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Malaysian Geographical or Geospatial Health (MyGeoHealth) is a term used to describe innovative method for monitoring environmental risk factors on human health. There are possible spatial relationship between environment and cholera outbreaks in Tawau, Sabah due to the recent outbreaks are hard to predict. Cholera is a diarrhoeal disease caused by Vibrio cholerae (Vc), which occurs naturally in coastal phytoplankton (Chl-a) related with sea surface temperature (SST), shellfish and man. This study adapts the MyGeoHealth by emphasizing the potential of geographical information system (GIS), satellite remote sensing (RS) and global positioning system (GPS) to develop an introduced cholera transmission risk system in Tawau, Sabah. Spatio-temporal pattern and effect of SST, Chl-a, and cholera cases were determined using integrated geospatial technologies (GIS, RS and GPS), statistics and epidemiological approaches. Although the results of the effect were only statistically minimum correlation, the disease could outbreak at anywhere and anytime particularly at high population, unhygienic environment, close to the contaminated water supply, and during the hot or the wet season. These spatial characteristics of outbreak could be used as a cholera transmission risk indicator and an efficient control plan in Sabah as required in the MyGeoHealth.

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Abstract. Cholera spatial epidemiology is the study of the spread and control of the disease spatial pattern and epidemics. Previous studies have shown that multi-factorial causation such as human behaviour, ecology and other infectious risk factors influence the disease outbreaks. Thus, understanding spatial pattern and possible interrelationship factors of the outbreaks are crucial to be explored an in-depth study. This study focuses on the integration of geographical information system (GIS) and epidemiological techniques in exploratory analyzing the cholera spatial pattern and distribution in the selected district of Sabah. Spatial Statistic and Pattern tools in ArcGIS and Microsoft Excel software were utilized to map and analyze the reported cholera cases and other data used. Meanwhile, cohort study in epidemiological technique was applied to investigate multiple outcomes of the disease exposure. The general spatial pattern of cholera was highly clustered showed the disease spread easily at a place or person to others especially 1500 meters from the infected person and locations. Although the cholera outbreaks in the districts are not critical, it could be endemic at the crowded areas, unhygienic environment, and close to contaminated water. It was also strongly believed that the coastal water of the study areas has possible relationship with the cholera transmission and phytoplankton bloom since the areas recorded higher cases. GIS demonstrates a vital spatial epidemiological technique in determining the distribution pattern and elucidating the hypotheses generating of the disease. The next research would be applying some advanced geo-analysis methods and other disease risk factors for producing a significant a local scale predictive risk model of the disease in Malaysia.