Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity
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Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity. / Kreuels, Benno; Kobbe, Robin; Adjei, Samuel; Kreuzberg, Christina; von Reden, Claudia; Bäter, Kathrin; Klug, Stefan; Busch, Wibke; Adjei, Ohene; May, Jürgen.
In: J INFECT DIS, Vol. 197, No. 1, 01.01.2008, p. 85-93.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -