Social and environmental determinants of malaria in space and time in Viet Nam.

The malaria burden in Viet Nam has been in decline in recent decades, but localised areas of high transmission remain. We used spatiotemporal analytical tools to determine the social and environmental drivers of malaria risk and to identify residual high-risk areas where control and surveillance res...

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Main Authors: Bui, H, Clements, A, Nguyen, Q, Nguyen, M, Le, X, Hay, S, Tran, T, Wertheim, H, Snow, R, Horby, P
Format: Journal article
Language:English
Published: 2011
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author Bui, H
Clements, A
Nguyen, Q
Nguyen, M
Le, X
Hay, S
Tran, T
Wertheim, H
Snow, R
Horby, P
author_facet Bui, H
Clements, A
Nguyen, Q
Nguyen, M
Le, X
Hay, S
Tran, T
Wertheim, H
Snow, R
Horby, P
author_sort Bui, H
collection OXFORD
description The malaria burden in Viet Nam has been in decline in recent decades, but localised areas of high transmission remain. We used spatiotemporal analytical tools to determine the social and environmental drivers of malaria risk and to identify residual high-risk areas where control and surveillance resources can be targeted. Counts of reported Plasmodium falciparum and Plasmodium vivax malaria cases by month (January 2007-December 2008) and by district were assembled. Zero-inflated Poisson regression models were developed in a bayesian framework. Models had the percentage of the district's population living below the poverty line, percent of the district covered by forest, median elevation, median long-term average precipitation, and minimum temperature included as fixed effects, and terms for temporal trend and residual district-level spatial autocorrelation. Strong temporal and spatial heterogeneity in counts of malaria cases was apparent. Poverty and forest cover were significantly associated with an increased count of malaria cases but the magnitude and direction of associations between climate and malaria varied by socio-ecological zone. There was a declining trend in counts of malaria cases during the study period. After accounting for the social and environmental fixed effects, substantial spatial heterogeneity was still evident. Unmeasured factors which may contribute to this residual variation include malaria control activities, population migration and accessibility to health care. Forest-related activities and factors encompassed by poverty indicators are major drivers of malaria incidence in Viet Nam.
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spelling oxford-uuid:63b279e1-52d9-4f98-85d7-2592de4356d22022-03-26T18:14:33ZSocial and environmental determinants of malaria in space and time in Viet Nam.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:63b279e1-52d9-4f98-85d7-2592de4356d2EnglishSymplectic Elements at Oxford2011Bui, HClements, ANguyen, QNguyen, MLe, XHay, STran, TWertheim, HSnow, RHorby, PThe malaria burden in Viet Nam has been in decline in recent decades, but localised areas of high transmission remain. We used spatiotemporal analytical tools to determine the social and environmental drivers of malaria risk and to identify residual high-risk areas where control and surveillance resources can be targeted. Counts of reported Plasmodium falciparum and Plasmodium vivax malaria cases by month (January 2007-December 2008) and by district were assembled. Zero-inflated Poisson regression models were developed in a bayesian framework. Models had the percentage of the district's population living below the poverty line, percent of the district covered by forest, median elevation, median long-term average precipitation, and minimum temperature included as fixed effects, and terms for temporal trend and residual district-level spatial autocorrelation. Strong temporal and spatial heterogeneity in counts of malaria cases was apparent. Poverty and forest cover were significantly associated with an increased count of malaria cases but the magnitude and direction of associations between climate and malaria varied by socio-ecological zone. There was a declining trend in counts of malaria cases during the study period. After accounting for the social and environmental fixed effects, substantial spatial heterogeneity was still evident. Unmeasured factors which may contribute to this residual variation include malaria control activities, population migration and accessibility to health care. Forest-related activities and factors encompassed by poverty indicators are major drivers of malaria incidence in Viet Nam.
spellingShingle Bui, H
Clements, A
Nguyen, Q
Nguyen, M
Le, X
Hay, S
Tran, T
Wertheim, H
Snow, R
Horby, P
Social and environmental determinants of malaria in space and time in Viet Nam.
title Social and environmental determinants of malaria in space and time in Viet Nam.
title_full Social and environmental determinants of malaria in space and time in Viet Nam.
title_fullStr Social and environmental determinants of malaria in space and time in Viet Nam.
title_full_unstemmed Social and environmental determinants of malaria in space and time in Viet Nam.
title_short Social and environmental determinants of malaria in space and time in Viet Nam.
title_sort social and environmental determinants of malaria in space and time in viet nam
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