Abstract
The Greater Accra Region is the smallest of the 16 administrative regions in Ghana. It is highly populated and characterized by tropical climatic conditions. Although efforts towards malaria control in Ghana have had positive impacts, malaria remains in the top five diseases reported at healthcare facilities within the Greater Accra Region. To further accelerate progress, analysis of regionally generated data is needed to inform control and management measures at this level. This study aimed to examine the climatic drivers of malaria transmission in the Greater Accra Region and identify inter-district variation in malaria burden. Monthly malaria cases for the Greater Accra Region were obtained from the Ghanaian District Health Information and Management System. Malaria cases were decomposed using seasonal-trend decomposition, based on locally weighted regression to analyze seasonality. A negative binomial regression model with a conditional autoregressive prior structure was used to quantify associations between climatic variables and malaria risk and spatial dependence. Posterior parameters were estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling. A total of 1,105,370 malaria cases were recorded in the region from 2015 to 2019. The overall malaria incidence for the region was approximately 47 per 1000 population. Malaria transmission was highly seasonal with an irregular inter-annual pattern. Monthly malaria case incidence was found to decrease by 2.3% (95% credible interval: 0.7–4.2%) for each 1 °C increase in monthly minimum temperature. Only five districts located in the south-central part of the region had a malaria incidence rate lower than the regional average at >95% probability level. The distribution of malaria cases was heterogeneous, seasonal, and significantly associated with climatic variables. Targeted malaria control and prevention in high-risk districts at the appropriate time points could result in a significant reduction in malaria transmission in the Greater Accra Region.
Highlights
IntroductionThe disease is commonly transmitted through the bite of an infected female
Findings from this study showed a negative correlation between malaria and minimum temperature in the Greater Accra Region of Ghana from 2015 to 2019
The results reported in this study expand on knowledge regarding the influence of climatic factors on malaria transmission previously found in other parts of Ghana, sub–Saharan Africa, and other malaria endemic countries [14,33,37,47]
Summary
The disease is commonly transmitted through the bite of an infected female. Other routes include mother to child transmission, whereby infected cells from the mother are transferred to the fetus through the placenta, transfusion of infected blood to a healthy individual, donation of infected organs, and through needle stick injuries among healthcare workers and intravenous drug users [1,2,3,4]. These are considered minor sources of transmission.
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