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Geostatistical modelling of malaria indicator survey data to assess the effects of interventions on the geographical distribution of malaria prevalence in children less than 5 years in Uganda

Author

Listed:
  • Julius Ssempiira
  • Betty Nambuusi
  • John Kissa
  • Bosco Agaba
  • Fredrick Makumbi
  • Simon Kasasa
  • Penelope Vounatsou

Abstract

Background: Malaria burden in Uganda has declined disproportionately among regions despite overall high intervention coverage across all regions. The Uganda Malaria Indicator Survey (MIS) 2014–15 was the second nationally representative survey conducted to provide estimates of malaria prevalence among children less than 5 years, and to track the progress of control interventions in the country. In this present study, 2014–15 MIS data were analysed to assess intervention effects on malaria prevalence in Uganda among children less than 5 years, assess intervention effects at regional level, and estimate geographical distribution of malaria prevalence in the country. Methods: Bayesian geostatistical models with spatially varying coefficients were used to determine the effect of interventions on malaria prevalence at national and regional levels. Spike-and-slab variable selection was used to identify the most important predictors and forms. Bayesian kriging was used to predict malaria prevalence at unsampled locations. Results: Indoor Residual Spraying (IRS) and Insecticide Treated Nets (ITN) ownership had a significant but varying protective effect on malaria prevalence. However, no effect was observed for Artemisinin Combination-based Therapies (ACTs). Environmental factors, namely, land cover, rainfall, day and night land surface temperature, and area type were significantly associated with malaria prevalence. Malaria prevalence was higher in rural areas, increased with the child’s age, and decreased with higher household socioeconomic status and higher level of mother’s education. The highest prevalence of malaria in children less than 5 years was predicted for regions of East Central, North East and West Nile, whereas the lowest was predicted in Kampala and South Western regions, and in the mountainous areas in Mid-Western and Mid-Eastern regions. Conclusions: IRS and ITN ownership are important interventions against malaria prevalence in children less than 5 years in Uganda. The varying effects of the interventions calls for selective implementation of control tools suitable to regional ecological settings. To further reduce malaria burden and sustain malaria control in Uganda, current tools should be supplemented by health system strengthening, and socio-economic development.

Suggested Citation

  • Julius Ssempiira & Betty Nambuusi & John Kissa & Bosco Agaba & Fredrick Makumbi & Simon Kasasa & Penelope Vounatsou, 2017. "Geostatistical modelling of malaria indicator survey data to assess the effects of interventions on the geographical distribution of malaria prevalence in children less than 5 years in Uganda," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-20, April.
  • Handle: RePEc:plo:pone00:0174948
    DOI: 10.1371/journal.pone.0174948
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    References listed on IDEAS

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    1. Paul Isolo Mukwaya & Hannington Sengendo & Shuaib Lwasa, 2010. "Urban Development Transitions and their Implications for Poverty Reduction and Policy Planning in Uganda," WIDER Working Paper Series wp-2010-045, World Institute for Development Economic Research (UNU-WIDER).
    2. Peter J. Diggle & Emanuele Giorgi, 2016. "Model-Based Geostatistics for Prevalence Mapping in Low-Resource Settings," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 111(515), pages 1096-1120, July.
    3. Mukwaya, Paul Isolo & Sengendo, Hannington & Lwasa, Shuaib, 2010. "Urban Development Transitions and their Implications for Poverty Reduction and Policy Planning in Uganda," WIDER Working Paper Series 045, World Institute for Development Economic Research (UNU-WIDER).
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    Cited by:

    1. Faustin Habyarimana & Shaun Ramroop, 2020. "Prevalence and Risk Factors Associated with Malaria among Children Aged Six Months to 14 Years Old in Rwanda: Evidence from 2017 Rwanda Malaria Indicator Survey," IJERPH, MDPI, vol. 17(21), pages 1-13, October.
    2. Samuel Manda & Ndamonaonghenda Haushona & Robert Bergquist, 2020. "A Scoping Review of Spatial Analysis Approaches Using Health Survey Data in Sub-Saharan Africa," IJERPH, MDPI, vol. 17(9), pages 1-20, April.
    3. Krzysztof Korzeniewski & Emilia Bylicka-Szczepanowska & Anna Lass, 2021. "Prevalence of Asymptomatic Malaria Infections in Seemingly Healthy Children, the Rural Dzanga Sangha Region, Central African Republic," IJERPH, MDPI, vol. 18(2), pages 1-14, January.

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