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A geostatistical analysis of the association between armed conflicts and Plasmodium falciparum malaria in Africa, 1997–2010

A geostatistical analysis of the association between armed conflicts and Plasmodium falciparum malaria in Africa, 1997–2010
A geostatistical analysis of the association between armed conflicts and Plasmodium falciparum malaria in Africa, 1997–2010
Background
The absence of conflict in a country has been cited as a crucial factor affecting the operational feasibility of achieving malaria control and elimination, yet mixed evidence exists on the influence that conflicts have had on malaria transmission. Over the past two decades, Africa has seen substantial numbers of armed conflicts of varying length and scale, creating conditions that can disrupt control efforts and impact malaria transmission. However, very few studies have quantitatively assessed the associations between conflicts and malaria transmission, particularly in a consistent way across multiple countries.

Methods
In this analysis an explicit geostatistical, autoregressive, mixed model is employed to quantitatively assess the association between conflicts and variations in Plasmodium falciparum parasite prevalence across a 13-year period in sub-Saharan Africa.

Results
Analyses of geolocated, malaria prevalence survey variations against armed conflict data in general showed a wide, but short-lived impact of conflict events geographically. The number of countries with decreased P. falciparum parasite prevalence (17) is larger than the number of countries with increased transmission (12), and notably, some of the countries with the highest transmission pre-conflict were still found with lower transmission post-conflict. For four countries, there were no significant changes in parasite prevalence. Finally, distance from conflicts, duration of conflicts, violence of conflict, and number of conflicts were significant components in the model explaining the changes in P. falciparum parasite rate.

Conclusions
The results suggest that the maintenance of intervention coverage and provision of healthcare in conflict situations to protect vulnerable populations can maintain gains in even the most difficult of circumstances, and that conflict does not represent a substantial barrier to elimination goals.
plasmodium falciparum parasite rate 2–10, conflict density, violence, variogram, malaria control
1475-2875
Sedda, Luigi
ee74dbd8-4f61-4f7f-a4ff-a08ecbc57723
Qi, Qiuyin
e62d7d22-e00e-45ec-b385-91d18269e533
Tatem, Andrew J.
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Sedda, Luigi
ee74dbd8-4f61-4f7f-a4ff-a08ecbc57723
Qi, Qiuyin
e62d7d22-e00e-45ec-b385-91d18269e533
Tatem, Andrew J.
6c6de104-a5f9-46e0-bb93-a1a7c980513e

Sedda, Luigi, Qi, Qiuyin and Tatem, Andrew J. (2015) A geostatistical analysis of the association between armed conflicts and Plasmodium falciparum malaria in Africa, 1997–2010. Malaria Journal, 14 (1). (doi:10.1186/s12936-015-1024-5).

Record type: Article

Abstract

Background
The absence of conflict in a country has been cited as a crucial factor affecting the operational feasibility of achieving malaria control and elimination, yet mixed evidence exists on the influence that conflicts have had on malaria transmission. Over the past two decades, Africa has seen substantial numbers of armed conflicts of varying length and scale, creating conditions that can disrupt control efforts and impact malaria transmission. However, very few studies have quantitatively assessed the associations between conflicts and malaria transmission, particularly in a consistent way across multiple countries.

Methods
In this analysis an explicit geostatistical, autoregressive, mixed model is employed to quantitatively assess the association between conflicts and variations in Plasmodium falciparum parasite prevalence across a 13-year period in sub-Saharan Africa.

Results
Analyses of geolocated, malaria prevalence survey variations against armed conflict data in general showed a wide, but short-lived impact of conflict events geographically. The number of countries with decreased P. falciparum parasite prevalence (17) is larger than the number of countries with increased transmission (12), and notably, some of the countries with the highest transmission pre-conflict were still found with lower transmission post-conflict. For four countries, there were no significant changes in parasite prevalence. Finally, distance from conflicts, duration of conflicts, violence of conflict, and number of conflicts were significant components in the model explaining the changes in P. falciparum parasite rate.

Conclusions
The results suggest that the maintenance of intervention coverage and provision of healthcare in conflict situations to protect vulnerable populations can maintain gains in even the most difficult of circumstances, and that conflict does not represent a substantial barrier to elimination goals.

Full text not available from this repository.

More information

Accepted/In Press date: 27 November 2015
e-pub ahead of print date: 16 December 2015
Published date: 16 December 2015
Keywords: plasmodium falciparum parasite rate 2–10, conflict density, violence, variogram, malaria control
Organisations: Global Env Change & Earth Observation, WorldPop, Geography & Environment, Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 385176
URI: https://eprints.soton.ac.uk/id/eprint/385176
ISSN: 1475-2875
PURE UUID: e02be5c3-3ee4-4fad-aa82-c31a3050686c
ORCID for Andrew J. Tatem: ORCID iD orcid.org/0000-0002-7270-941X

Catalogue record

Date deposited: 14 Jan 2016 13:06
Last modified: 20 Jul 2019 00:41

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Contributors

Author: Luigi Sedda
Author: Qiuyin Qi
Author: Andrew J. Tatem ORCID iD

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