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Yu Q, Qu Y, Zhang L, Yao X, Yang J, Chen S, Liu H, Wang Q, Wu M, Tao J, Zhou C, Alage IL, Liu S. Spatial spillovers of violent conflict amplify the impacts of climate variability on malaria risk in sub-Saharan Africa. Proc Natl Acad Sci U S A 2024; 121:e2309087121. [PMID: 38557184 PMCID: PMC11009658 DOI: 10.1073/pnas.2309087121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/02/2024] [Indexed: 04/04/2024] Open
Abstract
Africa carries a disproportionately high share of the global malaria burden, accounting for 94% of malaria cases and deaths worldwide in 2019. It is also a politically unstable region and the most vulnerable continent to climate change in recent decades. Knowledge about the modifying impacts of violent conflict on climate-malaria relationships remains limited. Here, we quantify the associations between violent conflict, climate variability, and malaria risk in sub-Saharan Africa using health surveys from 128,326 individuals, historical climate data, and 17,429 recorded violent conflicts from 2006 to 2017. We observe that spatial spillovers of violent conflict (SSVCs) have spatially distant effects on malaria risk. Malaria risk induced by SSVCs within 50 to 100 km from the households gradually increases from 0.1% (not significant, P>0.05) to 6.5% (95% CI: 0 to 13.0%). SSVCs significantly promote malaria risk within the average 20.1 to 26.9 °C range. At the 12-mo mean temperature of 22.5 °C, conflict deaths have the largest impact on malaria risk, with an approximately 5.8% increase (95% CI: 1.0 to 11.0%). Additionally, a pronounced association between SSVCs and malaria risk exists in the regions with 9.2 wet days per month. The results reveal that SSVCs increase population exposure to harsh environments, amplifying the effect of warm temperature and persistent precipitation on malaria transmission. Violent conflict therefore poses a substantial barrier to mosquito control and malaria elimination efforts in sub-Saharan Africa. Our findings support effective targeting of treatment programs and vector control activities in conflict-affected regions with a high malaria risk.
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Affiliation(s)
- Qiwei Yu
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Ying Qu
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Liqiang Zhang
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Xin Yao
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Jing Yang
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Siyuan Chen
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Hui Liu
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Qihao Wang
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Mengfan Wu
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Junpei Tao
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
| | - Chenghu Zhou
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Science and Natural Resources, Chinese Academy of Sciences, Beijing100101, China
| | - Isiaka Lukman Alage
- Space Research and Development Division, African Regional Centre for Space Science and Technology Education in English Ile ife, Ile ife, Osun220282, Nigeria
| | - Suhong Liu
- Department of Geography, State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing100875, China
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Rahmani AA, Susanna D, Febrian T. The relationship between climate change and malaria in South-East Asia: A systematic review of the evidence. F1000Res 2023; 11:1555. [PMID: 37867624 PMCID: PMC10585202 DOI: 10.12688/f1000research.125294.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background: Climatic change is an inescapable fact that implies alterations in seasons where weather occurrences have their schedules shift from the regular and magnitudes intensify to more extreme variations over a multi-year period. Southeast Asia is one of the many regions experiencing changes in climate and concurrently still has endemicities of malaria. Given that previous studies have suggested the influence of climate on malaria's vector the Anopheles mosquitoes and parasite the Plasmodium group, this study was conducted to review the evidence of associations made between malaria cases and climatic variables in Southeast Asia throughout a multi-year period. Methods: Our systematic literature review was informed by the PRISMA guidelines and registered in PROSPERO: CRD42022301826 on 5 th February 2022. We searched for original articles in English and Indonesian that focused on the associations between climatic variables and malaria cases. Results: The initial identification stage resulted in 535 records of possible relevance and after abstract screening and eligibility assessment we included 19 research articles for the systematic review. Based on the reviewed articles, changing temperatures, precipitation, humidity and windspeed were considered for statistical association across a multi-year period and are correlated with malaria cases in various regions throughout Southeast Asia. Conclusions: According to the review of evidence, climatic variables that exhibited a statistically significant correlation with malaria cases include temperatures, precipitation, and humidity. The strength of each climatic variable varies across studies. Our systematic review of the limited evidence indicates that further research for the Southeast Asia region remains to be explored.
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Affiliation(s)
- Ardhi Arsala Rahmani
- Doctoral Program in Public Health, Universitas Indonesia, Depok, Jawa Barat, 16424, Indonesia
| | - Dewi Susanna
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, Jawa Barat, 16424, Indonesia
| | - Tommi Febrian
- Global Green Growth Institute (GGGI), Jakarta, Daerah Khusus Ibukota (DKI), 12950, Indonesia
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Yurchenko AA, Naumenko AN, Artemov GN, Karagodin DA, Hodge JM, Velichevskaya AI, Kokhanenko AA, Bondarenko SM, Abai MR, Kamali M, Gordeev MI, Moskaev AV, Caputo B, Aghayan SA, Baricheva EM, Stegniy VN, Sharakhova MV, Sharakhov IV. Phylogenomics revealed migration routes and adaptive radiation timing of Holarctic malaria mosquito species of the Maculipennis Group. BMC Biol 2023; 21:63. [PMID: 37032389 PMCID: PMC10084679 DOI: 10.1186/s12915-023-01538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/08/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Phylogenetic analyses of closely related species of mosquitoes are important for better understanding the evolution of traits contributing to transmission of vector-borne diseases. Six out of 41 dominant malaria vectors of the genus Anopheles in the world belong to the Maculipennis Group, which is subdivided into two Nearctic subgroups (Freeborni and Quadrimaculatus) and one Palearctic (Maculipennis) subgroup. Although previous studies considered the Nearctic subgroups as ancestral, details about their relationship with the Palearctic subgroup, and their migration times and routes from North America to Eurasia remain controversial. The Palearctic species An. beklemishevi is currently included in the Nearctic Quadrimaculatus subgroup adding to the uncertainties in mosquito systematics. RESULTS To reconstruct historic relationships in the Maculipennis Group, we conducted a phylogenomic analysis of 11 Palearctic and 2 Nearctic species based on sequences of 1271 orthologous genes. The analysis indicated that the Palearctic species An. beklemishevi clusters together with other Eurasian species and represents a basal lineage among them. Also, An. beklemishevi is related more closely to An. freeborni, which inhabits the Western United States, rather than to An. quadrimaculatus, a species from the Eastern United States. The time-calibrated tree suggests a migration of mosquitoes in the Maculipennis Group from North America to Eurasia about 20-25 million years ago through the Bering Land Bridge. A Hybridcheck analysis demonstrated highly significant signatures of introgression events between allopatric species An. labranchiae and An. beklemishevi. The analysis also identified ancestral introgression events between An. sacharovi and its Nearctic relative An. freeborni despite their current geographic isolation. The reconstructed phylogeny suggests that vector competence and the ability to enter complete diapause during winter evolved independently in different lineages of the Maculipennis Group. CONCLUSIONS Our phylogenomic analyses reveal migration routes and adaptive radiation timing of Holarctic malaria vectors and strongly support the inclusion of An. beklemishevi into the Maculipennis Subgroup. Detailed knowledge of the evolutionary history of the Maculipennis Subgroup provides a framework for examining the genomic changes related to ecological adaptation and susceptibility to human pathogens. These genomic variations may inform researchers about similar changes in the future providing insights into the patterns of disease transmission in Eurasia.
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Affiliation(s)
- Andrey A Yurchenko
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- Kurchatov Genomics Center, the Federal Research Center, Institute of Cytology and Genetics, Novosibirsk, Russia
- Current Address: INSERM U981, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Anastasia N Naumenko
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Gleb N Artemov
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia
| | - Dmitry A Karagodin
- Laboratory of Cell Differentiation Mechanisms, the Federal Research Center, Institute of Cytology and Genetics, Novosibirsk, Russia
| | - James M Hodge
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Alena I Velichevskaya
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia
| | - Alina A Kokhanenko
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia
| | - Semen M Bondarenko
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia
| | - Mohammad R Abai
- Department of Medical Entomology and Vector Control, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Kamali
- Department of Medical Entomology and Parasitology, Tarbiat Modares University, Tehran, Iran
| | - Mikhail I Gordeev
- Department of General Biology and Ecology, State University of Education, Mytishchi, Russia
| | - Anton V Moskaev
- Department of General Biology and Ecology, State University of Education, Mytishchi, Russia
| | - Beniamino Caputo
- Dipartimento Di Sanità Pubblica E Malattie Infettive, Università Sapienza, Rome, Italy
| | - Sargis A Aghayan
- Scientific Center of Zoology and Hydroecology, National Academy of Sciences of the Republic of Armenia, Yerevan, Armenia
- Department of Zoology, Yerevan State University, Yerevan, Armenia
| | - Elina M Baricheva
- Laboratory of Cell Differentiation Mechanisms, the Federal Research Center, Institute of Cytology and Genetics, Novosibirsk, Russia
| | - Vladimir N Stegniy
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia
| | - Maria V Sharakhova
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
- Laboratory of Cell Differentiation Mechanisms, the Federal Research Center, Institute of Cytology and Genetics, Novosibirsk, Russia.
| | - Igor V Sharakhov
- Department of Entomology, the Fralin Life Sciences Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
- Department of Genetics and Cell Biology and the Laboratory of Ecology, Genetics and Environmental Protection, Tomsk State University, Tomsk, Russia.
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Lubinda J, Bi Y, Haque U, Lubinda M, Hamainza B, Moore AJ. Spatio-temporal monitoring of health facility-level malaria trends in Zambia and adaptive scaling for operational intervention. COMMUNICATIONS MEDICINE 2022; 2:79. [PMID: 35789566 PMCID: PMC9249860 DOI: 10.1038/s43856-022-00144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/15/2022] [Indexed: 12/02/2022] Open
Abstract
Background The spatial and temporal variability inherent in malaria transmission within countries implies that targeted interventions for malaria control in high-burden settings and subnational elimination are a practical necessity. Identifying the spatio-temporal incidence, risk, and trends at different administrative geographies within malaria-endemic countries and monitoring them in near real-time as change occurs is crucial for developing and introducing cost-effective, subnational control and elimination intervention strategies. Methods This study developed intelligent data analytics incorporating Bayesian trend and spatio-temporal Integrated Laplace Approximation models to analyse high-burden over 32 million reported malaria cases from 1743 health facilities in Zambia between 2009 and 2015. Results The results show that at least 5.4 million people live in catchment areas with increasing trends of malaria, covering over 47% of all health facilities, while 5.7 million people live in areas with a declining trend (95% CI), covering 27% of health facilities. A two-scale spatio-temporal trend comparison identified significant differences between health facilities and higher-level districts, and the pattern observed in the southeastern region of Zambia provides the first evidence of the impact of recently implemented localised interventions. Conclusions The results support our recommendation for an adaptive scaling approach when implementing national malaria monitoring, control and elimination strategies and a particular need for stratified subnational approaches targeting high-burden regions with increasing disease trends. Strong clusters along borders with highly endemic countries in the north and south of Zambia underscore the need for coordinated cross-border malaria initiatives and strategies. Malaria is an infectious disease that is widespread in many African countries. Malaria transmission within a country can vary between regions, so tailored interventions for malaria control and elimination targeted to different regions are necessary. To achieve this, it is important to measure and monitor the frequency of malaria infections, its risk, and trends at different geographic administrative scales. This study analysed over 32 million reported malaria cases from 1743 health facilities in Zambia between 2009 and 2015. The results showed an increasing national trend in malaria risk and malaria infection frequency and identified differences between health facility and district trends. These findings support a flexible approach when implementing and expanding national malaria monitoring, control and elimination strategies, especially in areas bordering countries where malaria is widespread, cross-border movement is common, and cross-border initiatives could be beneficial. Lubinda et al. analyse over 32 million health-facility reported malaria cases in Zambia (2009–15) to examine spatially-structured temporal trends. They observe overall increasing trends in risk and rates and highlight the potential benefits of using an adaptive scaling approach in national malaria strategies, and a need for cross-border initiatives.
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Idris IO, Ayeni GO, Iyamu IO, Sina-Odunsi AB, Adebisi YA, Obwoya JG. Factors influencing severity of recurrent malaria in a conflict-affected state of South Sudan: an unmatched case-control study. Confl Health 2022; 16:34. [PMID: 35690836 PMCID: PMC9188688 DOI: 10.1186/s13031-022-00463-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/28/2022] [Indexed: 11/26/2022] Open
Abstract
Background The burden of malaria remains the highest in sub-Saharan Africa and South Sudan is not an exception. The country has borne the brunt of years of chronic warfare and remains endemic of malaria, with increasing mortality and morbidity. Limited data still exists on factors influencing the recurrence of severe malaria, especially in emergency contexts such as South Sudan, affected by various conflicts and humanitarian situations. This study therefore aimed to investigate factors influencing severity of occurrence malaria in selected primary healthcare centres in South Sudan. This would assist and guide in malaria prevention, treatment, and eradication efforts. Methods We conducted an unmatched case-control study using routinely collected clinic data for individuals aged 1 year and above who received a diagnosis of severe malaria at 3 primary healthcare centres (PHCC); Malual Bab PHCC, Matangai PHCC and Malek PHCC between September 15, 2019 to December 15, 2019 in South Sudan. Patient characteristics were analyzed using simple descriptive statistics. Inferential statistics were also conducted to identify the associated factors influencing recurrence of severe malaria. All analyses were conducted using R Version 3.6.2. Results A total of 289 recurrent malaria cases were included in this study. More than half of the participants were female. Overall, the prevalence of severe recurrent malaria was 66.1% (191) while 74.4% (215) did not complete malaria treatment. Among those who did not complete malaria treatment, 76.7% (165) had severe recurrent malaria, while among those who completed malaria treatment 35.1% (26) had severe recurrent malaria (p < 0.001). There is a significant association between marital status (OR 0.33, 95% CI 0.19–0.56, p < 0.001), employment status (OR 0.35, 95% CI 0.14–0.87, p = 0.024), the use of preventive measures (OR 3.82, 95% CI 1.81–8.43, p < 0.001) and nutrition status (OR 0.22, 95% CI 0.13–0.37, p < 0.001). When adjusted for employment, marital status, nutritional and prevention measures in turns using Mantel–Haenszel test of association, this effect remained statistically significant. Conclusions Our study showed that there is a high prevalence of severe recurrent malaria in South Sudan and that a significant relationship exists between severe recurrent malaria and antimalarial treatment dosage completion influenced by certain personal and social factors such as marital status, employment status, the use of preventive measures and nutrition status. Findings from our study would be useful for effective response to control and prevent malaria in endemic areas of South Sudan.
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Affiliation(s)
- Israel Oluwaseyidayo Idris
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan. .,Department of Social and Preventive Medicine, V.N Karazin Kharkiv National University, Kharkiv, Ukraine. .,Department of Population Health, Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, UK.
| | - Gabriel Omoniyi Ayeni
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan
| | - Ihoghosa Osamuyi Iyamu
- School of Population and Public Health (SPPH), University of British Columbia, Vancouver, Canada
| | - Ayomide Busayo Sina-Odunsi
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Regional Office for the East and Horn of Africa, International Organization for Migration, United Nations Migration Agency, Nairobi, Kenya
| | | | - Justin Geno Obwoya
- Department of Field Operation and Project Coordination, Health Pooled Fund, Juba, South Sudan
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Lubinda J, Haque U, Bi Y, Shad MY, Keellings D, Hamainza B, Moore AJ. Climate change and the dynamics of age-related malaria incidence in Southern Africa. ENVIRONMENTAL RESEARCH 2021; 197:111017. [PMID: 33766570 DOI: 10.1016/j.envres.2021.111017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/27/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
In the last decade, many malaria-endemic countries, like Zambia, have achieved significant reductions in malaria incidence among children <5 years old but face ongoing challenges in achieving similar progress against malaria in older age groups. In parts of Zambia, changing climatic and environmental factors are among those suspectedly behind high malaria incidence. Changes and variations in these factors potentially interfere with intervention program effectiveness and alter the distribution and incidence patterns of malaria differentially between young children and the rest of the population. We used parametric and non-parametric statistics to model the effects of climatic and socio-demographic variables on age-specific malaria incidence vis-à-vis control interventions. Linear regressions, mixed models, and Mann-Kendall tests were implemented to explore trends, changes in trends, and regress malaria incidence against environmental and intervention variables. Our study shows that while climate parameters affect the whole population, their impacts are felt most by people aged ≥5 years. Climate variables influenced malaria substantially more than mosquito nets and indoor residual spraying interventions. We establish that climate parameters negatively impact malaria control efforts by exacerbating the transmission conditions via more conducive temperature and rainfall environments, which are augmented by cultural and socioeconomic exposure mechanisms. We argue that an intensified communications and education intervention strategy for behavioural change specifically targeted at ≥5 aged population where incidence rates are increasing, is urgently required and call for further malaria stratification among the ≥5 age groups in the routine collection, analysis and reporting of malaria mortality and incidence data.
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Affiliation(s)
- Jailos Lubinda
- School of Geography and Environmental Sciences, Ulster University, Coleraine, UK; School of Computing, Engineering and Intelligent Systems, Ulster University, Londonderry, United Kingdom; School of Nursing, Faculty of Life & Health Sciences, Jordanstown, Newtownabbey, United Kingdom.
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Centre, Fort Worth, TX, 76107, USA; Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Yaxin Bi
- School of Computing, Ulster University, Jordanstown, Newtownabbey, UK
| | | | - David Keellings
- Department of Geography, University of Alabama, Tuscaloosa, AL, USA
| | - Busiku Hamainza
- Ministry of Health, National Malaria Elimination Center, Lusaka, Zambia
| | - Adrian J Moore
- School of Geography and Environmental Sciences, Ulster University, Coleraine, UK
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Lubinda J, Bi Y, Hamainza B, Haque U, Moore AJ. Modelling of malaria risk, rates, and trends: A spatiotemporal approach for identifying and targeting sub-national areas of high and low burden. PLoS Comput Biol 2021; 17:e1008669. [PMID: 33647029 PMCID: PMC7951982 DOI: 10.1371/journal.pcbi.1008669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/11/2021] [Accepted: 01/04/2021] [Indexed: 01/16/2023] Open
Abstract
While mortality from malaria continues to decline globally, incidence rates in many countries are rising. Within countries, spatial and temporal patterns of malaria vary across communities due to many different physical and social environmental factors. To identify those areas most suitable for malaria elimination or targeted control interventions, we used Bayesian models to estimate the spatiotemporal variation of malaria risk, rates, and trends to determine areas of high or low malaria burden compared to their geographical neighbours. We present a methodology using Bayesian hierarchical models with a Markov Chain Monte Carlo (MCMC) based inference to fit a generalised linear mixed model with a conditional autoregressive structure. We modelled clusters of similar spatiotemporal trends in malaria risk, using trend functions with constrained shapes and visualised high and low burden districts using a multi-criterion index derived by combining spatiotemporal risk, rates and trends of districts in Zambia. Our results indicate that over 3 million people in Zambia live in high-burden districts with either high mortality burden or high incidence burden coupled with an increasing trend over 16 years (2000 to 2015) for all age, under-five and over-five cohorts. Approximately 1.6 million people live in high-incidence burden areas alone. Using our method, we have developed a platform that can enable malaria programs in countries like Zambia to target those high-burden areas with intensive control measures while at the same time pursue malaria elimination efforts in all other areas. Our method enhances conventional approaches and measures to identify those districts which had higher rates and increasing trends and risk. This study provides a method and a means that can help policy makers evaluate intervention impact over time and adopt appropriate geographically targeted strategies that address the issues of both high-burden areas, through intensive control approaches, and low-burden areas, via specific elimination programs.
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Affiliation(s)
- Jailos Lubinda
- School of Geography and Environmental Sciences, Ulster University, Coleraine, United Kingdom
- School of Computing, Engineering and Intelligent Systems, Ulster University, Londonderry, United Kingdom
| | - Yaxin Bi
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Busiku Hamainza
- Ministry of Health, National Malaria Elimination Centre, Lusaka, Zambia
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Centre, Fort Worth, Texas, United States of America
- Department of Geography, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Adrian J. Moore
- School of Geography and Environmental Sciences, Ulster University, Coleraine, United Kingdom
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