Assessing the Effects of Mosquito Nets on Malaria Mortality Using a Space Time Model: A Case Study of Rufiji and Ifakara Health and Demographic Surveillance System Sites in Rural Tanzania
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Although malaria decline has been observed in most sub-Saharan African countries, the disease still
represents a significant public health burden in Tanzania. There are contradictions on the effect of ownership of at
least one mosquito net at household on malaria mortality. This study presents a Bayesian modelling framework for the
analysis of the effect of ownership of at least one mosquito net at household on malaria mortality with environmental
factors as confounder variables.
Methods: The analysis used longitudinal data collected in Rufiji and Ifakara Health Demographic Surveillance System
(HDSS) sites for the period of 1999–2011 and 2002–2012, respectively. Bayesian framework modelling approach using
integrated nested laplace approximation (INLA) package in R software was used. The space time models were established
to assess the effect of ownership of mosquito net on malaria mortality in 58 villages in the study area.
Results: The results show that an increase of 10 % in ownership of mosquito nets at village level had an average of
5.2 % decrease inall age malaria deaths (IRR = 0.948, 95 % CI = 0.917, 0.977) in Rufiji HDSS and 12.1 % decrease in all
age malaria deaths (IRR = 0.879, 95 % CI = 0.806, 0.959) in Ifakara HDSS. In children under 5 years, results show an
average of 5.4 % decrease of malaria deaths (IRR = 0.946, 95 % CI = 0.909, 0.982) in Rufiji HDSS and 10 % decrease of
malaria deaths (IRR = 0.899, 95 % CI = 0.816, 0.995) in Ifakara HDSS. Model comparison show that model with spatial
and temporal random effects was the best fitting model compared to other models without spatial and temporal,
and with spatial–temporal interaction effects.
Conclusion: This modelling framework is appropriate and provides useful approaches to understanding the effect
of mosquito nets for targeting malaria control intervention. Furthermore, ownership of mosquito nets at household
showed a significant impact on malaria mortality.
Description
Keywords
Space time model, Malaria mortality
Citation
Selemani, M., Msengwa, A.S., Mrema, S., Shamte, A., Mahande, M.J., Yeates, K., Mbago, M.C. and Lutambi, A.M., 2016. Assessing the effects of mosquito nets on malaria mortality using a space time model: a case study of Rufiji and Ifakara Health and Demographic Surveillance System sites in rural Tanzania. Malaria Journal, 15(1), p.1.