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Household level spatio-temporal analysis of Plasmodium falciparum and Plasmodium vivax malaria in Ethiopia

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Abstract
Background: The global decline of malaria burden and goals for elimination has led to an increased interest in the fine-scale epidemiology of malaria. Micro-geographic heterogeneity of malaria infection could have implications for designing targeted small-area interventions. Methods: Two-year longitudinal cohort study data were used to explore the spatial and spatio-temporal distribution of malaria episodes in 2040 children aged < 10 years in 16 villages near the Gilgel-Gibe hydropower dam in Southwest Ethiopia. All selected households (HHs) were geo-referenced, and children were followed up through weekly house-to-house visits for two consecutive years to identify febrile episodes of P. falciparum and P. vivax infections. After confirming the spatial dependence of malaria episodes with Ripley's K function, SatScan(TM) was used to identify purely spatial and space-time clusters (hotspots) of annual malaria incidence for 2 years follow-up: year 1 (July 2008-June 2009) and year 2 (July 2009-June 2010). Results: In total, 685 P. falciparum episodes (in 492 HHs) and 385 P. vivax episodes (in 290 HHs) were identified, representing respectively incidence rates of 14.6 (95% CI: 13.4-15.6) and 8.2 (95% CI: 7.3-9.1) per 1000 child-months at risk. In year 1, the most likely (128 HHs with 63 episodes, RR = 2.1) and secondary (15 HHs with 12 episodes, RR = 5.31) clusters of P. vivax incidence were found respectively in southern and north-western villages; while in year 2, the most likely cluster was located only in north-western villages (85 HHs with 16 episodes, RR = 4.4). Instead, most likely spatial clusters of P. falciparum incidence were consistently located in villages south of the dam in both years: year 1 (167 HHs with 81 episodes, RR = 1.8) and year 2 (133 HHs with 67 episodes, RR = 2.2). Space-time clusters in southern villages for P. vivax were found in August-November 2008 in year 1 and between November 2009 and February 2010 in year 2; while for P. falciparum, they were found in September-November 2008 in year 1 and October-November 2009 in year 2. Conclusion: Hotspots of P. falciparum incidence in children were more stable at the geographical level and over time compared to those of P. vivax incidence during the study period.
Keywords
SOUTH-CENTRAL ETHIOPIA, TRANSMISSION, KNOWLEDGE, PATTERNS, CHILDREN, AREA, DAM, IDENTIFICATION, ELIMINATION, PREVALENCE, Spatio-temporal analysis, SatScan, Plasmodium vivax, Plasmodium, falciparum, Active case detection, Ethiopia

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Chicago
Seyoum, Dinberu, Delenasaw Yewhalaw, Luc Duchateau, Patrick Brandt, Angel Rosas-Aguirre, and Niko Speybroeck. 2017. “Household Level Spatio-temporal Analysis of Plasmodium Falciparum and Plasmodium Vivax Malaria in Ethiopia.” Parasites & Vectors 10.
APA
Seyoum, D., Yewhalaw, D., Duchateau, L., Brandt, P., Rosas-Aguirre, A., & Speybroeck, N. (2017). Household level spatio-temporal analysis of Plasmodium falciparum and Plasmodium vivax malaria in Ethiopia. PARASITES & VECTORS, 10.
Vancouver
1.
Seyoum D, Yewhalaw D, Duchateau L, Brandt P, Rosas-Aguirre A, Speybroeck N. Household level spatio-temporal analysis of Plasmodium falciparum and Plasmodium vivax malaria in Ethiopia. PARASITES & VECTORS. 2017;10.
MLA
Seyoum, Dinberu, Delenasaw Yewhalaw, Luc Duchateau, et al. “Household Level Spatio-temporal Analysis of Plasmodium Falciparum and Plasmodium Vivax Malaria in Ethiopia.” PARASITES & VECTORS 10 (2017): n. pag. Print.
@article{8537988,
  abstract     = {Background: The global decline of malaria burden and goals for elimination has led to an increased interest in the fine-scale epidemiology of malaria. Micro-geographic heterogeneity of malaria infection could have implications for designing targeted small-area interventions. 
Methods: Two-year longitudinal cohort study data were used to explore the spatial and spatio-temporal distribution of malaria episodes in 2040 children aged {\textlangle} 10 years in 16 villages near the Gilgel-Gibe hydropower dam in Southwest Ethiopia. All selected households (HHs) were geo-referenced, and children were followed up through weekly house-to-house visits for two consecutive years to identify febrile episodes of P. falciparum and P. vivax infections. After confirming the spatial dependence of malaria episodes with Ripley's K function, SatScan(TM) was used to identify purely spatial and space-time clusters (hotspots) of annual malaria incidence for 2 years follow-up: year 1 (July 2008-June 2009) and year 2 (July 2009-June 2010). 
Results: In total, 685 P. falciparum episodes (in 492 HHs) and 385 P. vivax episodes (in 290 HHs) were identified, representing respectively incidence rates of 14.6 (95\% CI: 13.4-15.6) and 8.2 (95\% CI: 7.3-9.1) per 1000 child-months at risk. In year 1, the most likely (128 HHs with 63 episodes, RR = 2.1) and secondary (15 HHs with 12 episodes, RR = 5.31) clusters of P. vivax incidence were found respectively in southern and north-western villages; while in year 2, the most likely cluster was located only in north-western villages (85 HHs with 16 episodes, RR = 4.4). Instead, most likely spatial clusters of P. falciparum incidence were consistently located in villages south of the dam in both years: year 1 (167 HHs with 81 episodes, RR = 1.8) and year 2 (133 HHs with 67 episodes, RR = 2.2). Space-time clusters in southern villages for P. vivax were found in August-November 2008 in year 1 and between November 2009 and February 2010 in year 2; while for P. falciparum, they were found in September-November 2008 in year 1 and October-November 2009 in year 2. 
Conclusion: Hotspots of P. falciparum incidence in children were more stable at the geographical level and over time compared to those of P. vivax incidence during the study period.},
  articleno    = {196},
  author       = {Seyoum, Dinberu and Yewhalaw, Delenasaw and Duchateau, Luc and Brandt, Patrick and Rosas-Aguirre, Angel and Speybroeck, Niko},
  issn         = {1756-3305},
  journal      = {PARASITES \& VECTORS},
  keyword      = {SOUTH-CENTRAL ETHIOPIA,TRANSMISSION,KNOWLEDGE,PATTERNS,CHILDREN,AREA,DAM,IDENTIFICATION,ELIMINATION,PREVALENCE,Spatio-temporal analysis,SatScan,Plasmodium vivax,Plasmodium,falciparum,Active case detection,Ethiopia},
  language     = {eng},
  pages        = {11},
  title        = {Household level spatio-temporal analysis of Plasmodium falciparum and Plasmodium vivax malaria in Ethiopia},
  url          = {http://dx.doi.org/10.1186/s13071-017-2124-6},
  volume       = {10},
  year         = {2017},
}

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