Bayesian Geostatistical Models Research Articles

Spatio-temporal spread of artemisinin resistance in Southeast Asia.

Current malaria elimination targets must withstand a colossal challenge-resistance to the current gold standard antimalarial drug, namely artemisinin derivatives. If artemisinin resistance significantly expands to Africa or India, cases and malaria-related deaths are set to increase substantially. Spatial information on the changing levels of artemisinin resistance in Southeast Asia is therefore critical for health organisations to prioritise malaria control measures, but available data on artemisinin resistance are sparse. We use a comprehensive database from the WorldWide Antimalarial Resistance Network on the prevalence of non-synonymous mutations in the Kelch 13 (K13) gene, which are known to be associated with artemisinin resistance, and a Bayesian geostatistical model to produce spatio-temporal predictions of artemisinin resistance. Our maps of estimated prevalence show an expansion of the K13 mutation across the Greater Mekong Subregion from 2000 to 2022. Moreover, the period between 2010 and 2015 demonstrated the most spatial change across the region. Our model and maps provide important insights into the spatial and temporal trends of artemisinin resistance in a way that is not possible using data alone, thereby enabling improved spatial decision support systems on an unprecedented fine-scale spatial resolution. By predicting for the first time spatio-temporal patterns and extents of artemisinin resistance at the subcontinent level, this study provides critical information for supporting malaria elimination goals in Southeast Asia.

Spatial analysis of modern contraceptive use among women who need it in Ethiopia: Using geo-referenced data from performance monitoring for action.

The challenge of achieving maternal and neonatal health-related goals in developing countries is significantly impacted by high fertility rates, which are partly attributed to limited access to family planning and access to the healthcare systems. The most widely used indicator to monitor family planning coverage is the proportion of women in reproductive age using contraception (CPR). However, this metric does not accurately reflect the true family planning coverage, as it fails to account for the diverse needs of women in reproductive age. Not all women in this category require contraception, including those who are pregnant, wish to become pregnant, sexually inactive, or infertile. To effectively address the contraceptive needs of those who require it, this study aims to estimate family planning coverage among this specific group. Further, we aimed to explore the geographical variation and factors influencing contraceptive uptake of contraceptive use among those who need. We used data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) survey of women of reproductive age and the service delivery point (SDP) survey conducted in 2019. A total of 4,390 women who need contraception were considered as the analytical sample. To account for the study design, sampling weights were considered to compute the coverage of modern contraceptive use disaggregated by socio-demographic factors. Bayesian geostatistical modeling was employed to identify potential factors associated with the uptake of modern contraception and produce spatial prediction to unsampled locations. The overall weighted prevalence of modern contraception use among women who need it was 44.2% (with 95% CI: 42.4%-45.9%). Across regions of Ethiopia, contraceptive use coverage varies from nearly 0% in Somali region to 52.3% in Addis Ababa. The average nearest distance from a woman's home to the nearest SDP was high in the Afar and Somali regions. The spatial mapping shows that contraceptive coverage was lower in the eastern part of the country. At zonal administrative level, relatively high (above 55%) proportion of modern contraception use coverage were observed in Adama Liyu Zone, Ilu Ababor, Misrak Shewa, and Kefa zone and the coverage were null in majority of Afar and Somali region zones. Among modern contraceptive users, use of the injectable dominated the method-mix. The modeling result reveals that, living closer to a SDP, having discussions about family planning with the partner, following a Christian religion, no pregnancy intention, being ever pregnant and being young increases the likelihood of using modern contraceptive methods. Areas with low contraceptive coverage and lower access to contraception because of distance should be prioritized by the government and other supporting agencies. Women who discussed family planning with their partner were more likely to use modern contraceptives unlike those without such discussion. Thus, to improve the coverage of contraceptive use, it is very important to encourage/advocate women to have discussions with their partner and establish movable health systems for the nomadic community.

High-resolution mapping of age- and gender-specific risk of Clonorchis sinensis infection risk in Guangdong, China: a geostatistical modeling study

BackgroundThe latest national survey on the distribution of human parasites in China demonstrated that Guangdong was among the endemic provinces with the highest Clonorchis sinensis infection rates. High-resolution, age- and gender-specific risk maps of the temporal and spatial distributions are essential for the targeted control work.MethodsDisease data on the prevalence of C.sinensis infection from 1990 onwards, either age- and gender-specific or aggregated across age and gender, were collected through systematic review and four large-scale surveys in Guangdong Province. Environmental and socioeconomic variables were obtained from open-access databases and employed as potential predictors. A Bayesian geostatistical model was developed to estimate the C.sinensis infection risk at high spatial resolution.ResultsThe final dataset included 606 surveys at 463 unique locations for C.sinensis infection. Our findings suggested that following an initial increase and stabilization, the overall population-adjusted prevalence had declined to 2.2% (95% Bayesian credible interval: 1.7–3.0%) in the period of 2015 onwards. From 2015 onwards, moderate and high infection risks were found in the northern regions (e.g. Heyuan and Shaoguan cities) and the southern Pearl River Delta (e.g. Foshan, Zhongshan, Zhuhai and Jiangmen cities), respectively. Age- and gender-specific risk maps revealed that males had a higher infection risk than females, and the infection risk was higher in adults compared to children.ConclusionsOur high-resolution risk maps of C. sinensis infection in Guangdong Province identified the spatial, temporal, age and gender heterogeneities, which can provide useful information assisting tailored control strategies.Graphical

A multi-source data approach to carbon stock prediction using Bayesian hierarchical geostatistical models in plantation forest ecosystems

ABSTRACT Modeling of environmental phenomena is usually confounded by the influence of multiple factors existing at different time and spatial scales. Bayesian modeling is presumed to be the best approach for modeling such complex systems. Using a Bayesian hierarchical inferential framework, we employed a multi-source data approach (i.e. remote sensing derived anthropogenic, climatic and topographic set of variables) to model Carbon (C) stock in a managed plantation forest ecosystem in Zimbabwe’s Eastern Highlands. We therefore investigated how two related multi-data sources of new generation remote sensing derived ancillary information influence C stock prediction required for building sustainable capacity in C monitoring and reporting. Two mainstream models constructed from Landsat-8 and Sentinel-2 derived vegetation indices coupled with climatic and topographic covariates were used to predict C stocks using forest inventory data collected using spatial coverage sampling. A multi-source data driven approach to C stock prediction yielded slightly lower predictions for both the Landsat-8 ( 1 ≤ M g C h a − 1 ≤ 135 ) and the Sentinel-2 ( 1 ≤ M g C h a − 1 ≤ 130 ) -based C stock models than C stock predictions published in related studies. Distance to settlements ( D I S T ) and N D V I are significant predictors of C stock with the Sentinel-2-based C stock model outperforming its Landsat-8 model variant in terms of prediction accuracy. The Sentinel-2-based C stock model resulted in a 1.17 MgCha−1 Root Mean Square Error (RMSE) with a ( 1 ≤ M g C h a − 1 ≤ 4 ) 95% credible interval whilst the Landsat-8-based C stock counterpart gave a 2.16 MgCha−1 RMSE with a ( 2 ≤ M g C h a − 1 ≤ 4 ) associated 95% credible interval. Despite a multi-source data prediction approach to the modeling of C stock in a managed plantation forest ecosystem set-up, the issues of scale still play a major role in modeling spatial variability of natural resource variables. Both climatic and topographic derived ancillary data are not significant predictors of C stock under the present modeling conditions. Accurate and precise accounting of C stock for climate change mitigation and action can best be done at landscape scales rather than local scale as the scale of variation for climate-change-related variables vary at larger spatial scales than the ones utilized in the present study.

Geospatial Analyses of Recent Household Surveys to Assess Changes in the Distribution of Zero-Dose Children and Their Associated Factors before and during the COVID-19 Pandemic in Nigeria.

The persistence of geographic inequities in vaccination coverage often evidences the presence of zero-dose and missed communities and their vulnerabilities to vaccine-preventable diseases. These inequities were exacerbated in many places during the coronavirus disease 2019 (COVID-19) pandemic, due to severe disruptions to vaccination services. Understanding changes in zero-dose prevalence and its associated risk factors in the context of the COVID-19 pandemic is, therefore, critical to designing effective strategies to reach vulnerable populations. Using data from nationally representative household surveys conducted before the COVID-19 pandemic, in 2018, and during the pandemic, in 2021, in Nigeria, we fitted Bayesian geostatistical models to map the distribution of three vaccination coverage indicators: receipt of the first dose of diphtheria-tetanus-pertussis-containing vaccine (DTP1), the first dose of measles-containing vaccine (MCV1), and any of the four basic vaccines (bacilli Calmette-Guerin (BCG), oral polio vaccine (OPV0), DTP1, and MCV1), and the corresponding zero-dose estimates independently at a 1 × 1 km resolution and the district level during both time periods. We also explored changes in the factors associated with non-vaccination at the national and regional levels using multilevel logistic regression models. Our results revealed no increases in zero-dose prevalence due to the pandemic at the national level, although considerable increases were observed in a few districts. We found substantial subnational heterogeneities in vaccination coverage and zero-dose prevalence both before and during the pandemic, showing broadly similar patterns in both time periods. Areas with relatively higher zero-dose prevalence occurred mostly in the north and a few places in the south in both time periods. We also found consistent areas of low coverage and high zero-dose prevalence using all three zero-dose indicators, revealing the areas in greatest need. At the national level, risk factors related to socioeconomic/demographic status (e.g., maternal education), maternal access to and utilization of health services, and remoteness were strongly associated with the odds of being zero dose in both time periods, while those related to communication were mostly relevant before the pandemic. These associations were also supported at the regional level, but we additionally identified risk factors specific to zero-dose children in each region; for example, communication and cross-border migration in the northwest. Our findings can help guide tailored strategies to reduce zero-dose prevalence and boost coverage levels in Nigeria.

Quantifying key vegetation parameters from Sentinel-3 and MODIS over the eastern Eurasian steppe with a Bayesian geostatistical model

Accurate estimation of grassland leaf area index (LAI), fractional vegetation cover (FVC), and aboveground biomass (AGB) is fundamental in grassland studies. The newly launched Ocean and Land Color Imager (OLCI) sensor onboard Sentinel-3 (S3) provides images with comparable spatial and spectral resolution with MODIS data. However, the use of S3 OLCI imageries for vegetation variable estimation is rarely evaluated. This study evaluated the potential of S3 OLCI and MODIS data for estimating grassland LAI, FVC, and AGB in the eastern Eurasian steppe. A Bayesian spatial model (Integrated Nested Laplace Approximation with Stochastic Partial Differential Equation, INLA-SPDE) was used to address spatial autocorrelation of in-situ observation data and to enhance our predictions. Our results showed that the models based on S3 OLCI data presented higher accuracy than models with MODIS data. The RMSEs decreased by 3.7–10.8 %, 3.7–7.5 %, and 1.6–14.2 % for LAI, FVC, and AGB predictions, respectively. Through combinations of multiple predictors, we confirmed the robustness of red edge bands for grassland variable estimation, the models employing red edge variables yielded 3.5 %, 3.2 %, and 0.4 % lower RMSEs than models with conventional visible and NIR bands for LAI, FVC, and AGB prediction, respectively. INLA-SPDE spatial model produced lower bias and higher prediction accuracy than random forest and random forests kriging method in most of the models; the INLA-SPDE predicted LAI and FVC maps also showed a better agreement with ground observations than MODIS and PROBA-V land products.

Distribution and treatment needs of soil-transmitted helminthiasis in Bangladesh: A Bayesian geostatistical analysis of 2017-2020 national survey data.

In Bangladesh, preventive chemotherapy targeting soil-transmitted helminth (STH) infections in school-age children has been implemented since 2008. To evaluate the success of this strategy, surveys were conducted between 2017 and 2020 in 10 out of 64 districts. We estimate the geographic distribution of STH infections by species at high spatial resolution, identify risk factors, and estimate treatment needs at different population subgroups. Bayesian geostatistical models were fitted to prevalence data of each STH species. Climatic, environmental, and socioeconomic predictors were extracted from satellite images, open-access, model-based databases, and demographic household surveys, and used to predict the prevalence of infection over a gridded surface at 1 x 1 km spatial resolution across the country, via Bayesian kriging. These estimates were combined with gridded population data to estimate the number of required treatments for different risk groups. The population-adjusted prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm across all ages is estimated at 9.9% (95% Bayesian credible interval: 8.0-13.0%), 4.3% (3.0-7.3%), and 0.6% (0.4-0.9%), respectively. There were 24 out of 64 districts with an estimated population-adjusted STH infection prevalence above 20%. The proportion of households with improved sanitation showed a statistically important, protective association for both, A. lumbricoides and T. trichiura prevalence. Precipitation in the driest month of the year was negatively associated with A. lumbricoides prevalence. High organic carbon concentration in the soil's fine earth fraction was related to a high hookworm prevalence. Furthermore, we estimated that 30.5 (27.2; 36.0) million dosages of anthelmintic treatments for school-age children were required per year in Bangladesh. For each of the STH species, the prevalence was reduced by at least 80% since treatment was scaled up more than a decade ago. The current number of deworming dosages could be reduced by up to 61% if the treatment strategy was adapted to the local prevalence.

Revised EU and WHO air quality thresholds: Where does Europe stand?

One year after the new WHO Global Air Quality Guidelines were published, the European Commission proposed revisions to the Ambient Air Quality Directives, seeking to align European Union air quality standards more closely with WHO recommendations. Here, we employed Bayesian geostatistical regression models to estimate at 1km2 spatial resolution the number of Europeans that would be currently exposed to levels above the new suggested thresholds for the three most harmful pollutants, namely PM2.5, PM10, and NO2. The results have shown that in 2021, 97.6% (95% credible interval: 95.1, 99.2%) of the total European population was exposed to PM2.5 levels exceeding the new WHO annual limit values, while 47.5% (36.2, 59.5%) lived in areas where the revised EU thresholds were exceeded. For PM10, the proportion of people exposed to concentrations above the WHO annual thresholds was estimated at 62.5% (54.0, 70.9%) and at 29.6 (21.9, 37.0%) above the EU values, whereas for NO2, the estimates were at 67.4% (57.9, 75.8%) and 20.2% (13.3, 28.5%), respectively. Our high-resolution model-based predictions are readily available to support policy makers and scientists working toward achieving the ambitious European zero-pollution vision for 2050.

The risk of developing postmenopausal breast cancer from ambient exposures to selected volatile organic compounds

ObjectivesTo estimate associations between incident postmenopausal breast cancer and environmental concentrations of five ambient volatile organic compounds (VOCs): benzene, hexane; ethylbenzene; n-decane; and 1,2,4-trimethylbenzene. MethodsWe conducted in Montreal a hospital-based case-control study between 1996 and 1997 and a population-based study between 2008 and 2011 of incident postmenopausal breast cancer. We measured five VOCs at about 130 locations during three sampling periods in 2005–2006 and we then used Bayesian geostatistical models to estimate concentrations of the VOCs at residential locations of participants in the two studies at the time of recruitment. We developed a directed acyclic graph to account for confounding but because of concerns with mis-specified models we used a series of unconditional logistic regression models to adjust for different combinations of personal risk factors, occupational exposures attributed by experts, air pollution data, and contextual variables. We estimated odds ratios (OR) for increases in concentrations across the interquartile ranges of the VOCs and associated 95% confidence intervals (CI). ResultsIn each study, we found that the ORs for each VOC were similar across the statistical models. In the hospital-based study, the ORs for the five VOCs varied between 0.77 and 1.04. In the population-based study, higher ORs were found for three VOCs: benzene, ORModel-7 = 1.12 (95%CI: 0.95, 1.31); hexane, ORModel-7 = 1.11 (95%CI: 0.97, 1.27); and 1,2,4-trimethyl-benzene, ORModel-7 = 1.07 (95%CI: 0.88, 1.31). We did not find important differences in sub-analyses by hormonal phenotype. ConclusionsIn the hospital-based study we did not find evidence of associations with these VOCs but in the population-based study there were indications of positive associations for environmental exposures to benzene and hexane.

Mapping the timeliness of routine childhood vaccination in The Gambia: A spatial modelling study

IntroductionTimeliness of routine vaccination shapes childhood infection risk and thus is an important public health metric. Estimates of indicators of the timeliness of vaccination are usually produced at the national or regional level, which may conceal epidemiologically relevant local heterogeneities and makeitdifficultto identify pockets of vulnerabilities that could benefit from targeted interventions. Here, we demonstrate the utility of geospatial modelling techniques in generating high-resolution maps of the prevalence of delayed childhood vaccination in The Gambia. To guide local immunisation policy and prioritize key interventions, we also identified the districts with a combination of high estimated prevalence and a significant population of affected infants. MethodsWe used the birth dose of the hepatitis-B vaccine (HepB0), third-dose of the pentavalent vaccine (PENTA3), and the first dose of measles-containing vaccine (MCV1) as examples to map delayed vaccination nationally at a resolution of 1 × 1-km2 pixel. We utilized cluster-level childhood vaccination data from The Gambia 2019–20 Demographic and Health Survey. We adopted a fully Bayesian geostatistical model incorporating publicly available geospatial covariates to aid predictive accuracy. The model was implemented using the integrated nested Laplace approximation—stochastic partial differential equation (INLA-SPDE) approach. ResultsWe found significant subnational heterogeneity in delayed HepB0, PENTA3 and MCV1 vaccinations. Specificdistricts in the central and eastern regions of The Gambia consistentlyexhibited the highest prevalence of delayed vaccination, while the coastal districts showed alower prevalence forallthree vaccines. We also found that districts in the eastern, central, as well as in coastal parts of The Gambia had a combination of high estimated prevalence of delayed HepB0, PENTA3 and MCV1 and a significant population of affected infants. ConclusionsOur approach provides decision-makers with a valuable tool to better understand local patterns of untimely childhood vaccination and identify districts where strengthening vaccine delivery systems could have the greatest impact.

Multi-site evaluation of stratified and balanced sampling of soil organic carbon stocks in agricultural fields

Estimating soil organic carbon (SOC) stocks in agricultural fields is essential for environmental and agronomic research, management, and policy. Stratified sampling is a classic strategy for estimating mean soil properties, and has recently been codified in SOC monitoring protocols. However, for the specific task of estimating the SOC stock of an agricultural field, concrete guidance is needed for which covariates to stratify on and how much stratification can improve estimation efficiency. It is also unknown how stratified sampling of SOC stocks compares to modern alternatives, notably doubly balanced sampling. To address these gaps, we collected high-density (average of 7 samples ha−1) and deep (average of 75 cm) measurements of SOC stocks at eight commercial fields under maize-soybean production in two US Midwestern states. We combined these measurements with a Bayesian geostatistical model to evaluate stratified and balanced sampling strategies that use a set of readily-available geographic, topographic, spectroscopic, and soil survey data. We examined the number of samples needed to achieve a given level of SOC stock estimation accuracy. While stratified sampling using these variables enables an average sample size reduction of 17% (95% CI, 11% to 23%) compared to simple random sampling, doubly balanced sampling is consistently more efficient, reducing sample sizes by 32% (95% CI, 25% to 37%). The data most important to these efficiency gains are a remotely-sensed SOC index, SSURGO estimates of SOC stocks, and the topographic wetness index. We conclude that in order to meet the urgent challenge of climate change, SOC stocks in agricultural fields could be more efficiently estimated by taking advantage of this readily-available data, especially with doubly balanced sampling.

Spatial predictive risk mapping of lymphatic filariasis residual hotspots in American Samoa using demographic and environmental factors.

American Samoa successfully completed seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006. The territory passed the school-based transmission assessment surveys in 2011 and 2015 but failed in 2016. One of the key challenges after the implementation of MDA is the identification of any residual hotspots of transmission. Based on data collected in a 2016 community survey in persons aged ≥8 years, Bayesian geostatistical models were developed for LF antigen (Ag), and Wb123, Bm14, Bm33 antibodies (Abs) to predict spatial variation in infection markers using demographic and environmental factors (including land cover, elevation, rainfall, distance to the coastline and distance to streams). In the Ag model, females had a 26.8% (95% CrI: 11.0-39.8%) lower risk of being Ag-positive than males. There was a 2.4% (95% CrI: 1.8-3.0%) increase in the odds of Ag positivity for every year of age. Also, the odds of Ag-positivity increased by 0.4% (95% CrI: 0.1-0.7%) for each 1% increase in tree cover. The models for Wb123, Bm14 and Bm33 Abs showed similar significant associations as the Ag model for sex, age and tree coverage. After accounting for the effect of covariates, the radii of the clusters were larger for Bm14 and Bm33 Abs compared to Ag and Wb123 Ab. The predictive maps showed that Ab-positivity was more widespread across the territory, while Ag-positivity was more confined to villages in the north-west of the main island. The findings may facilitate more specific targeting of post-MDA surveillance activities by prioritising those areas at higher risk of ongoing transmission.

Bayesian geostatistical modeling for discrete‐valued processes

AbstractWe introduce a flexible and scalable class of Bayesian geostatistical models for discrete data, based on nearest‐neighbor mixture processes (NNMP), referred to as discrete NNMP. To define the joint probability mass function (pmf) over a set of spatial locations, we build from local mixtures of conditional pmfs using a directed graphical model, with a directed acyclic graph that summarizes the nearest neighbor structure. The approach supports direct, flexible modeling for multivariate dependence through specification of general bivariate discrete distributions that define the conditional pmfs. In particular, we develop a modeling and inferential framework for copula‐based NNMPs that can attain flexible dependence structures, motivating the use of bivariate copula families for spatial processes. Moreover, the framework allows for construction of models given a pre‐specified family of marginal distributions that can vary in space, facilitating covariate inclusion. Compared to the traditional class of spatial generalized linear mixed models, where spatial dependence is introduced through a transformation of response means, our process‐based modeling approach provides both computational and inferential advantages. We illustrate the methodology with synthetic data examples and an analysis of North American Breeding Bird Survey data.

Spatiotemporal distributions of under-five mortality in Ethiopia between 2000 and 2019.

Under-five mortality declined in the last two decades in Ethiopia, but sub-national and local progress remains unclear. This study aimed to investigate the spatiotemporal distributions and ecological level factors of under-five mortality in Ethiopia. Data on under-five mortality were obtained from five different Ethiopian Demographic and Health Surveys (EDHS), conducted in 2000, 2005, 2011, 2016, and 2019. Environmental and healthcare access data were obtained from different publicly available sources. Bayesian geostatistical models were used to predict and visualize spatial risks for under-five mortality. The national under-five mortality rate in Ethiopia declined from 121 per 1000 live births in 2000 to 59 per 1000 live births in 2019. Spatial variation in under-five mortality was observed at regional and local levels with the highest rates reported in the Western, Eastern, and Central parts of Ethiopia. Spatial clustering of under-five mortality was significantly associated with population density, access to a water body, and climatic factors such as temperature. Under-five mortality rate declined over the past two decades and varied substantially at sub-national and local levels in Ethiopia. Increasing access to water and health care may help to reduce under-five mortality in high-risk areas. Therefore, interventions targeted to reduce under-five mortality should be strengthened in the areas that had a clustering of under-five mortality in Ethiopia by increasing access to quality health care access.

Mapping Local Variations and the Determinants of Childhood Stunting in Nigeria.

Understanding the specific geospatial variations in childhood stunting is essential for aligning appropriate health services to where new and/or additional nutritional interventions are required to achieve the Sustainable Development Goals (SDGs) and national targets. We described local variations in the prevalence of childhood stunting at the second administrative level and its determinants in Nigeria after accounting for the influence of geospatial dependencies. This study used the 2018 national Nigeria Demographic and Health Survey datasets (NDHS; N = 12,627). We used a Bayesian geostatistical modelling approach to investigate the prevalence of stunting at the second administrative level and its proximal and contextual determinants among children under five years of age in Nigeria. In 2018, the overall prevalence of childhood stunting in Nigeria was 41.5% (95% credible interval (CrI) from 26.4% to 55.7%). There were striking variations in the prevalence of stunting that ranged from 2.0% in Shomolu in Lagos State, Southern Nigeria to 66.4% in Biriniwa in Jigawa State, Northern Nigeria. Factors positively associated with stunting included being perceived as small at the time of birth and experience of three or more episodes of diarrhoea in the two weeks before the survey. Children whose mothers received a formal education and/or were overweight or obese were less likely to be stunted compared to their counterparts. Children who were from rich households, resided in households with improved cooking fuel, resided in urban centres, and lived in medium-rainfall geographic locations were also less likely to be stunted. The study findings showed wide variations in childhood stunting in Nigeria, suggesting the need for a realignment of health services to the poorest regions of Northern Nigeria.

The spatial-temporal risk profiling of Clonorchis sinensis infection over 50 years implies the effectiveness of control programs in South Korea: a geostatistical modeling study

Over the past 50 years, two national control programs on Clonorchis sinensis infection have been conducted in South Korea. Spatial-temporal profiles of infection risk provide useful information on assessing the effectiveness of the programs and planning spatial-targeted control strategies. Advanced Bayesian geostatistical joint models with spatial-temporal random effects were developed to analyze disease data collecting by a systematic review with potential influencing factors, and to handle issues of preferential sampling and data heterogeneities. Changes of the infection risk were analyzed. We presented the first spatial-temporal risk maps of C.sinensis infection at 5×5km2 resolution from 1970 to 2020 in South Korea. Moderate-to-high risk areas were shrunk, but temporal variances were shown in different areas. The population-adjusted estimated prevalence across the country was 5.99% (95% BCI: 5.09-7.01%) in 1970, when the first national deworming campaign began. It declined to 3.95% (95% BCI: 2.88-3.95%) in 1995, when the campaign suspended, and increased to 4.73% (95% BCI: 4.00-5.42%) in 2004, just before the Clonorchiasis Eradication Program (CEP). The population-adjusted prevalence was estimated at 2.77% (95% BCI: 1.67-4.34%) in 2020, 15 years after CEP started, corresponding to 1.42 (95% BCI: 0.85-2.23) million infected people. The first nationwide campaign and the CEP showed effectiveness on control of C.sinensis infection. Moderate-to-high risk areas identified by risk maps should be prioritized for control and intervention. The National Natural Science Foundation of China (project no. 82073665) and the Natural Science Foundation of Guangdong Province (project no. 2022A1515010042).

Determinants of exposure to Aedes mosquitoes: A comprehensive geospatial analysis in peri-urban Cambodia

Aedes mosquitoes are some of the most important and globally expansive vectors of disease. Public health efforts are largely focused on prevention of human-vector contact. A range of entomological indices are used to measure risk of disease, though with conflicting results (i.e. larval or adult abundance does not always predict risk of disease). There is a growing interest in the development and use of biomarkers for exposure to mosquito saliva, including for Aedes spp, as a proxy for disease risk. In this study, we conduct a comprehensive geostatistical analysis of exposure to Aedes mosquito bites among a pediatric cohort in a peri‑urban setting endemic to dengue, Zika, and chikungunya viruses. We use demographic, household, and environmental variables (the flooding index (NFI), land type, and proximity to a river) in a Bayesian geostatistical model to predict areas of exposure to Aedes aegypti bites. We found that hotspots of exposure to Ae. aegypti salivary gland extract (SGE) were relatively small (< 500 m and sometimes < 250 m) and stable across the two-year study period. Age was negatively associated with antibody responses to Ae. aegypti SGE. Those living in agricultural settings had lower antibody responses than those living in urban settings, whereas those living near recent surface water accumulation were more likely to have higher antibody responses. Finally, we incorporated measures of larval and adult density in our geostatistical models and found that they did not show associations with antibody responses to Ae. aegypti SGE after controlling for other covariates in the model. Our results indicate that targeted house- or neighborhood-focused interventions may be appropriate for vector control in this setting. Further, demographic and environmental factors more capably predicted exposure to Ae. aegypti mosquitoes than commonly used entomological indices.

Mapping the distribution of zero-dose children to assess the performance of vaccine delivery strategies and their relationships with measles incidence in Nigeria.

Geographically precise identification and targeting of populations at risk of vaccine-preventable diseases has gained renewed attention within the global health community over the last few years. District level estimates of vaccination coverage and corresponding zero-dose prevalence constitute a potentially useful evidence base to evaluate the performance of vaccination strategies. These estimates are also valuable for identifying missed communities, hence enabling targeted interventions and better resource allocation. Here, we fit Bayesian geostatistical models to map the routine coverage of the first doses of diphtheria-tetanus-pertussis vaccine (DTP1) and measles-containing vaccine (MCV1) and corresponding zero-dose estimates in Nigeria at 1x1 km resolution and the district level using geospatial data sets. We also map MCV1 coverage before and after the 2019 measles vaccination campaign in the northern states to further explore variations in routine vaccine coverage and to evaluate the effectiveness of both routine immunization (RI) and campaigns in reaching zero-dose children. Additionally, we map the spatial distributions of reported measles cases during 2018 to 2020 and explore their relationships with MCV zero-dose prevalence to highlight the public health implications of varying performance of vaccination strategies across the country. Our analysis revealed strong similarities between the spatial distributions of DTP and MCV zero dose prevalence, with districts with the highest prevalence concentrated mostly in the northwest and the northeast, but also in other areas such as Lagos state and the Federal Capital Territory. Although the 2019 campaign reduced MCV zero-dose prevalence substantially in the north, pockets of vulnerabilities remained in areas that had among the highest prevalence prior to the campaign. Importantly, we found strong correlations between measles case counts and MCV RI zero-dose estimates, which provides a strong indication that measles incidence in the country is mostly affected by RI coverage. Our analyses reveal an urgent and highly significant need to strengthen the country's RI program as a longer-term measure for disease control, whilst ensuring effective campaigns in the short term.

Interpolation of DHS survey data at subnational administrative level 2

Over the last several years and within the framework of the Sustainable Development Goals, there has been a need to improve the measurement and understanding of local geographic patterns to support more decentralized decision-making and more efficient program implementation. This requires more disaggregated data that are not currently available in a nationally representative household survey. This study explores the potential of model-based geostatistics methodology to model DHS survey indicators. We implement a stacked ensemble modeling approach that combines multiple model algorithmic methods to increase predictive validity relative to a single modeling. The approach captures potentially complex interactions and non-linear effects among the geospatial covariates. Three submodels are fitted to six DHS indicator survey data using the geospatial covariates as exploratory predictors. The model prediction surfaces generated from the submodels are used as covariates in the final Bayesian geostatistical model, which is implemented through a stochastic partial differential equation approach in the integrated nested Laplace approximations. The proposed approach can help to inform the allocation of resources and program implementation in areas that need more attention. Countries can use this approach to model other DHS survey indicators at much smaller spatial scales.

Ambient exposures to selected volatile organic compounds and the risk of prostate cancer in Montreal.

This study is based on a population-based case-control study of incident prostate cancer (PROtEuS) in men ≤ 75 years of age living in Montreal, Canada, in 2005 to 2012. We included 1172 cases and 1177 population controls. We had personal information, lifetime residential addresses, occupational exposures, and a variety of area-wide covariables. We inferred concentrations of the five VOCs using Bayesian geostatistical models using data from a dense environmental survey conducted in Montreal in 2005 to 2006. We used different sets of adjustments to estimate odds ratios (OR) and confidence intervals. We found nonlinear associations such that the ORs increased monotonically and then either flattened or fell off with increased exposures. The model that contained other environmental variables and contextual variables led to lower ORs and results were similar when we restricted analyses to controls recently screened or tested for prostate cancer or cases with low- or high-grade tumors. A change from the 5th to 25th percentile in mean environmental benzene levels led to an adjusted OR of 2.00 (95% confidence interval = 1.47, 2.71). We found positive associations between prostate cancer and concentrations of benzene and ethylbenzene, independently of previous testing for prostate cancer or tumor grade, suggesting that exposure to certain ambient VOCs may increase incidence.