@article{Ouedraogo2018-rc,

title = {Spatial distribution and determinants of asymptomatic malaria  risk among children under 5 years in 24 districts in Burkina  Faso},

author = {Mady Ou\'{e}draogo and S\'{e}kou Samadoulougou and Toussaint Rouamba and Herv\'{e} Hien and John E M Sawadogo and Halidou Tinto and Victor A Alegana and Niko Speybroeck and Fati Kirakoya-Samadoulougou},

doi = {10.1186/s12936-018-2606-9},

issn = {1475-2875},

year  = {2018},

date = {2018-12-01},

urldate = {2018-12-01},

journal = {Malar. J.},

volume = {17},

number = {1},

pages = {460},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: In malaria endemic countries, asymptomatic cases 

 constitute an important reservoir of infections sustaining 

 transmission. Estimating the burden of the asymptomatic 

 population and identifying areas with elevated risk is important 

 for malaria control in Burkina Faso. This study analysed the 

 spatial distribution of asymptomatic malaria infection among 

 children under 5 in 24 health districts in Burkina Faso and 

 identified the determinants of this distribution. METHODS: The 

 data used in this study were collected in a baseline survey on 

 ``evaluation of the impact of pay for performance on the quality 

 of care'' conducted in 24 health districts in Burkina Faso, 

 between October 2013 and March 2014. This survey involved 7844 

 households and 1387 community health workers. A Bayesian 

 hierarchical logistic model that included spatial dependence and 

 covariates was implemented to identify the determinants of 

 asymptomatic malaria infection. The posterior probability 

 distribution of a parameter from the model was summarized using 

 odds ratio (OR) and 95% credible interval (95% CI). RESULTS: 

 The overall prevalence of asymptomatic malaria infection in 

 children under 5 years of age was estimated at 38.2%. However, 

 significant variation was observed between districts ranging 

 from 11.1% in the district of Barsalgho to 77.8% in the 

 district of Gaoua. Older children (48-59 vs \< 6 months: OR: 6.79 

 [5.62, 8.22]), children from very poor households (Richest vs 

 poorest: OR: 0.85 [0.74-0.96]), households located more than 5 

 km from a health facility (\< 5 km vs $geq$ 5 km: OR: 1.14 

 [1.04-1.25]), in localities with inadequate number of nurses (\< 

 3 vs $geq$ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67 

 [1.39-2.01]) and those surveyed in high transmission period of 

 asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk 

 for asymptomatic malaria infection. In addition, the spatial 

 analysis identified the following nine districts that reported 

 significantly higher risks: Bati\'{e}, Boromo, Dano, 

 Di\'{e}bougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The 

 district of Zabr\'{e} reported the lowest risk. CONCLUSION: The 

 analysis of spatial distribution of infectious reservoir allowed 

 the identification of risk areas as well as the identification 

 of individual and contextual factors. Such national spatial 

 analysis should help to prioritize areas for increased malaria 

 control activities.},

keywords = {Bayesian; Burkina Faso; Health district; Malaria; Map; Spatial},

pubstate = {published},

tppubtype = {article}

}