Integrated Nested Laplace Approximation Research Articles

Ecological factors associated with fox feces density in an Echinococcus multilocularis endemic zone in Japan

IntroductionHuman alveolar echinococcosis caused by Echinococcus multilocularis is an important zoonotic disease in the northern hemisphere. The life cycle of E. multilocularis is maintained primarily in wild animals and requires an intermediate host (mainly small mammals). Human can become an intermediate host through accidental ingestion of E. multilocularis eggs. Hokkaido Prefecture is the only area of Japan in which human alveolar echinococcosis is endemic. The purposes of this study were to elucidate the land use ecological factors associated with the density of red fox feces along paved roads and the relationship between the distributions of red fox (Vulpes vulpes) populations and fox feces, which determine the level of hazard from eggs.MethodsA series of surveys was conducted in the central part of the Nemuro Peninsula of Hokkaido, excluding urban areas, over a total of 4 years in May–June in 2014 and 2016–2018 when red foxes remain with their cubs around the dens. Transects of 500 m were set up on paved roads, and feces within the transects were counted. Univariable and multivariable analyses were performed to examine ecological factors including the principal components (PCs) of five land use–type occupancy proportions within 500 m and 1 km, respectively, as explanatory fixed-effect variables. The number of feces in each transect was examined as the response variable using integrated nested Laplace approximation with negative binomial errors with a spatio-temporal autocorrelations structure to separate the effects of similarities of neighboring locations and annual variation. The multivariable models with the lowest widely applicable information criterion values were selected.ResultsThe feces density was explained by the PC of the 500- m buffer (−0.27, 2.5th and 97.5th percentiles: −0.44, −0.10) characterized by mixed forests (−0.82) and scarcity of residential areas (0.29) and the proximity to the nearest livestock farm house (−0.35, 2.5th and 97.5th percentiles: −0.53, −0.17). This suggested that foxes defecate in the areas where prey is abundant, avoiding humans.DiscussionPolicy discussions regarding bait distribution design targeting these conditions should be initiated.

Bayesian hierarchical spatiotemporal modelling of tuberculosis – Human immunodeficiency virus co-infection in Ethiopia

Understanding the epidemiological patterns of tuberculosis-human immunodeficiency virus (TB-HIV) co-infection over space and time is crucial because it assists in identifying areas with high risks that need special control strategies. This article aimed to determine districts in Ethiopia that are most vulnerable to TB-HIV co-infection by examining the spatiotemporal patterns of the co-infection across four years, from 2015 to 2018. The study’s data came from Ethiopia’s Federal Ministry of Health. The data was analysed by applying the Bayesian hierarchical spatiotemporal modelling. We considered four models with different space–time interaction structures via the Integrated Nested Laplace Approximation (INLA) in the R-INLA package. In addition, we have applied the Deviance Information Criterion to select the most suitable model. The mean raw annual TB-HIV relative risk (RR) continuously decreased from 2015 to 2018, and the raw RRs of co-infection varied over districts and years. The spatiotemporal model, which allows for space–time interaction with independent spatial random effect and dependent temporal random effect, was the preferred model for describing the variations in TB-HIV co-infection across different districts over time. The prior variance for the spatial structured random effect had a smaller precision mode than the spatial unstructured random effect. This difference reveals that the former accounted for more spatial autocorrelation than the latter, indicating an information-borrowing effect amongst districts. Furthermore, the findings exhibit that the relative risk of TB-HIV co-infection had significant spatiotemporal variation and clustering. Through this research, further information was obtained regarding the temporal evolution of the geographical spread of TB and HIV co-infection at the district level in the country. It also made it possible to determine districts that should receive priority for control actions because of their high risk of co-infection.

Spatiotemporal Distribution of Human Rabies and Identification of Predominant Risk Factors in China from 2004 to 2020.

Human rabies is a prevalent issue in China, posing a significant public health concern in the country. This study fitted the Bayesian model of separable in spatial and temporal variation and inseparable spatiotemporal variation in disease risk respectively based on Integrated Nested Laplace Approximation (INLA) to investigate the spatiotemporal characteristics of human rabies across 31 provinces in China from 2004 to 2020. It also investigated the influence of natural and socio-environmental factors on the incidence of the disease. Within the study period, a total of 26,807 cases of human rabies were reported, with the highest risk of incidence occurring in 2007, followed by a steady annual decline to the lowest risk in 2020. Guangxi Province exhibited the highest risk, while Jilin Province had the lowest, with the southern, central, and eastern regions reporting higher risks than the northern and western areas. By 2020, most provinces such as Guangxi and Guizhou had significantly reduced their relative risk (RR) of human rabies from historical highs. However, some provinces like Hunan, Henan, and Jiangsu experienced an increase in RR compared to previous years. As the annual average temperature increases, the risk of human rabies incidence in China correspondingly rises. Conversely, with increases in the annual average daily sunshine duration, per capita disposable income of urban residents, and local government healthcare expenditures, the risk of human rabies incidence declines. We conclude that the risk of human rabies in China initially increased and then decreased annually from 2004 to 2020. Future efforts should continuously increase financial investments in rabies prevention and control, focusing particularly on Hunan, Henan, Jiangsu, and provinces characterized by higher temperatures, shorter sunshine durations, and lower economic levels.

Modeling the Causes of Urban Traffic Crashes: Accounting for Spatiotemporal Instability in Cities

Traffic crashes have become one of the key public health issues, triggering significant apprehension among citizens and urban authorities. However, prior studies have often been limited by their inability to fully capture the dynamic and complex nature of spatiotemporal instability in urban traffic crashes, typically focusing on static or purely spatial effects. Addressing this gap, our study employs a novel methodological framework that integrates an Integrated Nested Laplace Approximation (INLA)-based Stochastic Partial Differential Equation (SPDE) model with spatially adaptive graph structures, which enables the effective handling of vast and intricate geospatial data while accounting for spatiotemporal instability. This approach represents a significant advancement over conventional models, which often fail to account for the fluid interplay between time-varying weather conditions, geographical attributes, and crash severity. We applied this methodology to analyze traffic crashes across three major U.S. cities—New York, Los Angeles, and Houston—using comprehensive crash data from 2016 to 2019. Our findings reveal city-specific disparities in the factors influencing severe traffic crashes, which are defined as incidents resulting in at least one person sustaining serious injury or death. Despite some universal trends, such as the risk-enhancing effect of cold weather and pedestrian crossings, we find marked differences across cities in relation to factors like temperature, precipitation, and the presence of certain traffic facilities. Additionally, the adjustment observed in the spatiotemporal standard deviations, with values such as 0.85 for New York and 0.471 for Los Angeles, underscores the varying levels of annual temporal instability across cities, indicating that the fluctuation in crash severity factors over time differs markedly among cities. These results underscore the limitations of traditional modeling approaches, demonstrating the superiority of our spatiotemporal method in capturing the heterogeneity of urban traffic crashes. This work has important policy implications, suggesting a need for tailored, location-specific strategies to improve traffic safety, thereby aiding authorities in better resource allocation and strategic planning.

Modelling of the time to death of breast cancer patients at Hiwot Fana Specialized University Hospital

Breast cancer is the most common cause of cancer death and is a frequently diagnosed cancer among women worldwide. It is becoming a challenging health condition in Ethiopia with a high rate of morbidity and mortality. The main aim of this study was to model the time to death in breast cancer patients at Hiwot Fana Specialized University Hospital. A retrospective cohort study was carried out from April 1st, 2020, to April 1st, 2023, and 296 women were included in the study. We used nonparametric methods and Bayesian accelerated failure time models (with Laplace approximation) to identify risk factors and choose a model fitting breast cancer patient data. Model comparison was performed using the marginal likelihood, deviance information criterion and Watanabe Akaike information criterion. From the total of 296 patients in the study, 56 (18.9%) died. The estimated median survival time was 33 months. The log-rank test showed that age group, stage, alcohol consumption, smoking habit, and comorbidity were potential risk factors associated with the time to death in breast cancer patients at the 5% level of significance. The Bayesian Weibull accelerated failure time model was found to be the best fitted model for predicting the survival time of patients with minimum DIC (520.39) and WAIC (521.59) values. The final Bayesian Weibull AFT model with the integrated nested Laplace approximation estimation technique revealed that age group, stage, alcohol consumption, smoking habit, and comorbidity were significantly associated with the time to death in breast cancer patients. Individuals older than 65 years, with stage IV disease, drinking alcohol, smoking cigarettes and having comorbidities had shortened survival times in patients with breast cancer. Hence, Hiwot Fana Specialized University Hospital and related bodies should work on awareness creation to reduce smoking habits and alcohol use as well as give due attention to elderly and stage IV breast cancer patients during intervention.

Bayesian spatial-temporal analysis and determinants of cardiovascular diseases in Tanzania mainland

BackgroundCardiovascular Diseases (CVDs) are health-threatening conditions that account for high mortality in the world. Approximately 23.6 million deaths due to CVD is expected in the year 2030 worldwide. The CVD burden is more severe in developing countries, including Tanzania.ObjectivesThis study analyzed the spatial-temporal trends and determinants of cardiovascular diseases in Tanzania from 2010 to 2019.MethodsIndividual data were extracted from Jakaya Kikwete Cardiac Institute (JKCI), Mbeya Zonal Referral Hospital (MZRH), Kilimanjaro Christian Medical Centre (KCMC) and Bugando hospitals and the geographical data from TMA. The model containing spatial and temporal components was analyzed using the Bayesian hierarchical method implemented using Integrated Nested Laplace Approximation (INLA).ResultsThe results found that the incidence of CVD increased from 2010 to 2014 and decreased from 2015 to 2019. The southern highlands, lake, central and coastal zones were more likely to have CVD problems than others. It was also revealed that people aged 60–64 years OR = 1.49, females OR = 1.51, smokers OR = 1.76, alcohol drinkers OR = 1.48, and overweight OR = 1.89 were more likely to have CVD problems. Additionally, a 1oC increase in the average annual air maximum temperature was related to a 14% risk of developing CVD problems. The study revealed that the model, which included spatial and temporal random effects, was the best-predicting model.ConclusionThe study shows a decreased CVD incidence rate from 2015 to 2019. The CVD incidences occurred more in Tanzania’s coastal and lake areas between 2010 and 2019. The demographic, lifestyle and geographical risk factors were significantly associated with the CVD.

Bayesian feedback in the framework of ecological sciences

In ecological studies, it is not uncommon to encounter scenarios where the same phenomenon (e.g., species occurrence, species abundance) is observed using two different types of samplers. For example, species data can be collected from scientific sampling with a completely random sample pattern, but also from opportunistic sampling (e.g., whale watching from commercial fishing vessels or bird watching from citizen science), where observers tend to look for particular species in areas where they expect to find them.Species Distribution Models (SDMs) are widely used tools for analysing this type of ecological data. In particular, two models are available for the aforementioned data: a geostatistical model (GM) for data collected where the sampling design is not directly related to the observations, and a preferential model (PM) for data obtained from opportunistic sampling.The integration of information from disparate sources can be addressed through the use of expert elicitation and integrated models. This paper focuses on a sequential Bayesian procedure for linking two models by updating prior distributions. The Bayesian paradigm is implemented together with the integrated nested Laplace approximation (INLA) methodology, which is an effective approach for making inference and predictions in spatial models with high performance and low computational cost. This sequential approach has been evaluated through the simulation of various scenarios and the subsequent comparison of the results from sharing information between models using a variety of criteria. The procedure has also been exemplified on a real dataset.The primary findings indicate that, in general, it is preferable to transfer information from the independent (with a completely random sampling) model to the preferential model rather than in the alternative direction. However, this depends on several factors, including the spatial range and the spatial arrangement of the sampling locations.

Spatio‐temporal occupancy models with INLA

Abstract Modern methods for quantifying, predicting and mapping species distributions have played a crucial part in biodiversity conservation. Occupancy models have become a popular choice for analysing species occurrence data due to their ability to separate out the observational error induced by imperfect detection of a species, and the sources of bias affecting the occupancy process. However, the spatial and temporal variation in occupancy that is not accounted for by environmental covariates is often ignored or modelled through simple spatial structures as the computational costs of fitting explicit spatio‐temporal models is too high. In this work, we demonstrate how Integrated Nested Laplace Approximation (INLA) may be used to fit complex spatio‐temporal occupancy models and how the R‐INLA package can provide a user‐friendly interface to make such complex models available to users. We show how occupancy models, provided some simplification on the detection process is assumed, can be framed as latent Gaussian models and, as such, benefit from the powerful INLA framework. A large selection of complex modelling features, and random effect models, including spatio‐temporal models, have already been implemented in R‐INLA. These also become available for occupancy models, providing the user with an efficient, reliable and flexible toolbox. We illustrate how INLA provides a flexible and computationally efficient framework for developing and fitting complex occupancy models using two complex case studies. Through these, we show how different spatio‐temporal models that include spatial‐varying trends, smooth terms and spatio‐temporal random effects can be fitted to aggregated detection/non‐detection data. At the cost of limiting the complexity of the detection model structure, INLA can incorporate a range of rather complex structures in the ecological process of interest and hence, extend the functionality of occupancy models. The limitations of occupancy models in terms of scalability for large spatio‐temporal data sets remain a challenge and an active area of research. INLA‐based occupancy models provide an alternative inferential and computational framework to fit complex spatio‐temporal occupancy models. The need for new and more flexible computationally efficient approaches to fit such models makes INLA an attractive option for addressing complex ecological problems, and a promising area of research.

Trivariate Joint Modeling for Family Data with Longitudinal Counts, Recurrent Events and a Terminal Event with Application to Lynch Syndrome.

Trivariate joint modeling for longitudinal count data, recurrent events, and a terminal event for family data has increased interest in medical studies. For example, families with Lynch syndrome (LS) are at high risk of developing colorectal cancer (CRC), where the number of polyps and the frequency of colonoscopy screening visits are highly associated with the risk of CRC among individuals and families. To assess how screening visits influence polyp detection, which in turn influences time to CRC, we propose a clustered trivariate joint model. The proposed model facilitates longitudinal count data that are zero-inflated and over-dispersed and invokes individual-specific and family-specific random effects to account for dependence among individuals and families. We formulate our proposed model as a latent Gaussian model to use the Bayesian estimation approach with the integrated nested Laplace approximation algorithm and evaluate its performance using simulation studies. Our trivariate joint model is applied to a series of 18 families from Newfoundland, with the occurrence of CRC taken as the terminal event, the colonoscopy screening visits as recurrent events, and the number of polyps detected at each visit as zero-inflated count data with overdispersion. We showed that our trivariate model fits better than alternative bivariate models and that the cluster effects should not be ignored when analyzing family data. Finally, the proposed model enables us to quantify heterogeneity across families and individuals in polyp detection and CRC risk, thus helping to identify individuals and families who would benefit from more intensive screening visits.

The Processing Spatial Data for Statistical Modeling and Visualization Case study: INLA model for COVID-19 in Alabama, USA

This research emphasizes the visualization of spatial data for statistical modelling and analysis of the relative risk associated with the COVID-19 pandemic in Alabama, USA. We used Bayesian analysis and the Integrated Nested Laplace Approximation (INLA) approach on data ranging from March 11, 2020, to December 31, 2022, which included observed COVID-19 cases, the population for each of the Alabama counties, and a Geographical map of the state. The geographical distribution of COVID-19’s relative risk was determined using various spatial statistical techniques, indicating high-risk locations. The study used Besag-York-Mollié (BYM) models to assess the posterior relative risk of COVID-19, and it found a statistically significant average decrease in COVID-19 case rates across the 67 counties evaluated. These findings have practical implications for evidence-based policymaking in pandemic prevention, mitigation, and preparation.

Modeling suspected malaria cases in Papua province with second order Besag-York-Mollie 2 spatial regression

The number of malaria cases in Indonesia has increased in recent years. The highest malaria cases in Indonesia are in the eastern region, namely Papua Province, where in 2021 there were 86,022 cases. This study aims to model suspected malaria cases in Papua using the Integrated Nested Laplace Approximation (INLA) approach. Modelling is carried out with two different orders to see the difference in determining the best results. The results showed that second-order spatial modelling provides better results than first order modelling because the RMSE value is smaller than the first-order model. Based on these results, it is concluded that the INLA approach with second-order spatial modelling is effective for analysing and predicting suspected malaria cases in Papua. Therefore, these results can be used as a reference in developing malaria control strategies in the region.

The hospitalisation risk of chronic circulatory and respiratory diseases associated with coal mining in the general population in Queensland, Australia

Queensland is the main coal mining state in Australia where populations in coal mining areas have been historically exposed to coal mining emissions. Although a higher risk of chronic circulatory and respiratory diseases has been associated with coal mining globally, few studies have investigated these associations in the Queensland general population. This study estimates the association of coal production with hospitalisations for chronic circulatory and respiratory diseases in Queensland considering spatial and temporal variations during 1997–2014.An ecological analysis used a Bayesian hierarchical spatiotemporal model to estimate the association of coal production with standardised rates of each, chronic circulatory and respiratory diseases, adjusting for sociodemographic factors and considering the spatial structure of Queensland's statistical areas (SA2) in the 18-year period. Two specifications; with and without a space-time interaction effect were compared using the integrated nested Laplace approximation -INLA approach. The posterior mean of the best fit model was used to map the spatial, temporal and spatiotemporal trends of risk.The analysis considered 2,831,121 hospitalisation records. Coal mining was associated with a 4 % (2.4—5.5) higher risk of hospitalisation for chronic respiratory diseases in the model with a space-time interaction effect which had the best fit. An emerging higher risk of either chronic circulatory and respiratory diseases was identified in eastern areas and some coal-mining areas in central and southeast Queensland. There were important disparities in the spatiotemporal trend of risk between coal -and non-coal mining areas for each, chronic circulatory and respiratory diseases.Coal mining is associated with an increased risk of chronic respiratory diseases in the Queensland general population. Bayesian spatiotemporal analyses are robust methods to identify environmental determinants of morbidity in exposed populations. This methodology helps identifying at-risk populations which can be useful to support decision-making in health. Future research is required to investigate the causality links between coal mining and these diseases.

Marginal inference for hierarchical generalized linear mixed models with patterned covariance matrices using the Laplace approximation

AbstractWe develop hierarchical models and methods in a fully parametric approach to generalized linear mixed models for any patterned covariance matrix. The Laplace approximation is used to marginally estimate covariance parameters by integrating over all fixed and latent random effects. The Laplace approximation relies on Newton–Raphson updates, which also leads to predictions for the latent random effects. We develop methodology for complete marginal inference, from estimating covariance parameters and fixed effects to making predictions for unobserved data. The marginal likelihood is developed for six distributions that are often used for binary, count, and positive continuous data, and our framework is easily extended to other distributions. We compare our methods to fully Bayesian methods, automatic differentiation, and integrated nested Laplace approximations (INLA) for bias, mean‐squared (prediction) error, and interval coverage, and all methods yield very similar results. However, our methods are much faster than Bayesian methods, and more general than INLA. Examples with binary and proportional data, count data, and positive‐continuous data are used to illustrate all six distributions with a variety of patterned covariance structures that include spatial models (both geostatistical and areal models), time series models, and mixtures with typical random intercepts based on grouping.

Estimating the spatial distribution of the white shark in the Mediterranean Sea via an integrated species distribution model accounting for physical barriers

AbstractConserving oceanic apex predators, such as sharks, is of utmost importance. However, scant abundance and distribution data often challenge understanding the population status of many threatened species. Occurrence records are often scarce and opportunistic, and fieldwork aimed to retrieve additional data is expensive and prone to failure. Integrating various data sources becomes crucial to developing species distribution models for informed sampling and conservation purposes. The white shark, for example, is a rare but persistent inhabitant of the Mediterranean Sea. Here, it is considered Critically Endangered by the IUCN, while population abundance, distribution patterns, and habitat use are still poorly known. This study uses available occurrence records from 1985 to 2021 from diverse sources to construct a spatial log‐Gaussian Cox process, with data‐source specific detection functions and thinning, and accounting for physical barriers. This model estimates white shark presence intensity alongside uncertainty through a Bayesian approach with Integrated Nested Laplace Approximation (INLA) and the inlabru R package. For the first time, we projected species occurrence hot spots and landscapes of relative abundance (continuous measure of animal density in space) throughout the Mediterranean Sea. This approach can be used with other rare species for which presence‐only data from different sources are available.

Bayesian survival analysis with INLA.

This tutorial shows how various Bayesian survival models can be fitted using the integrated nested Laplace approximation in a clear, legible, and comprehensible manner using the INLA and INLAjoint R-packages. Such models include accelerated failure time, proportional hazards, mixture cure, competing risks, multi-state, frailty, and joint models of longitudinal and survival data, originally presented in the article "Bayesian survival analysis with BUGS." In addition, we illustrate the implementation of a new joint model for a longitudinal semicontinuous marker, recurrent events, and a terminal event. Our proposal aims to provide the reader with syntax examples for implementing survival models using a fast and accurate approximate Bayesian inferential approach.

High‐Frequency Ground Motions of Earthquakes Correlate With Fault Network Complexity

AbstractUnderstanding the generation of damaging, high‐frequency ground motions during earthquakes is essential both for fundamental science and for effective hazard preparation. Various theories exist regarding the origin of high‐frequency ground motions, including the standard paradigm linked to slip heterogeneity on the rupture plane, and alternative perspectives associated with fault complexity. To assess these competing hypotheses, we measure ground motion amplitudes in different frequency bands for 3 ≤ M ≤ 5.8 earthquakes in Southern California and compare them to empirical ground motion models. We utilize a Bayesian inference technique called the Integrated Nested Laplace Approximation (INLA) to identify earthquake source regions that produce higher or lower ground motions than expected. Our analysis reveals a strong correlation between fault complexity measurements and the high‐frequency ground motion event terms identified by INLA. These findings suggest that earthquakes on complex faults (or fault networks) lead to stronger‐than‐expected ground motions at high frequencies.

Exploring Dengue Dynamics: A Multi-Scale Analysis of Spatio-Temporal Trends in Ibagué, Colombia.

Our study examines how dengue fever incidence is associated with spatial (demographic and socioeconomic) alongside temporal (environmental) factors at multiple scales in the city of Ibagué, located in the Andean region of Colombia. We used the dengue incidence in Ibagué from 2013 to 2018 to examine the associations with climate, socioeconomic, and demographic factors from the national census and satellite imagery at four levels of local spatial aggregation. We used geographically weighted regression (GWR) to identify the relevant socioeconomic and demographic predictors, and we then integrated them with environmental variables into hierarchical models using integrated nested Laplace approximation (INLA) to analyze the spatio-temporal interactions. Our findings show a significant effect of spatial variables across the different levels of aggregation, including human population density, gas and sewage connection, percentage of woman and children, and percentage of population with a higher education degree. Lagged temporal variables displayed consistent patterns across all levels of spatial aggregation, with higher temperatures and lower precipitation at short lags showing an increase in the relative risk (RR). A comparative evaluation of the models at different levels of aggregation revealed that, while higher aggregation levels often yield a better overall model fit, finer levels offer more detailed insights into the localized impacts of socioeconomic and demographic variables on dengue incidence. Our results underscore the importance of considering macro and micro-level factors in epidemiological modeling, and they highlight the potential for targeted public health interventions based on localized risk factor analyses. Notably, the intermediate levels emerged as the most informative, thereby balancing spatial heterogeneity and case distribution density, as well as providing a robust framework for understanding the spatial determinants of dengue.

Designing a Bayesian adaptive clinical trial to evaluate novel mechanical ventilation strategies in acute respiratory failure using integrated nested Laplace approximations

BackgroundAdaptive trials usually require simulations to determine values for design parameters, demonstrate error rates, and establish the sample size. We designed a Bayesian adaptive trial comparing ventilation strategies for patients with acute hypoxemic respiratory failure using simulations. The complexity of the analysis would usually require computationally expensive Markov Chain Monte Carlo methods but this barrier to simulation was overcome using the Integrated Nested Laplace Approximations (INLA) algorithm to provide fast, approximate Bayesian inference. MethodsWe simulated two-arm Bayesian adaptive trials with equal randomization that stratified participants into two disease severity states. The analysis used a proportional odds model, fit using INLA. Trials were stopped based on pre-specified posterior probability thresholds for superiority or futility, separately for each state. We calculated the type I error and power across 64 scenarios that varied the probability thresholds and the initial minimum sample size before commencing adaptive analyses. Two designs that maintained a type I error below 5%, a power above 80%, and a feasible mean sample size were evaluated further to determine the optimal design. ResultsPower generally increased as the initial sample size and the futility threshold increased. The chosen design had an initial recruitment of 500 and a superiority threshold of 0.9925, and futility threshold of 0.95. It maintained high power and was likely to reach a conclusion before exceeding a feasible sample size. ConclusionsWe designed a Bayesian adaptive trial to evaluate novel strategies for ventilation using the INLA algorithm to efficiently evaluate a wide range of designs through simulation.

Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island

ObjectivePolicy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may...

Spatiotemporal Bayesian modeling of the risk of congenital syphilis in São Paulo, SP, Brazil

The aim of this study is to analyze the spatiotemporal risk of congenital syphilis (CS) in high-prevalence areas in the city of São Paulo, SP, Brazil, and to evaluate its relationship with socioeconomic, demographic, and environmental variables. An ecological study was conducted based on secondary CS data with spatiotemporal components collected from 310 areas between 2010 and 2016. The data were modeled in a Bayesian context using the integrated nested Laplace approximation (INLA) method. Risk maps showed an increasing CS trend over time and highlighted the areas that presented the highest and lowest risk in each year. The model showed that the factors positively associated with a higher risk of CS were the Gini index and the proportion of women aged 18–24 years without education or with incomplete primary education, while the factors negatively associated were the proportion of women of childbearing age and the mean per capita income.