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Spatio-temporal analysis of mortality among children under the age of five in Manhiça (Mozambique) during the period 1997-2005.

Escaramís G, Carrasco JL, Aponte JJ, Nhalungo D, Nhacolo A, Alonso P, Ascaso C - Int J Health Geogr (2011)

Bottom Line: The results showed that childhood mortality in all the area was modified from year to year describing a convex time-trend but the spatial pattern described by the neighbourhood-specific underlying mortality rates did not change during the entire period from 1997 to 2005, where neighbourhoods with highest risks are situated in the peripheral side of the district.The results of this study suggest that the health intervention programmes established in Manhiça to alleviate the effects of flooding on child mortality should cover a period of around five years and that special attention might be focused on eradicating malaria transmission.These outcomes also suggest the utility of suitably modelling space-time trend variations in a region when a point effect of an environmental factor affects all the study area.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bioestadística, Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Background: Reducing childhood mortality is the fourth goal of the Millennium Development Goals agreed at the United Nations Millennium Summit in September 2000. However, childhood mortality in developing countries remains high. Providing an accurate picture of space and time-trend variations in child mortality in a region might generate further ideas for health planning actions to achieve such a reduction. The purpose of this study was to examine the spatio-temporal variation for child mortality rates in Manhiça, a district within the Maputo province of southern rural Mozambique during the period 1997-2005 using a proper generalized linear mixed model.

Results: The results showed that childhood mortality in all the area was modified from year to year describing a convex time-trend but the spatial pattern described by the neighbourhood-specific underlying mortality rates did not change during the entire period from 1997 to 2005, where neighbourhoods with highest risks are situated in the peripheral side of the district. The spatial distribution, though more blurred here, was similar to the spatial distribution of child malaria incidence in the same area. The peak in mortality rates observed in 2001 could have been caused by the precipitation system that started in early February 2000, following which heavy rains flooded parts of Mozambique's southern provinces. However, the mortality rates at the end of the period returned to initial values.

Conclusions: The results of this study suggest that the health intervention programmes established in Manhiça to alleviate the effects of flooding on child mortality should cover a period of around five years and that special attention might be focused on eradicating malaria transmission. These outcomes also suggest the utility of suitably modelling space-time trend variations in a region when a point effect of an environmental factor affects all the study area.

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Point predictions of relative risks for child mortality in Manhiça district, derived from the Poisson regression mixed model corresponding from left to right to: 1997, 1999, 2001, 2003 and 2005.
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Figure 3: Point predictions of relative risks for child mortality in Manhiça district, derived from the Poisson regression mixed model corresponding from left to right to: 1997, 1999, 2001, 2003 and 2005.

Mentions: Figure 3 describes the spatio-temporal variability of the neighbourhood-specific relative risks. For the sake of simplicity maps for the years 1997, 1999, 2001, 2003 and 2005 are shown, while the remaining years in the study period are taken as intermediate steps. It can be seen that the highest rates of child mortality are reached in 2001, although the situation returns to initial values in 2005, with a very similar spatial pattern along the whole period analysed, where the biggest cluster with lower relative risks is situated in the west-central side of the district. The slight difference of the spatial pattern of the relative risks across years is due to the little changes of the socio-demographic indicators during the period under consideration.


Spatio-temporal analysis of mortality among children under the age of five in Manhiça (Mozambique) during the period 1997-2005.

Escaramís G, Carrasco JL, Aponte JJ, Nhalungo D, Nhacolo A, Alonso P, Ascaso C - Int J Health Geogr (2011)

Point predictions of relative risks for child mortality in Manhiça district, derived from the Poisson regression mixed model corresponding from left to right to: 1997, 1999, 2001, 2003 and 2005.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3050678&req=5

Figure 3: Point predictions of relative risks for child mortality in Manhiça district, derived from the Poisson regression mixed model corresponding from left to right to: 1997, 1999, 2001, 2003 and 2005.
Mentions: Figure 3 describes the spatio-temporal variability of the neighbourhood-specific relative risks. For the sake of simplicity maps for the years 1997, 1999, 2001, 2003 and 2005 are shown, while the remaining years in the study period are taken as intermediate steps. It can be seen that the highest rates of child mortality are reached in 2001, although the situation returns to initial values in 2005, with a very similar spatial pattern along the whole period analysed, where the biggest cluster with lower relative risks is situated in the west-central side of the district. The slight difference of the spatial pattern of the relative risks across years is due to the little changes of the socio-demographic indicators during the period under consideration.

Bottom Line: The results showed that childhood mortality in all the area was modified from year to year describing a convex time-trend but the spatial pattern described by the neighbourhood-specific underlying mortality rates did not change during the entire period from 1997 to 2005, where neighbourhoods with highest risks are situated in the peripheral side of the district.The results of this study suggest that the health intervention programmes established in Manhiça to alleviate the effects of flooding on child mortality should cover a period of around five years and that special attention might be focused on eradicating malaria transmission.These outcomes also suggest the utility of suitably modelling space-time trend variations in a region when a point effect of an environmental factor affects all the study area.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bioestadística, Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Background: Reducing childhood mortality is the fourth goal of the Millennium Development Goals agreed at the United Nations Millennium Summit in September 2000. However, childhood mortality in developing countries remains high. Providing an accurate picture of space and time-trend variations in child mortality in a region might generate further ideas for health planning actions to achieve such a reduction. The purpose of this study was to examine the spatio-temporal variation for child mortality rates in Manhiça, a district within the Maputo province of southern rural Mozambique during the period 1997-2005 using a proper generalized linear mixed model.

Results: The results showed that childhood mortality in all the area was modified from year to year describing a convex time-trend but the spatial pattern described by the neighbourhood-specific underlying mortality rates did not change during the entire period from 1997 to 2005, where neighbourhoods with highest risks are situated in the peripheral side of the district. The spatial distribution, though more blurred here, was similar to the spatial distribution of child malaria incidence in the same area. The peak in mortality rates observed in 2001 could have been caused by the precipitation system that started in early February 2000, following which heavy rains flooded parts of Mozambique's southern provinces. However, the mortality rates at the end of the period returned to initial values.

Conclusions: The results of this study suggest that the health intervention programmes established in Manhiça to alleviate the effects of flooding on child mortality should cover a period of around five years and that special attention might be focused on eradicating malaria transmission. These outcomes also suggest the utility of suitably modelling space-time trend variations in a region when a point effect of an environmental factor affects all the study area.

Show MeSH
Related in: MedlinePlus