Epidemiology and Health

Original Articles

Modeling the relationship between malaria prevalence and insecticide-treated bed net coverage in Nigeria using a Bayesian spatial generalized linear mixed model with a Leroux prior: Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Adewale F. Lukman; Epidemiol Health. 2021;43:e2021041. Published online June 4, 2021; DOI: https://doi.org/10.4178/epih.e2021041

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Abstract

OBJECTIVES
To evaluate malaria transmission in relation to insecticide-treated net (ITN) coverage in Nigeria.

METHODS

We used an exploratory analysis approach to evaluate variation in malaria transmission in relation to ITN distribution in 1,325 Demographic and Health Survey clusters in Nigeria. A Bayesian spatial generalized linear mixed model with a Leroux conditional autoregressive prior for the random effects was used to model the spatial and contextual variation in malaria prevalence and ITN distribution after adjusting for environmental variables.

RESULTS

Spatial smoothed maps showed the nationwide distribution of malaria and ITN. The distribution of ITN varied significantly across the 6 geopolitical zones (p<0.05). The North-East had the least ITN distribution (0.196±0.071), while ITN distribution was highest in the South-South (0.309±0.075). ITN coverage was also higher in rural areas (0.281±0.074) than in urban areas (0.240±0.096, p<0.05). The Bayesian hierarchical regression results showed a non-significant negative relationship between malaria prevalence and ITN coverage, but a significant spatial structured random effect and unstructured random effect. The correlates of malaria transmission included rainfall, maximum temperature, and proximity to water.

CONCLUSIONS

Reduction in malaria transmission was not significantly related to ITN coverage, although much could be achieved in attempts to curtail malaria transmission through enhanced ITN coverage. A multifaceted and integrated approach to malaria control is strongly advocated.

Summary

Key Message
Scaling up equity in ITN distribution and coverage, awareness and knowledge on ITN utilization are important integrated approaches to mitigate malaria transmission in Nigeria.

Citations

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A Systematic Review of Areal Units and Adjacency Used in Bayesian Spatial and Spatio-Temporal Conditional Autoregressive Models in Health Research
Zemenu Tadesse Tessema, Getayeneh Antehunegn Tesema, Susannah Ahern, Arul Earnest
International Journal of Environmental Research and Public Health.2023; 20(13): 6277. CrossRef
Malaria transmission in Africa: Its relationship with yellow fever and measles
Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Luzia Helena Carvalho
PLOS ONE.2022; 17(5): e0268080. CrossRef
Bayesian spatio-temporal modelling and mapping of malaria and anaemia among children between 0 and 59 months in Nigeria
Jecinta U. Ibeji, Henry Mwambi, Abdul-Karim Iddrisu
Malaria Journal.2022;[Epub] CrossRef

A small window into the status of malaria in North Korea: estimation of imported malaria incidence among visitors from South Korea: Jisun Sung, Hae-Kwan Cheong, Ah-Young Lim, Jong-Hun Kim; Epidemiol Health. 2020;42:e2020068. Published online November 21, 2020; DOI: https://doi.org/10.4178/epih.e2020068

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Abstract Summary PDF: Abstract
OBJECTIVES
This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea.
METHODS
The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles.
RESULTS
A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data.
CONCLUSIONS
The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.; Summary

Korean summary
본 연구는 2000-2008년 금강산을 여행한 대한민국 국민과 2005-2015년 개성공단에서 근무한 대한민국 국민에서의 말라리아 발생률을 추정하여 국제사회에 보고된 북한의 말라리아 발생률과 비교 평가하였다. 향후 남북한의 교류가 활성화 되었을 때 북한을 방문하고 돌아온 국민에서의 말라리아 발생률 자료를 사용하여 북한 현지에서의 말라리아 발생률 현황 추이를 살펴볼 수 있을 것으로 보인다.

Epidemiology of Malaria in Korea, 2000.: Jung Sik Yoo, Kyung Hee Lee, Un Yeong Goh, Jong Soo Lee, Byung Guk Yang; Korean J Epidemiol. 2001;23(2):19-24.

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Abstract PDF: Abstract
PURPOSE
In Korea, vivax malaria re-emerged in 1993 and the outbreak continued in several areas near the DMZ until now. This study was conducted to define the epidemiologic pattern of malaria in Korea and to examine the changes comparing to the one in 1999.
METHODS
We collected information about civilian, veteran patients through the National malaria surveillance system and soldier from the Ministry of National Defense. We analyze epidemiological characteristics of malaria by groups (civilian, veteran, soldier).
RESULTS
The reported cases of malaria in 2000 were 4,142 that number is an increase of 14% in numbers compared with those of 1999's. Most of cases occured in 17 counties nearby DMZ and from May to October(98.7%) seasonally. The incidence rates (per 100,000) in 2000 by residence were 17.0 in Gangwon-Do, 15.5 in Incheon Metropolitan city, 10.3 in Gyeonggi-Do was dereased. The risk area in 2000 were 17 counties located nearly DMZ and the high risk area were 5 counties where the incidence rate greater than 100. In case of civilian and veteran, the time required to diagnosis from onset of symptom was 8.1 days on the average.
CONCLUSION
Epidemiologic pattern of malaria in 2000 did not differ from the one in 1999. Et showed regional spread (increasing risk area) but incidence rate was lowered in the high risk area of 1999. And it is necessary that we pay more attention to Gangwon-Do and Incheon metrocity to reduce the incidence rate in 2001.; Summary

Indigenous Malaria Surveillance in Korea.: Dae Seong Kim, Soon Duck Kim, Yong Tae Yum, Chae Seung Lim, Kab Ro Lee, Mi Sook Park, Bae Jung Yoon; Korean J Epidemiol. 1997;19(2):180-189.

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Abstract PDF: Abstract
Malaria, one of the compulsory notifiable diseases, has been diappeared from Korea based on that fact no notification on malaria case was received from local health agencies during the last decade or so. Recently, Indigenous malaria has been re-emerged since 1993 and 549 cases was notificated till 1996. We conducted a surveillance system on the resurgent malaria outbreaks in the northern area of Kyonggi Province around the Imjin River. Malaria Surveillance Networks(MSNs) were established in Paju and Yoncheon between August 1996 and December 1996. When a febrile patient visits a clinic or a hospital, clinician takes a blood sample and refer to district malaria laboratory for the sample. The blood sample is examined in the malaria laboratory(public health center), and if malaria parasites are found, a radical or curative treatment is offered to patients. MSNs took 94 febrile cases and identified 23 malaria cases(24.5%). All malaria cases were infected by the indigenous vivax malaria. In Paju, 14 of 62 febrile cases(22.6%) were malaria outbreaks and 9 of 32 febrile cases(28.1%) in Yoncheon. In Korea resurgent malaria, malaria surveillance system should be operated for a program based on the district public health center with the coupled laboratory and dispensary.; Summary

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