Foot-and-Mouth Disease Space-Time Clusters and Risk Factors in Cattle and Buffalo in Bangladesh.

Foot-and-mouth disease (FMD) is highly endemic in Bangladesh. Using passive surveillance data (case records from all 64 districts of Bangladesh, 2014-2017) and district domestic ruminant population estimates, we calculated FMD cumulative incidence per 10,000 animals at risk per district, conducted cluster (Moran's spatial autocorrelation and scan statistics) and hotspot analysis (local indicator of spatial association statistic), created predictive maps and identified risk factors using a geographically weighted regression model. A total of 548,817 FMD cases in cattle and buffalo were reported during the four-year study period. The highest proportion (31.5%) of cases were reported during the post-monsoon season, and from Chattogram (29.2%) division. Five space-time clusters, 9 local clusters, and 14 hotspots were identified. Overall, higher cumulative incidences of FMD were consistently predicted in eastern parts of Bangladesh. The precipitation in the pre-monsoon season (p=0.0008) was positively associated with FMD in Bangladesh. Results suggest climate plays an important role in the epidemiology of FMD in Bangladesh, and high risk zones exist. In a resource limited-setting, hotspots and clusters should be prioritized for vaccination coverage, and surveillance for FMD should be targeted in eastern areas of Bangladesh and during the post-monsoon season.