Multilevel and geo-statistical modeling of malaria risk in children of Burkina Faso

Particle and Fibre Toxicology

Annie Robert²  Marcia C Castro¹  Mathilde De Keukeleire³  Fati Kirakoya-Samadoulougou²  Mathieu Maheu-Giroux¹  Sekou Samadoulougou² 

[1] Department of Global Health & Population, Harvard School of Public Health, Boston, MA, USA;Pôle Epidémiologie et Biostatistique (EPID), Institut de Recherche Expérimentale et Clinique (IREC), Faculté de Santé Publique (FSP), Université catholique de Louvain (UCL), Clos Chapelle-aux-champs 30, bte B1.30.13, 1200 Bruxelles, Belgium;Georges Lemaitre Center for Earth and Climate Research, Earth and Life Institute (ELI), Université catholique de Louvain (UCL), Louvain-la-Neuve, Belgium

关键词: Integrated Nested Laplace Approximation;    Malaria burden;    Bayesian variable selection;    Random effect models;    Geo-statistics;    Plasmodium falciparum;    Burkina Faso;   

Others  :  1181886
DOI  :  10.1186/1756-3305-7-350

 received in 2014-03-03, accepted in 2014-07-19,  发布年份 2014

【 摘 要 】

Background

Previous research on determinants of malaria in Burkina Faso has largely focused on individual risk factors. Malaria risk, however, is also shaped by community, health system, and climatic/environmental characteristics. The aims of this study were: i) to identify such individual, household, community, and climatic/environmental risk factors for malaria in children under five years of age, and ii) to produce a parasitaemia risk map of Burkina Faso.

Methods

The 2010 Demographic and Health Survey (DHS) was the first in Burkina Faso that tested children for malaria parasitaemia. Multilevel and geo-statistical models were used to explore determinants of malaria using this nationally representative database.

Results

Parasitaemia was collected from 6,102 children, of which 66.0% (95% confidence interval (CI): 64.0-68.0%) were positive for Plasmodium spp. Older children (>23 months) were more likely to be parasitaemic than younger ones, while children from wealthier households and whose mother had higher education were at a lower risk. At the community level, living in a district with a rate of attendance to health facilities lower than 2 visits per year was significantly associated with greater odds of being infected. Malaria prevalence was also associated with higher normalized difference vegetation index, lower average monthly rainfall, and lower population densities. Predicted malaria parasitaemia was spatially variable with locations falling within an 11%-92% prevalence range. The number of parasitaemic children was nonetheless concentrated in areas of high population density, albeit malaria risk was notably higher in the sparsely populated rural areas.

Conclusion

Malaria prevalence in Burkina Faso is considerably higher than in neighbouring countries. Our spatially-explicit population-based estimates of malaria risk and infected number of children could be used by local decision-makers to identify priority areas where control efforts should be enhanced.

【 授权许可】

   
2014 Samadoulougou et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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