Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity

TY - JOUR

T1 - Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity

AU - Kreuels, Benno

AU - Kobbe, Robin

AU - Adjei, Samuel

AU - Kreuzberg, Christina

AU - von Reden, Claudia

AU - Bäter, Kathrin

AU - Klug, Stefan

AU - Busch, Wibke

AU - Adjei, Ohene

AU - May, Jürgen

PY - 2008/1/1

Y1 - 2008/1/1

N2 - BACKGROUND: In sub-Saharan Africa, malaria is a leading cause of morbidity and mortality among young children. Detailed knowledge of spatial variation of malaria epidemiology and associated risk factors is important for planning and evaluating malaria-control measures.METHODS: The spatial variation of malaria incidences and socioeconomic factors were assessed over 21 months, from January 2003 to September 2005, in 535 children from 9 villages of a small rural area with high Plasmodium falciparum transmission in Ghana. Household positions were mapped by use of a global positioning system, and the spatial effects on malaria rates were assessed by means of ecological analyses and bivariate Poisson regression controlling for possible confounding factors.RESULTS: Malaria incidence was surprisingly heterogeneous between villages, and ecological analyses showed strong correlations with village area (R(2) = 0.74; P = .003) and population size (R(2) = 0.68; P = .006). Malaria risk was affected by a number of socioeconomic factors. Poisson regression showed an independent linear rate reduction with increasing distance between children's households and the fringe of the forest.CONCLUSIONS: The exact location of households in villages is an independent and important factor for the variation of malaria incidence in children from high-transmission areas. This fact should be considered in the planning of intervention trials and in spatial targeting of malaria interventions at a local level.

AB - BACKGROUND: In sub-Saharan Africa, malaria is a leading cause of morbidity and mortality among young children. Detailed knowledge of spatial variation of malaria epidemiology and associated risk factors is important for planning and evaluating malaria-control measures.METHODS: The spatial variation of malaria incidences and socioeconomic factors were assessed over 21 months, from January 2003 to September 2005, in 535 children from 9 villages of a small rural area with high Plasmodium falciparum transmission in Ghana. Household positions were mapped by use of a global positioning system, and the spatial effects on malaria rates were assessed by means of ecological analyses and bivariate Poisson regression controlling for possible confounding factors.RESULTS: Malaria incidence was surprisingly heterogeneous between villages, and ecological analyses showed strong correlations with village area (R(2) = 0.74; P = .003) and population size (R(2) = 0.68; P = .006). Malaria risk was affected by a number of socioeconomic factors. Poisson regression showed an independent linear rate reduction with increasing distance between children's households and the fringe of the forest.CONCLUSIONS: The exact location of households in villages is an independent and important factor for the variation of malaria incidence in children from high-transmission areas. This fact should be considered in the planning of intervention trials and in spatial targeting of malaria interventions at a local level.

KW - Animals

KW - Endemic Diseases

KW - Female

KW - Geographic Information Systems

KW - Ghana

KW - Humans

KW - Incidence

KW - Infant

KW - Malaria, Falciparum

KW - Male

KW - Prospective Studies

KW - Rural Population

KW - Topography, Medical

KW - Trees

U2 - 10.1086/524066

DO - 10.1086/524066

M3 - SCORING: Journal article

C2 - 18171290

VL - 197

SP - 85

EP - 93

JO - J INFECT DIS

JF - J INFECT DIS

SN - 0022-1899

IS - 1

ER -