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Published in: Malaria Journal 1/2011

Open Access 01-12-2011 | Research

Comparison of infant malaria incidence in districts of Maputo province, Mozambique

Authors: Orlando P Zacarias, Peter Majlender

Published in: Malaria Journal | Issue 1/2011

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Abstract

Background

Malaria is one of the principal health problems in Mozambique, representing 48% of total external consultations and 63% of paediatric hospital admissions in rural and general hospitals with 26.7% of total mortality. Plasmodium falciparum is responsible for 90% of all infections being also the species associated with most severe cases. The aim of this study was to identify zones of high malaria risk, showing their spatially and temporal pattern.

Methods

Space and time Poison model for the analysis of malaria data is proposed. This model allows for the inclusion of environmental factors: rainfall, temperature and humidity as predictor variables. Modelling and inference use the fully Bayesian approach via Markov Chain Monte Carlo (MCMC) simulation techniques. The methodology is applied to analyse paediatric data arising from districts of Maputo province, Mozambique, between 2007 and 2008.

Results

Malaria incidence risk is greater for children in districts of Manhiça, Matola and Magude. Rainfall and humidity are significant predictors of malaria incidence. The risk increased with rainfall (relative risk - RR: .006761, 95% interval: .001874, .01304), and humidity (RR: .049, 95% interval: .03048, .06531). Malaria incidence was found to be independent of temperature.

Conclusions

The model revealed a spatial and temporal pattern of malaria incidence. These patterns were found to exhibit a stable malaria transmission in most non-coastal districts. The findings may be useful for malaria control, planning and management.
Appendix
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Literature
1.
go back to reference Breman JG: The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg. 2001, 64 (S): 1-11.PubMed Breman JG: The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg. 2001, 64 (S): 1-11.PubMed
2.
go back to reference Breman JG, Alilio MS, Mills A: Conquering the intolerable burden of malaria:what's new, what's needed: summary. Am J Trop Med Hyg. 2004, 71 (S2): 1-15.PubMed Breman JG, Alilio MS, Mills A: Conquering the intolerable burden of malaria:what's new, what's needed: summary. Am J Trop Med Hyg. 2004, 71 (S2): 1-15.PubMed
3.
go back to reference Campbell JD, Sow SO, Levine MM, Kotloff KL: The causes of hospital admission and death among children in Bamako, Mali. J Trop Ped. 2004, 50: 158-163. 10.1093/tropej/50.3.158.CrossRef Campbell JD, Sow SO, Levine MM, Kotloff KL: The causes of hospital admission and death among children in Bamako, Mali. J Trop Ped. 2004, 50: 158-163. 10.1093/tropej/50.3.158.CrossRef
4.
go back to reference Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, Tulloch S, Oldfield FS, Hayes R: Mortality and morbidity from malaria among children in a rural area of the Gambia. Trans R Soc Trop Med Hyg. 1987, 81: 478-486. 10.1016/0035-9203(87)90170-2.CrossRefPubMed Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, Tulloch S, Oldfield FS, Hayes R: Mortality and morbidity from malaria among children in a rural area of the Gambia. Trans R Soc Trop Med Hyg. 1987, 81: 478-486. 10.1016/0035-9203(87)90170-2.CrossRefPubMed
5.
go back to reference Greenwood BM, Marsh K, Snow EW: Why some children develop severe malaria?. Parasitol Today. 1991, 7: 277-288. 10.1016/0169-4758(91)90096-7.CrossRefPubMed Greenwood BM, Marsh K, Snow EW: Why some children develop severe malaria?. Parasitol Today. 1991, 7: 277-288. 10.1016/0169-4758(91)90096-7.CrossRefPubMed
6.
go back to reference Camargo LMA, Ferreira MU, Krieger H, Camargo EP, Silva LP: Unstable hypoendemic malaria in Rondonia (Western Amazon Region, Brazil): epidemic outbreaks and work - associated incidence in a agroindustrial rural settlement. Am J Trop Med Hyg. 1994, 51: 16-25.PubMed Camargo LMA, Ferreira MU, Krieger H, Camargo EP, Silva LP: Unstable hypoendemic malaria in Rondonia (Western Amazon Region, Brazil): epidemic outbreaks and work - associated incidence in a agroindustrial rural settlement. Am J Trop Med Hyg. 1994, 51: 16-25.PubMed
7.
go back to reference Abellana R, Ascaso C, Saute F, Nhalungo D, Delino A, Alonso P: Spatio-seasonal modelling of the incidence rate of malaria in Mozambique. Malar J. 2008, 7: 228-10.1186/1475-2875-7-228.PubMedCentralCrossRefPubMed Abellana R, Ascaso C, Saute F, Nhalungo D, Delino A, Alonso P: Spatio-seasonal modelling of the incidence rate of malaria in Mozambique. Malar J. 2008, 7: 228-10.1186/1475-2875-7-228.PubMedCentralCrossRefPubMed
8.
go back to reference Schellenberg JA, Newell JN, Snow RW, Mung'ala V, Marsh K, Smith PG, Hayes RJ: An analysis of the geographical distribution of severe malaria in children in Kilifi district, Kenya. Int J Epidemiol. 1998, 27: 323-329. 10.1093/ije/27.2.323.CrossRefPubMed Schellenberg JA, Newell JN, Snow RW, Mung'ala V, Marsh K, Smith PG, Hayes RJ: An analysis of the geographical distribution of severe malaria in children in Kilifi district, Kenya. Int J Epidemiol. 1998, 27: 323-329. 10.1093/ije/27.2.323.CrossRefPubMed
9.
go back to reference Snow RW, Schellenberg JA, Peshu N, Forster D, Newton CR, Winstanley PA, Mwangi I, Waruiru C, Warn PA, Newbold C: Periodicity and space-time clustering of severe childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg. 1993, 87: 386-390. 10.1016/0035-9203(93)90007-D.CrossRefPubMed Snow RW, Schellenberg JA, Peshu N, Forster D, Newton CR, Winstanley PA, Mwangi I, Waruiru C, Warn PA, Newbold C: Periodicity and space-time clustering of severe childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg. 1993, 87: 386-390. 10.1016/0035-9203(93)90007-D.CrossRefPubMed
10.
go back to reference National Malaria Control Programme. 2007, Republic of Mozambique, Maputo National Malaria Control Programme. 2007, Republic of Mozambique, Maputo
11.
go back to reference Gething PW, Noor AM, Gikandi PW, Ogara EAA, Altkinson PW, Hay SI, Nixon MS, Snow RW: Improving imperfect data from health management information systems in Africa using space-time geostatistics. PLoS Med. 2006, 3: 271-10.1371/journal.pmed.0030271.CrossRef Gething PW, Noor AM, Gikandi PW, Ogara EAA, Altkinson PW, Hay SI, Nixon MS, Snow RW: Improving imperfect data from health management information systems in Africa using space-time geostatistics. PLoS Med. 2006, 3: 271-10.1371/journal.pmed.0030271.CrossRef
12.
go back to reference Zacarias OP, Andersson M: Mapping malaria incidence that accounts for environmental factors in Maputo province-Mozambique. Malar J. 2010, 9: 79-10.1186/1475-2875-9-79.PubMedCentralCrossRefPubMed Zacarias OP, Andersson M: Mapping malaria incidence that accounts for environmental factors in Maputo province-Mozambique. Malar J. 2010, 9: 79-10.1186/1475-2875-9-79.PubMedCentralCrossRefPubMed
13.
go back to reference The R Foundation for Statistical Computing. Version 2.6.2 ISBN 3-900051-07-0 The R Foundation for Statistical Computing. Version 2.6.2 ISBN 3-900051-07-0
14.
go back to reference Richardscon S, Abellan JJ, Best N: Bayesian spatio-temporal analysis of joint patterns of male and female lung cancer risks in Yorkshire (UK). Statistical Methods in Medical Research. 2006, 15: 385-407. 10.1191/0962280206sm458oa.CrossRef Richardscon S, Abellan JJ, Best N: Bayesian spatio-temporal analysis of joint patterns of male and female lung cancer risks in Yorkshire (UK). Statistical Methods in Medical Research. 2006, 15: 385-407. 10.1191/0962280206sm458oa.CrossRef
15.
go back to reference Thomas A, Best N, Lunn D, Arnold R, Spiegelhalter D:Winbugs - GeoBUGS User Manual, Version 1.2. 2004, Thomas A, Best N, Lunn D, Arnold R, Spiegelhalter D:Winbugs - GeoBUGS User Manual, Version 1.2. 2004,
16.
go back to reference Molineaux L: The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. Malaria: Principles and Pratices of Malariology. Edited by: Wernsdorfer WH, McGregor I. 1988, Churchill Livingstone, London, 2: 931-998. Molineaux L: The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. Malaria: Principles and Pratices of Malariology. Edited by: Wernsdorfer WH, McGregor I. 1988, Churchill Livingstone, London, 2: 931-998.
17.
go back to reference Kazembe N, Lawrence N: Spatial modelling and risk factors of malaria incidence in northern Malawi. Acta Trop. 2007, 102: 126-137. 10.1016/j.actatropica.2007.04.012.CrossRefPubMed Kazembe N, Lawrence N: Spatial modelling and risk factors of malaria incidence in northern Malawi. Acta Trop. 2007, 102: 126-137. 10.1016/j.actatropica.2007.04.012.CrossRefPubMed
18.
go back to reference Baume C, Helitzer D, Katchur SP: Patterns of care for childhood malaria in Zambia. Soc Sci Med. 2000, 51: 1491-1503. 10.1016/S0277-9536(00)00049-6.CrossRefPubMed Baume C, Helitzer D, Katchur SP: Patterns of care for childhood malaria in Zambia. Soc Sci Med. 2000, 51: 1491-1503. 10.1016/S0277-9536(00)00049-6.CrossRefPubMed
19.
go back to reference Molyneux CS, Mung'ala-Odera V, Harpham T, Snow RW: Maternal responses to childhood fevers: a comparison of rural and urban residents in costal Kenya. Trop Med Int Health. 1999, 4: 836-845. 10.1046/j.1365-3156.1999.00489.x.CrossRefPubMed Molyneux CS, Mung'ala-Odera V, Harpham T, Snow RW: Maternal responses to childhood fevers: a comparison of rural and urban residents in costal Kenya. Trop Med Int Health. 1999, 4: 836-845. 10.1046/j.1365-3156.1999.00489.x.CrossRefPubMed
20.
go back to reference Mabaso MLH, Craig M, Vounatsou P, Smith T: Towards empirical description of malaria seasonality in southern Africa: the example of Zimbabwe. Trop Med Int Health. 2005, 10: 909-918. 10.1111/j.1365-3156.2005.01462.x.CrossRefPubMed Mabaso MLH, Craig M, Vounatsou P, Smith T: Towards empirical description of malaria seasonality in southern Africa: the example of Zimbabwe. Trop Med Int Health. 2005, 10: 909-918. 10.1111/j.1365-3156.2005.01462.x.CrossRefPubMed
21.
go back to reference Kleinschmidt I, Sharp BL, Mueller I, Vounatsou P: Rise in malaria incidence rates in South Africa: A small-area spatial analysis of variation in time trends. Am J Epidemiol. 2002, 155: 257-264. 10.1093/aje/155.3.257.CrossRefPubMed Kleinschmidt I, Sharp BL, Mueller I, Vounatsou P: Rise in malaria incidence rates in South Africa: A small-area spatial analysis of variation in time trends. Am J Epidemiol. 2002, 155: 257-264. 10.1093/aje/155.3.257.CrossRefPubMed
22.
go back to reference Kleinschmidt I, Sharp BL, Clarke CPY, Curtis B, Frasez C: Use of generalized linear mixed models in the spatial analysis of small area malaria incidence rates in KwaZulu Natal, South Africa. Am J Epidemiol. 2001, 153: 1213-1221. 10.1093/aje/153.12.1213.CrossRefPubMed Kleinschmidt I, Sharp BL, Clarke CPY, Curtis B, Frasez C: Use of generalized linear mixed models in the spatial analysis of small area malaria incidence rates in KwaZulu Natal, South Africa. Am J Epidemiol. 2001, 153: 1213-1221. 10.1093/aje/153.12.1213.CrossRefPubMed
23.
go back to reference Lindelow M: The utilization of curative health care in Mozambique: Does income matter. J African Economies. 2005, 14: 435-482. 10.1093/jae/eji015.CrossRef Lindelow M: The utilization of curative health care in Mozambique: Does income matter. J African Economies. 2005, 14: 435-482. 10.1093/jae/eji015.CrossRef
24.
go back to reference Enosse S, Mabunda S, Thompson R: Sensibilidade in vivo e prevalencia de marcadores genéticos da resistência do Plasmodium falciparum a sulfadoxina-pirimetamina no decurso de uma epedemia de malária no sul de Moçambique. XI Jornadas de Saúde. 2001, Abstract book, - 67 Enosse S, Mabunda S, Thompson R: Sensibilidade in vivo e prevalencia de marcadores genéticos da resistência do Plasmodium falciparum a sulfadoxina-pirimetamina no decurso de uma epedemia de malária no sul de Moçambique. XI Jornadas de Saúde. 2001, Abstract book, - 67
25.
go back to reference Clements AC, Barnett AG, Cheng ZW, Snow RW, Zhou HN: Space-time variation of malaria incidence in Yunnan province, China. Malar J. 2009, 8: 180-10.1186/1475-2875-8-180.PubMedCentralCrossRefPubMed Clements AC, Barnett AG, Cheng ZW, Snow RW, Zhou HN: Space-time variation of malaria incidence in Yunnan province, China. Malar J. 2009, 8: 180-10.1186/1475-2875-8-180.PubMedCentralCrossRefPubMed
Metadata
Title
Comparison of infant malaria incidence in districts of Maputo province, Mozambique
Authors
Orlando P Zacarias
Peter Majlender
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2011
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-10-93

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