Rachel Lowe|James Chirombo|Adrian M. Tompkins
Relative importance of climatic, geographic and socio-economic determinants of malaria in Malawi
The Abdus Salam International Centre for Theoretical Physics (ICTP)|Ministry of Health|The Abdus Salam International Centre for Theoretical Physics (ICTP)
malaria transmission influenced variations meteorological conditions impact biology parasite vector also socioeconomic conditions levels urbanization poverty education impact human vulnerability vector habitat many potential drivers malaria extrinsic climate intrinsic population immunity often difficult disentangle presents challenge modelling malaria risk space time statistical mixed model framework proposed model malaria risk district level malawi using agestratified spatiotemporal dataset malaria cases july 2004 june 2011 several climatic geographic socioeconomic factors thought influence malaria incidence tested exploratory model order account unobserved confounding factors influence malaria accounted using measured covariates generalized linear mixed model adopted included structured unstructured spatial temporal random effects hierarchical bayesian framework using markov chain monte carlo simulation used model fitting prediction using stepwise model selection procedure several explanatory variables identified significant associations malaria including climatic cartographic socioeconomic data intervention variations unobserved confounding factors spatial correlation considered bayesian framework final model emerged statistically significant predictor variables limited average precipitation quadratic relation average temperature three months previous month interest modelling malaria risk malawi important account spatial temporal heterogeneity correlation districts observed unobserved confounding factors allowed precipitation temperature months prior malaria season interest found significantly determine spatial temporal variations malaria incidence climate information found improve estimation malaria relative risk 41 districts malawi particularly higher altitudes transmission irregular highlights potential value climatedriven seasonal malaria forecasts