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Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso

Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso
Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso

Background: In malaria endemic countries, asymptomatic cases constitute an important reservoir of infections sustaining transmission. Estimating the burden of the asymptomatic population and identifying areas with elevated risk is important for malaria control in Burkina Faso. This study analysed the spatial distribution of asymptomatic malaria infection among children under 5 in 24 health districts in Burkina Faso and identified the determinants of this distribution. Methods: The data used in this study were collected in a baseline survey on "evaluation of the impact of pay for performance on the quality of care" conducted in 24 health districts in Burkina Faso, between October 2013 and March 2014. This survey involved 7844 households and 1387 community health workers. A Bayesian hierarchical logistic model that included spatial dependence and covariates was implemented to identify the determinants of asymptomatic malaria infection. The posterior probability distribution of a parameter from the model was summarized using odds ratio (OR) and 95% credible interval (95% CI). Results: The overall prevalence of asymptomatic malaria infection in children under 5 years of age was estimated at 38.2%. However, significant variation was observed between districts ranging from 11.1% in the district of Barsalgho to 77.8% in the district of Gaoua. Older children (48-59 vs < 6 months: OR: 6.79 [5.62, 8.22]), children from very poor households (Richest vs poorest: OR: 0.85 [0.74-0.96]), households located more than 5 km from a health facility (< 5 km vs ≥ 5 km: OR: 1.14 [1.04-1.25]), in localities with inadequate number of nurses (< 3 vs ≥ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67 [1.39-2.01]) and those surveyed in high transmission period of asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk for asymptomatic malaria infection. In addition, the spatial analysis identified the following nine districts that reported significantly higher risks: Batié, Boromo, Dano, Diébougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The district of Zabré reported the lowest risk. Conclusion: The analysis of spatial distribution of infectious reservoir allowed the identification of risk areas as well as the identification of individual and contextual factors. Such national spatial analysis should help to prioritize areas for increased malaria control activities.

Bayesian, Burkina Faso, Health district, Malaria, Map, Spatial
1475-2875
Ouédraogo, Mady
2961dc7b-7767-44cf-8abd-05d2ef14bd6d
Samadoulougou, Sékou
ce6f48a6-e05f-427f-9abc-dea2960d7807
Rouamba, Toussaint
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Hien, Hervé
4f1a7ef4-c78b-4027-9b8a-360ab9fb1bf7
Sawadogo, John E.M.
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Tinto, Halidou
8f149b48-e65f-4ae7-9e4e-5d7923e61c85
Alegana, Victor A.
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Speybroeck, Niko
885e2e5d-83b8-4695-9fc9-c9e3b00bccf3
Kirakoya-Samadoulougou, Fati
7198d2b2-fc56-4251-a9b6-3fe512c105a5
Ouédraogo, Mady
2961dc7b-7767-44cf-8abd-05d2ef14bd6d
Samadoulougou, Sékou
ce6f48a6-e05f-427f-9abc-dea2960d7807
Rouamba, Toussaint
6c1b9f83-cf67-4594-96a6-ab29fd0af593
Hien, Hervé
4f1a7ef4-c78b-4027-9b8a-360ab9fb1bf7
Sawadogo, John E.M.
4dffa863-63fd-4b42-bc40-8a2e1e45e25f
Tinto, Halidou
8f149b48-e65f-4ae7-9e4e-5d7923e61c85
Alegana, Victor A.
f5bd6ab7-459e-4122-984f-2bdb5f906d82
Speybroeck, Niko
885e2e5d-83b8-4695-9fc9-c9e3b00bccf3
Kirakoya-Samadoulougou, Fati
7198d2b2-fc56-4251-a9b6-3fe512c105a5

Ouédraogo, Mady, Samadoulougou, Sékou, Rouamba, Toussaint, Hien, Hervé, Sawadogo, John E.M., Tinto, Halidou, Alegana, Victor A., Speybroeck, Niko and Kirakoya-Samadoulougou, Fati (2018) Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso. Malaria Journal, 17 (1). (doi:10.1186/s12936-018-2606-9).

Record type: Article

Abstract

Background: In malaria endemic countries, asymptomatic cases constitute an important reservoir of infections sustaining transmission. Estimating the burden of the asymptomatic population and identifying areas with elevated risk is important for malaria control in Burkina Faso. This study analysed the spatial distribution of asymptomatic malaria infection among children under 5 in 24 health districts in Burkina Faso and identified the determinants of this distribution. Methods: The data used in this study were collected in a baseline survey on "evaluation of the impact of pay for performance on the quality of care" conducted in 24 health districts in Burkina Faso, between October 2013 and March 2014. This survey involved 7844 households and 1387 community health workers. A Bayesian hierarchical logistic model that included spatial dependence and covariates was implemented to identify the determinants of asymptomatic malaria infection. The posterior probability distribution of a parameter from the model was summarized using odds ratio (OR) and 95% credible interval (95% CI). Results: The overall prevalence of asymptomatic malaria infection in children under 5 years of age was estimated at 38.2%. However, significant variation was observed between districts ranging from 11.1% in the district of Barsalgho to 77.8% in the district of Gaoua. Older children (48-59 vs < 6 months: OR: 6.79 [5.62, 8.22]), children from very poor households (Richest vs poorest: OR: 0.85 [0.74-0.96]), households located more than 5 km from a health facility (< 5 km vs ≥ 5 km: OR: 1.14 [1.04-1.25]), in localities with inadequate number of nurses (< 3 vs ≥ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67 [1.39-2.01]) and those surveyed in high transmission period of asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk for asymptomatic malaria infection. In addition, the spatial analysis identified the following nine districts that reported significantly higher risks: Batié, Boromo, Dano, Diébougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The district of Zabré reported the lowest risk. Conclusion: The analysis of spatial distribution of infectious reservoir allowed the identification of risk areas as well as the identification of individual and contextual factors. Such national spatial analysis should help to prioritize areas for increased malaria control activities.

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Accepted/In Press date: 1 December 2018
e-pub ahead of print date: 7 December 2018
Published date: 7 December 2018
Keywords: Bayesian, Burkina Faso, Health district, Malaria, Map, Spatial

Identifiers

Local EPrints ID: 427013
URI: https://eprints.soton.ac.uk/id/eprint/427013
ISSN: 1475-2875
PURE UUID: bc24b523-20fa-4d41-84ff-df60f048000d
ORCID for Victor A. Alegana: ORCID iD orcid.org/0000-0001-5177-9227

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Date deposited: 20 Dec 2018 17:30
Last modified: 30 Nov 2019 01:31

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