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Modelling spatio-temporal dynamics of malaria and mortality to develop optimised interventions and surveillance tools in Africa

English title Modelling spatio-temporal dynamics of malaria and mortality to develop optimised interventions and surveillance tools in Africa
Applicant Vounatsou Penelope
Number 147286
Funding scheme r4d (Swiss Programme for Research on Global Issues for Development)
Research institution Swiss Tropical and Public Health Institute
Institution of higher education University of Basel - BS
Main discipline Medical Statistics
Start/End 01.04.2014 - 31.08.2017
Approved amount 493'655.00
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All Disciplines (3)

Discipline
Medical Statistics
Infectious Diseases
Methods of Epidemiology and Preventive Medicine

Keywords (12)

geostatistics; Demographic Health Surveys; mapping; mortality; Malaria Indicator Surveys; Gaussian process; Bayesian methods; Markov chain Monte Carlo; spatio-temporal process; Africa; Millennium Development Goals; malaria

Lay Summary (Italian)

Lead
C'è un forte impegno da parte dei paesi e dei donatori per raggiungere gli obiettivi di malaria fissati per l'anno 2015 all’interno degli Obiettivi di Sviluppo del Millennio. In molti paesi, sono state condotte delle indagini nazionali volte a monitorare gli indicatori di salute principali, quali i casi malaria, mortalità infantile e materna cosí come gli indicatori degli interventi sanitari corrispondenti. Tuttavia, nonostante questi sforzi e le risorse investite nella raccolta dei dati, l’informazione estratta nella maggior parte dei paesi è scarsa e si è piuttosto limitata al calcolo di medie nazionali, trascurando eterogeneità e differenze su scale inferiori. Inoltre, vi è un uso limitato dei dati nella valutazione degli interventi in corso, perché le analisi esistenti non riguardano indicatori di salute, prestazioni del sistema sanitario, né l'attuazione di interventi a scala locale.
Lay summary

L' obiettivo generale del progetto è quello di ridurre i casi malaria in Africa attraverso lo sviluppo e convalida di strumenti  (metodi , conoscenze, software) per migliorare la sorveglianza della malaria al fine di controllo e successiva eliminazione. Il progetto persegue i seguenti obiettivi specifici: (i) valutare le dinamiche spazio-temporali di rischio di malaria e misurare l'efficacia degli interventi a scala locale in Africa; (ii) stimare la mortalità attibuibile alla malaria in tutte le fasce d’età in Africa; (iii) valutare le dinamiche spazio-temporali e ottenere stime aggiornate ad alta risoluzione di mortalità neonatale e infantile in Africa; (iv) stimare il contributo delle prestazioni e degli interventi nei sistemi sanitari sulle dinamiche spazio-temporali del rischio di malaria e sulla mortalità (infantile e materna) in Uganda (Africa orientale) e Burkina Faso (Africa occidentale); (v) proporre strategie per ottimizzare le prestazioni dei sistemi sanitari ed interventi per ridurre i casi di malaria e il tasso di mortalità; (vi) sviluppare e diffondere il software per la sorveglianza della malaria (i.e. software per la mappatura geostatistica di rischio di malaria e diagnosi precoce dei focolai di malaria).Le stime spazio-temporali valuteranno il progresso verso gli obiettivi di malaria e mortalità che sono parte degli Obiettivi  di Sviluppo del Millennio ed altri obiettivi globali considerando le variazioni regionali piuttosto che le medie nazionali. I risultati del progetto saranno tradotti in strumenti  (mappe di rischio di malaria a varie risoluzioni geografiche, analisi di costo-efficacia di diversi interventi  sanitari, strategie per migliorare le performance del sistema sanitario, software di sorveglianza) per l’ausilio diretto dei programmi di controllo per l’eliminazione della malaria e la riduzione di mortalità infantile e materna. 

Direct link to Lay Summary Last update: 09.04.2014

Lay Summary (English)

Lead
There is a strong commitment from most countries and donors to reach malaria targets set for the year 2015 in the Millennium Development Goals. In many countries, national surveys have been repeatedly conducted to monitor key health-related indicators such as malaria, child and maternal mortality and relevant interventions. However, despite these efforts and resources invested in data collection, the information extracted from the data by most countries is poor and it is rather limited to national averages, overlooking regional and smaller scale heterogeneities and disparities. Additionally, there is limited use of the data in evaluating on-going interventions because existing analyses do not relate variations in the health indicators, system performance and implementation of interventions at local scale.
Lay summary

The overarching goal of the project is to reduce malaria burden in Africa by developing and validating tools (methods, knowledge, software) to strengthen malaria surveillance for disease control and elimination. The project will pursue the following interrelated specific objectives: (i) assess spatio-temporal dynamics of malaria risk and measure effectiveness of related interventions at local scale in Africa; (ii)   estimate the malaria-related mortality across all age groups in Africa; (iii) assess spatio-temporal dynamics and obtain up-todate high resolution estimates of infant and child mortality  across Africa; (iv) estimate the contribution of health systems performance and interventions in the spatio-temporal dynamics of malaria and mortality (child and maternal) in Uganda (East Africa) and Burkina Faso (West Africa); (v) propose strategies to optimize health systems performance and interventions to reduce malaria and mortality burden; (vi) develop and disseminate software for malaria surveillance (i.e. Bayesian geostatistical  malaria mapping and  early detection of malaria outbreaks).

The spatio-temporal estimates will evaluate success in achieving malaria and mortality related MDGs and other global targets considering regional disparities rather than national averages. The project results will be translated to tools (e.g. maps, burden estimates at different geographical resolution, cost-effectiveness of different interventions, strategies to improve health system performance, surveillance software) that can directly assist efforts of the control programmes towards malaria elimination and reduction of child and maternal mortality. Additionally, these products can be used to influence policy makers to choose spatially targeted, cost-effective interventions and improve local health systems in Uganda and Burkina Faso.  The malaria surveillance software would be easily installed in NMCPs other than Burkina Faso and Uganda. It can be also easily adapted for surveillance of other diseases.

Direct link to Lay Summary Last update: 09.04.2014

Responsible applicant and co-applicants

Employees

Publications

Publication
Modelling the relationship between malaria prevalence as a measure of transmission and mortality across age groups
Khagayi Sammy, Desai Meghna, Amek Nyaguara, Were Vincent, Onyango Eric Donald, Odero Christopher, Otieno Kephas, Bigogo Godfrey, Munga Stephen, Odhiambo Frank, Hamel Mary J., Kariuki Simon, Samuels Aaron M., Slutsker Laurence, Gimnig John, Vounatsou Penelope (2019), Modelling the relationship between malaria prevalence as a measure of transmission and mortality across age groups, in Malaria Journal, 18(1), 247-247.
Geographical variations of the associations between health interventions and all-cause under-five mortality in Uganda
Nambuusi Betty B., Ssempiira Julius, Makumbi Fredrick E., Utzinger Jürg, Kasasa Simon, Vounatsou Penelope (2019), Geographical variations of the associations between health interventions and all-cause under-five mortality in Uganda, in BMC Public Health, 19(1), 1330-1330.
The effects and contribution of childhood diseases on the geographical distribution of all-cause under-five mortality in Uganda
Nambuusi Betty Bukenya, Ssempiira Julius, Makumbi Fredrick E., Kasasa Simon, Vounatsou Penelope (2019), The effects and contribution of childhood diseases on the geographical distribution of all-cause under-five mortality in Uganda, in Parasite Epidemiology and Control, e00089-e00089.
Infant and child mortality in relation to malaria transmission in KEMRI/CDC HDSS, Western Kenya: validation of verbal autopsy
Amek Nyaguara O., Van Eijk Annemieke, Lindblade Kim A., Hamel Mary, Bayoh Nabie, Gimnig John, Laserson Kayla F., Slutsker Laurence, Smith Thomas, Vounatsou Penelope (2018), Infant and child mortality in relation to malaria transmission in KEMRI/CDC HDSS, Western Kenya: validation of verbal autopsy, in Malaria Journal, 17(1), 37-37.
Measuring health facility readiness and its effects on severe malaria outcomes in Uganda
Ssempiira Julius, Kasirye Ibrahim, Kissa John, Nambuusi Betty, Mukooyo Eddie, Opigo Jimmy, Makumbi Fredrick, Kasasa Simon, Vounatsou Penelope (2018), Measuring health facility readiness and its effects on severe malaria outcomes in Uganda, in Scientific Reports, 8(1), 17928-17928.
Interactions between climatic changes and intervention effects on malaria spatio-temporal dynamics in Uganda
Ssempiira Julius, Kissa John, Nambuusi Betty, Mukooyo Eddie, Opigo Jimmy, Makumbi Fredrick, Kasasa Simon, Vounatsou Penelope (2018), Interactions between climatic changes and intervention effects on malaria spatio-temporal dynamics in Uganda, in Parasite Epidemiology and Control, 3(3), e00070-e00070.
The effect of case management and vector-control interventions on space–time patterns of malaria incidence in Uganda
Ssempiira J, Kissa J, Nambuusi B, Kyozira C, Rutazaana D, Mukooyo E, Opigo J, Makumbi F, Kasasa S, Vounatsou P (2018), The effect of case management and vector-control interventions on space–time patterns of malaria incidence in Uganda, in Malaria Journal, 17:162, 1-11.
Challenges of DHS and MIS to capture the entire pattern of malaria parasite risk and intervention effects in countries with different ecological zones: the case of Cameroon
Massoda Tonye SG, Kouambeng C, Wounang R, Vounatsou P (2018), Challenges of DHS and MIS to capture the entire pattern of malaria parasite risk and intervention effects in countries with different ecological zones: the case of Cameroon, in Malaria Jounnal, 17:156(1), 1-14.
Geostatistical modelling of malaria indicator survey data to assess the effects of interventions on the geographical distribution of malaria prevalence in children less than 5 years in Uganda.
Ssempiira Julius, Nambuusi Betty, Kissa John, Agaba Bosco, Makumbi Fredrick, Kasasa Simon, Vounatsou Penelope (2017), Geostatistical modelling of malaria indicator survey data to assess the effects of interventions on the geographical distribution of malaria prevalence in children less than 5 years in Uganda., in PloS one, 12(4), 0174948-0174948.
Bayesian spatio-temporal modeling of mortality in relation to malaria incidence in Western Kenya
Khagayi Sammy, Amek N, Bigogo G, Odhiambo F, Vounatsou Penelope (2017), Bayesian spatio-temporal modeling of mortality in relation to malaria incidence in Western Kenya, in PLoS One, 12(7), 1-19.
The contribution of malaria control interventions on spatio-temporal changes of parasitaemia risk in Uganda during 2009-2014
Ssempiira J, Nambuusi B, Kissa J, Agaba B, Makumbi F, Kasasa S, Vounatsou P (2017), The contribution of malaria control interventions on spatio-temporal changes of parasitaemia risk in Uganda during 2009-2014, in Parasites and Vectors, 10(1), 1-13.
Spatial mapping and prediction of Plasmodium falciparum infection risk among school-aged children in Côte d'Ivoire.
Houngbedji Clarisse A, Chammartin Frédérique, Yapi Richard B, Hürlimann Eveline, N'Dri Prisca B, Silué Kigbafori D, Soro Gotianwa, Koudou Benjamin G, Assi Serge-Brice, N'Goran Eliézer K, Fantodji Agathe, Utzinger Jürg, Vounatsou Penelope, Raso Giovanna (2016), Spatial mapping and prediction of Plasmodium falciparum infection risk among school-aged children in Côte d'Ivoire., in Parasites & vectors, 9(1), 494-494.
Assessing the effects of malaria interventions on the geographical distribution of parasitaemia risk in Burkina Faso.
Diboulo Eric, Sié Ali, Vounatsou Penelope (2016), Assessing the effects of malaria interventions on the geographical distribution of parasitaemia risk in Burkina Faso., in Malaria journal, 15, 228-228.
Ecological Drivers of Mansonella perstans Infection in Uganda and Patterns of Co-endemicity with Lymphatic Filariasis and Malaria.
Stensgaard Anna-Sofie, Vounatsou Penelope, Onapa Ambrose W, Utzinger Jürg, Pedersen Erling M, Kristensen Thomas K, Simonsen Paul E (2016), Ecological Drivers of Mansonella perstans Infection in Uganda and Patterns of Co-endemicity with Lymphatic Filariasis and Malaria., in PLoS neglected tropical diseases, 10(1), 0004319-0004319.
Malaria risk in Nigeria: Bayesian geostatistical modelling of 2010 malaria indicator survey data
Adigun Abbas (2015), Malaria risk in Nigeria: Bayesian geostatistical modelling of 2010 malaria indicator survey data, in Malaria Journal, (156), 1-8.
Bayesian variable selection in modelling geographical heterogeneity in malaria transmission from sparse data: an application to Nouna Health and Demographic Surveillance System (HDSS) data, Burkina Fa
Diboulo Eric (2015), Bayesian variable selection in modelling geographical heterogeneity in malaria transmission from sparse data: an application to Nouna Health and Demographic Surveillance System (HDSS) data, Burkina Fa, in Parasites & Vectors, 8(118), 1-14.
Effects of vector-control interventions on changes in risk of malaria parasitaemia in sub-Saharan Africa: a spatial and temporal analysis
Giardina Federica, Kasasa Simon, Sié Ali, Utzinger Jürg, Tanner Marcel, Vounatsou Penelope (2014), Effects of vector-control interventions on changes in risk of malaria parasitaemia in sub-Saharan Africa: a spatial and temporal analysis, in Lancet Global Health, 2(10), e601-e615.

Collaboration

Group / person Country
Types of collaboration
Vincent Fred Ssennono, Bureau of Statistics Uganda (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Nafomon Sogoba, Malaria Research and Training Center, Université de Bamako Mali (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Combary Patrice, Head, National, Malaria Control Program (NMCP) Burkina Faso (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Jimmy Opigo, NMCP Manager Uganda (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Eliézer K. N’Goran, UFR Biosciences, Université de Cocody-Abidjan Ivory Coast (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Banza Baya, Head, National Institut of statistics and Demography Burkina Faso (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Olusola Oresanya, Monitoring annd Evaluation, National Malaria Control Program Nigeria (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Dr Keziah L. Malm, National Malaria Control Programme Ghana (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Professor Ousmane Fayé, Départment de parasitologie, Université Cheikh Anta Diop, Dakar Senegal (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
IECID 2017 Impact of Environmental Change on Infectious Diseases Talk given at a conference Interactions between climatic changes and malaria intervention effects on the spatio-temporal disease dynamics 17.05.2017 Trieste, Italy Kasasa Simon; Vounatsou Penelope; Makumbi Fredrick;
EMOP XII, 12th European Multicolloquium of Parasitology Talk given at a conference Applications of Bayesian spatio-temporal modelling to the control of parasitic diseases 20.07.2016 Turku, Finland Sié Ali; Kasasa Simon; Utzinger Jürg; Makumbi Fredrick; Vounatsou Penelope;
Inaugural Sub-Saharan Africa Conference on Spatial and Spatiotemporal Statistics Talk given at a conference Special selected topics on spatiotemporal Bayesian modelling and fields of application (Vounatsou P) 19.11.2015 Johannesburg, South Africa Sié Ali; Utzinger Jürg; Vounatsou Penelope; Kasasa Simon;
Autumn meeting on Latent Gaussian Models 2015 Poster Bayesian variable selection of spatiotemporally varying coefficients with predictive processes using i-INLA 17.09.2015 Trondheim, Norway Vounatsou Penelope;
GEOMED 2015 Talk given at a conference Geostatistical modelling of sparse survey data 10.09.2015 Florence, Italy Vounatsou Penelope;
9th European Congress of Tropical Medicine and Health (ECTMIH) Talk given at a conference From mapping to risk profiling to predictions and interventions (Vounatsou P) 06.09.2015 Basel, Switzerland Utzinger Jürg; Kasasa Simon; Sié Ali; Vounatsou Penelope;
3èmes Journées Scientifiques de Recherche en Santé Talk given at a conference Notification d’évènements indésirables aux antipaludéens à travers la plateforme de surveillance de l’efficacité et de la sécurité des médicaments du réseau INDEPTH (Millogo O) 29.07.2015 Nouna, Burkina Faso Sié Ali; Vounatsou Penelope;
3èmes Journées Scientifiques de Recherche en Santé Talk given at a conference Sélection de variables dans la modélisation géostatistique bayésienne de l’hétérogénéité de la transmission du paludisme: Une application sur les données du système de surveillance démographique et de santé (HDSS) de Nouna, Burkina Faso (Diboulo E) 29.07.2015 Nouna, Burkina Faso Vounatsou Penelope; Sié Ali;
3èmes Journées Scientifiques de Recherche en Santé Talk given at a conference Modélisation géostatistique Bayésienne du risque du paludisme au Burkina Faso : Une application aux données de L’EDSBF-MICS IV 2010 (Diboulo E) 29.07.2015 Nouna, Burkina Faso Sié Ali; Vounatsou Penelope;
3èmes Journées Scientifiques de Recherche en Santé, Nouna Talk given at a conference Modélisation spatio-temporelle de la prévalence du paludisme au Burkina Faso: cas confirmés par les TDR de 2013- 2014 (Doamba JEO) 29.07.2015 Nouna, Burkina Faso Vounatsou Penelope; Sié Ali;


Knowledge transfer events



Self-organised

Title Date Place
R4D project results dissemination meeting 23.08.2017 Kampala, Uganda
Worksop on the lanch of the r4d project 10.02.2015 Ouagadougou, Burkina Faso

Associated projects

Number Title Start Funding scheme
163473 Movement rates of African malaria vectors and their implications in models of vector control interventions 01.01.2016 Project funding (Div. I-III)

Abstract

Background: There is a strong commitment from most countries and donors to reach malaria targets set for the year 2015 in the Millennium Development Goals (MDG), the World Health Assembly (WHA), the Roll Back Malaria (RBM) Partnership and Global Malaria Action Plan (GMAP). In many countries, national surveys have been repeatedly conducted to monitor key health-related indicators such as malaria, child and maternal mortality and relevant interventions. However, despite these efforts and resources invested in data collection, the information extracted from the data by most countries is poor and it is rather limited to national averages, overlooking regional and smaller scale heterogeneities and disparities. Additionally, there is limited use of the data in evaluating on-going interventions because existing analyses do not relate variations in the health indicators, system performance and implementation of interventions at local scale. Bayesian geostatistical modelling is the state-of-the-art approach for estimating the disease burden or child mortality at local scales and for measuring the effects of interventions from national survey data. However, most analyses focus on the spatial distribution of the health outcomes without linking health intervention and system performance data. In addition, lack of advance statistical expertise in the control programmes and readily available software to perform routinely geostatistical analyses for surveillance limits the use of the methods to statisticians or specialised epidemiologists. Goal and specific objectives: The overarching goal of the project is to reduce malaria burden in Africa by developing and validating tools (methods, knowledge, software) to strengthen malaria surveillance for disease control and elimination. The project will pursue the following interrelated specific objectives: (i) assess spatio-temporal dynamics of malaria risk and measure effectiveness of related interventions at local scale in Africa; (ii) estimate the malaria-related mortality across all age groups in Africa; (iii) assess spatio-temporal dynamics and obtain up-todate high resolution estimates of infant and child mortality across Africa; (iv) estimate the contribution of health systems performance and interventions in the spatio-temporal dynamics of malaria and mortality (child and maternal) in Uganda (East Africa) and Burkina Faso (West Africa); (v) propose strategies to optimize health systems performance and interventions to reduce malaria and mortality burden and (vi) develop and disseminate software for malaria surveillance.Methods of investigation: We propose to accomplish these objectives by (a) employing and further developing Bayesian spatio-temporal methodology for mortality and malaria surveillance; (ii) analysing well known spatially structured databases from Africa (i.e. demographic health surveys (DHS), malaria indicator surveys (MIS), Malaria Indicator Cluster Surveys (MICS), malaria transmission intensity and mortality burden across Africa (MTIMBA)); and © compiling geo-referenced databases on interventions, health systems performance indicators and relevant epidemiological outcomes in Uganda and Burkina Faso. Additional data in the two study countries will be obtained from Health Demographic Surveillance Systems (HDSS), Health Information Systems (HIS), National Malaria Control Programmes (NMCP), health facilities and community surveys.Proposed time frame: January 2013 to December 2016.Significance: The spatio-temporal estimates will evaluate success in achieving malaria and mortality related MDGs and other global targets considering regional disparities rather than national averages. The project results will be translated to tools (e.g. maps, burden estimates at different geographical resolution, cost-effectiveness of different interventions, strategies to improve health system performance, surveillance software) that can directly assist efforts of the control programmes towards malaria elimination and reduction of child and maternal mortality. Additionally, these products can be used to influence policy makers to choose spatially targeted, cost-effective interventions and improve local health systems in Uganda and Burkina Faso. The up-to-date, geo-referenced estimates of infant and under five mortality can be considered as socio-economic proxies at high spatial resolution across Africa. They can be used to improve spatially explicit burden estimates of poverty-related neglected diseases in Africa. The malaria surveillance software would be easily installed in NMCPs other than Burkina Faso and Uganda. It can be also easily adapted for surveillance of other diseases.
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