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Bayesian spatial analysis of childhood diseases in Zimbabwe.

Tsiko RG - BMC Public Health (2015)

Bottom Line: The results suggest that until recently, sex of child had little or no significant association with childhood diseases.In addition, the link between sanitation, parental education, antenatal care, vaccination and childhood diseases was found to be both intuitive and counterintuitive.There is also clear evidence of significant high prevalence of childhood diseases in Mashonaland than in Matabeleland provinces.

View Article: PubMed Central - PubMed

Affiliation: Department of Geoinformatics and Surveying, University of Zimbabwe, P. O Box MP167, Mount Pleasant, Harare, Zimbabwe. tsikoruz@yahoo.com.

ABSTRACT

Background: Many sub-Saharan countries are confronted with persistently high levels of childhood morbidity and mortality because of the impact of a range of demographic, biological and social factors or situational events that directly precipitate ill health. In particular, under-five morbidity and mortality have increased in recent decades due to childhood diarrhoea, cough and fever. Understanding the geographic distribution of such diseases and their relationships to potential risk factors can be invaluable for cost effective intervention.

Methods: Bayesian semi-parametric regression models were used to quantify the spatial risk of childhood diarrhoea, fever and cough, as well as associations between childhood diseases and a range of factors, after accounting for spatial correlation between neighbouring areas. Such semi-parametric regression models allow joint analysis of non-linear effects of continuous covariates, spatially structured variation, unstructured heterogeneity, and other fixed effects on childhood diseases. Modelling and inference made use of the fully Bayesian approach via Markov Chain Monte Carlo (MCMC) simulation techniques. The analysis was based on data derived from the 1999, 2005/6 and 2010/11 Zimbabwe Demographic and Health Surveys (ZDHS).

Results and conclusions: The results suggest that until recently, sex of child had little or no significant association with childhood diseases. However, a higher proportion of male than female children within a given province had a significant association with childhood cough, fever and diarrhoea. Compared to their counterparts in rural areas, children raised in an urban setting had less exposure to cough, fever and diarrhoea across all the survey years with the exception of diarrhoea in 2010. In addition, the link between sanitation, parental education, antenatal care, vaccination and childhood diseases was found to be both intuitive and counterintuitive. Results also showed marked geographical differences in the prevalence of childhood diarrhoea, fever and cough. Across all the survey years Manicaland province reported the highest cases of childhood diseases. There is also clear evidence of significant high prevalence of childhood diseases in Mashonaland than in Matabeleland provinces.

No MeSH data available.


Related in: MedlinePlus

Study Area
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Fig1: Study Area

Mentions: The ZDHS samples were based on a stratified, two-stage cluster process. First, Enumeration Areas (EAs) were selected with equal probability across the 10 provinces of Zimbabwe (Fig. 1). There were 230 EAs for the 1999 survey, 400 for the 2005–6 survey, and 406 for the 2010–11 survey. Secondly, within each of these EAs, a complete household listing and mapping exercise was conducted, forming the basis of the second-stage sampling. All private households were listed. The list excluded people living in institutional households such as army barracks, hospitals, police camps etc. Households included in the survey were selected from the EA household lists, with the sample being proportional to the total number of households in the EA.Fig. 1


Bayesian spatial analysis of childhood diseases in Zimbabwe.

Tsiko RG - BMC Public Health (2015)

Study Area
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4556011&req=5

Fig1: Study Area
Mentions: The ZDHS samples were based on a stratified, two-stage cluster process. First, Enumeration Areas (EAs) were selected with equal probability across the 10 provinces of Zimbabwe (Fig. 1). There were 230 EAs for the 1999 survey, 400 for the 2005–6 survey, and 406 for the 2010–11 survey. Secondly, within each of these EAs, a complete household listing and mapping exercise was conducted, forming the basis of the second-stage sampling. All private households were listed. The list excluded people living in institutional households such as army barracks, hospitals, police camps etc. Households included in the survey were selected from the EA household lists, with the sample being proportional to the total number of households in the EA.Fig. 1

Bottom Line: The results suggest that until recently, sex of child had little or no significant association with childhood diseases.In addition, the link between sanitation, parental education, antenatal care, vaccination and childhood diseases was found to be both intuitive and counterintuitive.There is also clear evidence of significant high prevalence of childhood diseases in Mashonaland than in Matabeleland provinces.

View Article: PubMed Central - PubMed

Affiliation: Department of Geoinformatics and Surveying, University of Zimbabwe, P. O Box MP167, Mount Pleasant, Harare, Zimbabwe. tsikoruz@yahoo.com.

ABSTRACT

Background: Many sub-Saharan countries are confronted with persistently high levels of childhood morbidity and mortality because of the impact of a range of demographic, biological and social factors or situational events that directly precipitate ill health. In particular, under-five morbidity and mortality have increased in recent decades due to childhood diarrhoea, cough and fever. Understanding the geographic distribution of such diseases and their relationships to potential risk factors can be invaluable for cost effective intervention.

Methods: Bayesian semi-parametric regression models were used to quantify the spatial risk of childhood diarrhoea, fever and cough, as well as associations between childhood diseases and a range of factors, after accounting for spatial correlation between neighbouring areas. Such semi-parametric regression models allow joint analysis of non-linear effects of continuous covariates, spatially structured variation, unstructured heterogeneity, and other fixed effects on childhood diseases. Modelling and inference made use of the fully Bayesian approach via Markov Chain Monte Carlo (MCMC) simulation techniques. The analysis was based on data derived from the 1999, 2005/6 and 2010/11 Zimbabwe Demographic and Health Surveys (ZDHS).

Results and conclusions: The results suggest that until recently, sex of child had little or no significant association with childhood diseases. However, a higher proportion of male than female children within a given province had a significant association with childhood cough, fever and diarrhoea. Compared to their counterparts in rural areas, children raised in an urban setting had less exposure to cough, fever and diarrhoea across all the survey years with the exception of diarrhoea in 2010. In addition, the link between sanitation, parental education, antenatal care, vaccination and childhood diseases was found to be both intuitive and counterintuitive. Results also showed marked geographical differences in the prevalence of childhood diarrhoea, fever and cough. Across all the survey years Manicaland province reported the highest cases of childhood diseases. There is also clear evidence of significant high prevalence of childhood diseases in Mashonaland than in Matabeleland provinces.

No MeSH data available.


Related in: MedlinePlus