Spatially Filtered Multilevel Analysis on Spatial Determinants for Malaria Occurrence in Korea.

Sehyeong Kim,Youngho Kim

doi:10.3390/ijerph16071250

Abstract

Since its re-emergence in 1993, the spatial patterns of malaria outbreaks in South Korea have drastically changed. It is well known that complicated interactions between humans, nature, and socio-economic factors lead to a spatial dependency of vivax malaria occurrences. This study investigates the spatial factors determining malaria occurrences in order to understand and control malaria risks in Korea. A multilevel model is applied to simultaneously analyze the variables in different spatial scales, and eigenvector spatial filtering is used to explain the spatial autocorrelation in the malaria occurrence data. The results show that housing costs, average age, rice paddy field ratio, and distance from the demilitarized zone (DMZ) are significant on the level-1 spatial scale; health budget per capita and military base area ratio are significant on the level-2 spatial scale. The results show that the spatially filtered multilevel model provides better analysis results in handling spatial issues.

Highlights

Plasmodium vivax, an endemic factious disease known as tertian malaria, was prevalent on the Korean peninsula for centuries
The results show that malaria transmission in South Korea demilitarized zone (DMZ), health budget per capita, and military base area ratio throughout multiple is significantly influenced by housing costs, average age, rice paddy field ratio, distance from the levels of analysis
The results indicate that spatial units with lower housing costs, lower average age, higher rice paddy ratios, less distance from the DMZ, lower health budget per capita, and higher military base area ratios are more susceptible to malaria risks

Summary

Introduction

Plasmodium vivax, an endemic factious disease known as tertian malaria, was prevalent on the Korean peninsula for centuries. It was eradicated in South Korea in 1979 through a national control project and improvements in public sanitation [1]. The re-emergence of malaria in South Korea is noteworthy because it is speculated to have originated from adjoining North Korea [4,5]. The initial re-emergence occurred in Paju, which is a remote rural area with little population except for several military bases because of its proximity to the border between North and South Korea.

Methods

Results

Conclusion