases of influenza have been reported in the countries of the Eastern Mediterranean region during the study period. Results detected four high-risk cluster in this region. According to the results, incidence of influenza in Bahrain, Kuwait and the Qatar was significantly higher than expected. In the second place, Oman and Tunisia were also considered as a high-risk region, separately. Jordan was the next cluster, however there was no statistically significant difference between expected and observed cases of influenza in this cluster. Conclusion: The results of flexible spatial exploration statistics indicated the high incidence of influenza in the countries of west of Asia and north of Africa in the Eastern Mediterranean region. Therefore, the influenza control system at the regional and national levels in high-risk countries is strongly recommended