I. Kleinschmidt et al., Use of generalized linear mixed models in the spatial analysis of small-area malaria incidence rates in KwaZulu Natal, South Africa, AM J EPIDEM, 153(12), 2001, pp. 1213-1221
Citations number
30
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
Spatial statistical analysis of 1994-1995 small-area malaria incidence rate
s in the population of the northernmost districts of KwaZulu Natal, South A
frica, was undertaken to identify factors that might explain very strong he
terogeneity in the rates. In this paper, the authors describe a method of a
djusting the regression analysis results for strong spatial correlation in
the rates by using generalized linear mixed models and variograms. The resu
lts of the spatially adjusted, multiple regression analysis showed that mal
aria incidence was significantly positively associated with higher winter r
ainfall and a higher average maximum temperature and was significantly nega
tively associated with increasing distance from water bodies. The statistic
al model was used to produce a map of predicted malaria incidence in the ar
ea, taking into account local variation from the model prediction if this v
ariation was supported by the data. The predictor variables showed that eve
n small differences in climate can have very marked effects on the intensit
y of malaria transmission, even in areas subject to malaria control for man
y years. The results of this study have important implications for malaria
control programs in the area.