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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Space-time clustering of childhood malaria at the household level: A dynamic cohort in a Mali village
BMC Public Health, Volume 6, Article 286, Year 2006
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Description
Background: Spatial and temporal heterogeneities in the risk of malaria have led the WHO to recommend fine-scale stratification of the epidemiological situation, making it possible to set up actions and clinical or basic researches targeting high-risk zones. Before initiating such studies it is necessary to define local patterns of malaria transmission and infection (in time and in space) in order to facilitate selection of the appropriate study population and the intervention allocation. The aim of this study was to identify, spatially and temporally, high-risk zones of malaria, at the household level (resolution of 1 to 3 m). Methods: This study took place in a Malian village with hyperendemic seasonal transmission as part of Mali-Tulane Tropical Medicine Research Center (NIAID/NIH). The study design was a dynamic cohort (22 surveys, from June 1996 to June 2001) on about 1300 children (<12 years) distributed between 173 households localized by GPS. We used the computed parasitological data to analyzed levels of Plasmodium falciparum, P. malariae and P. ovale infection and P. falciparum gametocyte carriage by means of time series and Kulldorff's scan statistic for space-time cluster detection. Results: The time series analysis determined that malaria parasitemia (primarily P. falciparum) was persistently present throughout the population with the expected seasonal variability pattern and a downward temporal trend. We identified six high-risk clusters of P. falciparum infection, some of which persisted despite an overall tendency towards a decrease in risk. The first high-risk cluster of P. falciparum infection (rate ratio = 14.161) was detected from September 1996 to October 1996, in the north of the village. Conclusion: This study showed that, although infection proportions tended to decrease, high-risk zones persisted in the village particularly near temporal backwaters. Analysis of this heterogeneity at the household scale by GIS methods lead to target preventive actions more accurately on the high-risk zones identified. This mapping of malaria risk makes it possible to orient control programs, treating the high-risk zones identified as a matter of priority, and to improve the planning of intervention trials or research studies on malaria. © 2006 Gaudart et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Gaudart, J.
France, Marseille
Aix Marseille Université
Poudiougou, Belco
France, Marseille
Aix Marseille Université
Mali, Bamako
University of Bamako
Dicko, Alassane A.
Mali, Bamako
University of Bamako
Ranque, S.
France, Marseille
Aix Marseille Université
Touré, Ousmane B.
Mali, Bamako
University of Bamako
Sagara, Issaka
Mali, Bamako
University of Bamako
Diallo, M.
Mali, Bamako
University of Bamako
Diawara, Sory Ibrahim
Mali, Bamako
University of Bamako
Ouattara, A.
Mali, Bamako
University of Bamako
Diakité, Mahamadou L.
Mali, Bamako
University of Bamako
Doumbo, Ogobara K.
Mali, Bamako
University of Bamako
Statistics
Citations: 152
Authors: 11
Affiliations: 2
Identifiers
Doi:
10.1186/1471-2458-6-286
ISSN:
14712458
e-ISSN:
14712458
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
Mali