Spatial and space–time clustering of mortality due to malaria in rural Tanzania evidence from Ifakara and Rufiji Health and Demographic Surveillance System sites.pdfVIP

Selemani et al. Malar J DOI 10.1186/s12936-015-0905-y RESEARCH Open Access Spatial and space–time clustering of mortality due to malaria in rural Tanzania: evidence from Ifakara and Ruiji Health and Demographic Surveillance System sites 1,2* 2 2 2 3 4 Majige Selemani , Sigilbert Mrema , Amri Shamte , Josephine Shabani , Michael J. Mahande , Karen Yeates , 1 1 2 Amina S. Msengwa , Maurice C. Y. Mbago and Angelina M. Lutambi Abstract Background: Although, malaria control interventions are widely implemented to eliminate malaria disease, malaria is still a public health problem in Tanzania. Understanding the risk factors, spatial and space–time clustering for malaria deaths is essential for targeting malaria interventions and efective control measures. In this study, spatial methods were used to identify local malaria mortality clustering using verbal autopsy data. Methods: The analysis used longitudinal data collected in Ruiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period 1999–2011 and 2002–2012, respectively. Two models were used. The irst was a non-spatial model where logistic regression was used to determine a household’s characteristic or an individual’s risk of malaria deaths. The second was a spatial Poisson model applied to estimate spatial clustering of malaria mortality using ™ SaTScan , with age as a covariate. ArcGIS Geographical Information System software was used to map the estimates obtained to show clustering and the variations related to malaria mortality. Results: A total of 11,462 deaths in 33 villages and 9328 deaths in