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- Title
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.
- Authors
Okunlola, Oluyemi A.; Oyeyemi, Oyetunde T.; Lukman, Adewale F.
- Abstract
<bold>Objectives: </bold>To evaluate malaria transmission in relation to insecticide-treated net (ITN) coverage in Nigeria.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Publication
Epidemiology & Health, 2021, Vol 43, p1
- ISSN
2092-7193
- Publication type
journal article
- DOI
10.4178/epih.e2021041