The epidemiology and small-scale spatial heterogeneity of urinary schistosomiasis in Lusaka province, Zambia

Simoonga, Christopher and Kazembe, Lawrence N. and Kristensen, Thomas K. and Olsen, Annette and Appleton, Chris C. and Mubita, Patricia and Mubila, Likezo (2008) The epidemiology and small-scale spatial heterogeneity of urinary schistosomiasis in Lusaka province, Zambia. Geospatial health , 3 (1). pp. 57-67. ISSN 1970-7096

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Abstract

In line with the aims of the “National Bilharzia Control Programme” and the “School Health and Nutrition Programme” in Zambia, a study on urinary schistosomiasis was conducted in 20 primary schools of Lusaka province to further our understanding of the epidemiology of the infection, and to enhance spatial targeting of control. We investigated risk factors associated with urinary schistosomiasis, and examined small-scale spatial heterogeneity in prevalence, using data collected from 1,912 schoolchildren, 6 to 15-year-old, recruited from 20 schools in Kafue and Luangwa districts. The risk factors identified included geographical location, altitude, normalized difference vegetation index (NDVI), maximum temperature, age, sex of the child and intermediate host snail abundance. Three logistic regression models were fitted assuming different random effects to allow for spatial structuring. The mean prevalence rate was 9.6%, with significance difference between young and older children (odds ratio (OR) = 0.71; 95% confidence interval (CI) = 0.51-0.96). The risk of infection was related to intermediate host snail abundance (OR = 1.03; 95% CI = 1.00-1.05) and vegetation cover (OR = 1.04; 95% CI = 1.00-1.07). Schools located either on the plateau and the valley also differed in prevalence and intensity of infection for moderate infection to none (OR = 1.64; 95% CI = 1.36- 1.96). The overall predictive performance of the spatial random effects model was higher than the ordinary logistic regression. In addition, evidence of heterogeneity of the infection risk was found at the micro-geographical level. A sound understanding of small-scale heterogeneity, caused by spatial aggregation of schoolchildren, is important to inform health planners for implementing control schistosomiasis interventions.

Item Type:	Article
Uncontrolled Keywords:	urinary schistosomiasis, spatial epidemiology, Bayesian analysis, Zambia
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 614 Medicina legale; incidenza delle malattie; Medicina preventiva pubblica > 614.4 Incidenza delle malattie e misure pubblica per prevenirle (classificare qui l'Epidemiologia, l'Epidemiologia clinica) > 614.42 Incidenza delle malattie, e misure pubbliche per prevenirle. Incidenza (classificare qui la prevalenza; la Geografia medica; l'Epidemiologia spaziale; i rilevamenti sanitari) 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 614 Medicina legale; incidenza delle malattie; Medicina preventiva pubblica > 614.5 Incidenza di specifiche malattie e tipi di malattia e misure pubbliche per prevenirle > 614.55 Parassitosi e malattie causate da funghi (micosi) > 614.553 Malattie causate da trematodi (infezioni da trematodi) (Include la Schistosomiasi) 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.9 Altre malattie (altri rami della Medicina) > 616.96 Parassitosi, malattie causate da funghi (micosi) (classificare qui la Parassitologia medica) > 616.963 Malattie causate da trematodi (infezioni da trematodi) (include la schistosomiasi)
Depositing User:	biblioteca 7
Date Deposited:	30 Jun 2010 08:14
Last Modified:	07 Jul 2010 10:14
URI:	http://eprints.bice.rm.cnr.it/id/eprint/2823

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