Effects of Socio-Environmental Factors on Malaria Infection in Pakistan: A Bayesian Spatial Analysis.

Muhammad Farooq Umer,Guihua Zhuang,Wenbiao Hu,Shumaila Zofeen,Xin Qi,Abdul Majeed

doi:10.3390/ijerph16081365

Abstract

The role of socio-environmental factors in shaping malaria dynamics is complex and inconsistent. Effects of socio-environmental factors on malaria in Pakistan at district level were examined. Annual malaria cases data were obtained from Directorate of Malaria Control Program, Pakistan. Meteorological data were supplied by Pakistan Meteorological Department. A major limitation was the use of yearly, rather than monthly/weekly malaria data in this study. Population data, socio-economic data and education score data were downloaded from internet. Bayesian conditional autoregressive model was used to find the statistical association of socio-environmental factors with malaria in Pakistan. From 136/146 districts in Pakistan, >750,000 confirmed malaria cases were included, over a three years’ period (2013–2015). Socioeconomic status ((posterior mean value −3.965, (2.5% quintile, −6.297%), (97.5% quintile, −1.754%)) and human population density (−7.41 × 10−4, −0.001406%, −1.05 × 10−4 %) were inversely related, while minimum temperature (0.1398, 0.05275%, 0.2145%) was directly proportional to malaria in Pakistan during the study period. Spatial random effect maps presented that moderate relative risk (RR, 0.75 to 1.24) and high RR (1.25 to 1.99) clusters were scattered throughout the country, outnumbering the ones’ with low RR (0.23 to 0.74). Socio-environmental variables influence annual malaria incidence in Pakistan and needs further evaluation.

Highlights

Malaria incidence exhibited considerable decline worldwide since year 2000 [1,2]
Study confirmed that Human Development Index (HDI), and socioeconomic status, is inversely proportional to the Ourincidence study confirmed that HDI, socioeconomic status, is inversely proportional to the malaria at the district level,and analogous to what predominantly has already been evidenced malaria incidence at the district level, analogous to what predominantly has already been evidenced in the literature [30,31,32]
Ourthe study provided evidence that malaria higher in areastowith low socioeconomic status and upholds notion that malaria is both input and incidence was higher in areas with low socioeconomic status and upholds the notion that malaria is output of poverty; the decision makers in Pakistan should devise strategies for the equitable both input and output of poverty; the decision makers in Pakistan should devise strategies for distribution of the resources and direct malaria control interventions towards high-risk districts having the equitable distribution of the resources and direct malaria control interventions towards high-risk low socio-economic conditions

Summary

Introduction

Malaria incidence exhibited considerable decline worldwide since year 2000 [1,2]. Despite this noteworthy progress, 2014 onwards, the drop rate seems to be arrested or even reversed in some of theWorld Health Organization (WHO) regions [3]. Malaria incidence exhibited considerable decline worldwide since year 2000 [1,2]. Despite this noteworthy progress, 2014 onwards, the drop rate seems to be arrested or even reversed in some of the. World Health Organization (WHO) regions [3]. This change in disease trend stresses on capitalizing decades long efforts, to achieving global goals of malaria control and elimination, with special focus on the developing countries in the world. Socio-environmental variables influence spatial and temporal distribution, intensity and duration of infectious diseases in general [4,5,6]; and occurrence, transmission, seasonality and periodicity of malaria in particular [7,8,9].

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Results

Discussion

Conclusion