Severe-malaria infection and its outcomes among pregnant women in Burkina Faso health-districts: Hierarchical Bayesian space-time models applied to routinely-collected data from 2013 to 2018

This study used hierarchical-Bayesian Spatio-temporal modeling to explore space-time patterns and pinpoint health-districts with an exceedance probability of severe MiP incidence and fatality rate. Study also assessed effect of health-district service delivery (readiness) on severe-MiP outcomes.Severe-MiP fatality rate declined considerably while its incidence rate remained unchanged between January-2013 and December-2018. Severe-MiP cases persisted throughout the year with peaks between. These peaks increased 2.5-fold the fatality rate. Furthermore, severe-MiP fatality was higher in health-districts classified as low-readiness (IRR=2.469, 95%CrI: 1.632-3.738). However, the fatality rate decreased significantly with proper coverage with three doses for intermittent-preventive-treatment with sulphadoxine-pyrimethamine. Severe-MiP burden was heterogeneous spatially and temporally. The study suggested that health-programs should increase health-districts readiness and optimize resource allocation in high burden areas and months.
Source: Spatial and Spatio-temporal Epidemiology - Category: Epidemiology Source Type: research