Mapping local variation in household overcrowding across Africa from 2000 to 2018: a modelling study

Chipeta, Michael G.; Kumaran, Emmanuelle  P. A.; Browne, Annie J.; Hamadani, Bahar H. Kashef; Haines–Woodhouse, Georgina; Sartorius, Benn; Reiner, Robert C.; Dolecek, Christiane; Hay, Simon I.; Moore, Catrin E.

doi:10.1016/s2542-5196(22)00149-8

Cited by 10 publications

(4 citation statements)

References 52 publications

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“…Through consultation with experts in Uganda, we identified five predictive covariates for TB incidence, all of which vary by district and year: 1) household crowding; 22 2) nighttime lights, a proxy for local variation in economic activity; 23 3) HIV prevalence; 24 4) refugees per capita; 25 and 5) cattle per capita, a proxy for pastoral populations. 26 We also identified one predictive covariate for TB case notification reporting completeness, which varies by district: average travel time to the nearest health facility.…”

Section: Methodsmentioning

confidence: 99%

Mapping TB incidence across districts in Uganda to inform health program activities

Henry,

Zawedde-Muyanja,

Majwala

et al. 2024

IJTLD OPEN

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<sec><title>BACKGROUND</title>Identifying spatial variation in TB burden can help national TB programs effectively allocate resources to reach and treat all people with TB. However, data limitations pose challenges for subnational TB burden estimation.</sec><sec><title>METHODS</title>We developed a small-area modeling approach using geo-positioned prevalence survey data, case notifications, and geospatial covariates to simultaneously estimate spatial variation in TB incidence and case notification completeness across districts in Uganda from 2016–2019. TB incidence was estimated using 1) cluster-level data from the national 2014–2015 TB prevalence survey transformed to incidence, and 2) case notifications adjusted for geospatial covariates of health system access. The case notification completeness surface was fit jointly using observed case notifications and estimated incidence.</sec><sec><title>RESULTS</title>Estimated pulmonary TB incidence among adults varied >10-fold across Ugandan districts in 2019. Case detection increased nationwide from 2016 to 2019, and the number of districts with case detection rates >70% quadrupled. District-level estimates of TB incidence were five times more precise than a model using TB prevalence survey data alone.</sec><sec><title>CONCLUSION</title>A joint spatial modeling approach provides useful insights for TB program operation, outlining areas where TB incidence estimates are highest and health programs should concentrate their efforts. This approach can be applied in many countries with high TB burden.</sec>

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Section: Methodsmentioning

confidence: 99%

Mapping TB incidence across districts in Uganda to inform health program activities

Henry,

Zawedde-Muyanja,

Majwala

et al. 2024

IJTLD OPEN

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“…Presence and type of handwashing facility used by the child's household None; Limited; Basic [87] Household crowding Number of residents per sleeping room in the child's household [88] <2.0; 2.0-2.9; 3.0-3.9; �4.0…”

Section: Handwashing Facilitymentioning

confidence: 99%

The Planetary Child Health & Enterics Observatory (Plan-EO): A protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs

Colston,

Fang,

Houpt

et al. 2024

PLoS ONE

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Background Diarrhea remains a leading cause of childhood illness throughout the world that is increasing due to climate change and is caused by various species of ecologically sensitive pathogens. The emerging Planetary Health movement emphasizes the interdependence of human health with natural systems, and much of its focus has been on infectious diseases and their interactions with environmental and human processes. Meanwhile, the era of big data has engendered a public appetite for interactive web-based dashboards for infectious diseases. However, enteric infectious diseases have been largely overlooked by these developments. Methods The Planetary Child Health & Enterics Observatory (Plan-EO) is a new initiative that builds on existing partnerships between epidemiologists, climatologists, bioinformaticians, and hydrologists as well as investigators in numerous low- and middle-income countries. Its objective is to provide the research and stakeholder community with an evidence base for the geographical targeting of enteropathogen-specific child health interventions such as novel vaccines. The initiative will produce, curate, and disseminate spatial data products relating to the distribution of enteric pathogens and their environmental and sociodemographic determinants. Discussion As climate change accelerates there is an urgent need for etiology-specific estimates of diarrheal disease burden at high spatiotemporal resolution. Plan-EO aims to address key challenges and knowledge gaps by making and disseminating rigorously obtained, generalizable disease burden estimates. Pre-processed environmental and EO-derived spatial data products will be housed, continually updated, and made publicly available for download to the research and stakeholder communities. These can then be used as inputs to identify and target priority populations living in transmission hotspots and for decision-making, scenario-planning, and disease burden projection. Study registration PROSPERO protocol #CRD42023384709.

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“…Urbanisation in LMICs contributes significantly to overcrowding and poor sanitation; these conditions provide a perfect recipe for spreading infectious diseases such as COVID-19. 47 In 2018, the urban population of Ethiopia was estimated to account for 21.2% of its 112 million people, and its urbanisation rate stood at 4.9%. At the onset of the COVID-19 pandemic, governments globally implemented non-pharmaceutical interventions to reduce the spread of COVID-19, including partial or total lockdowns of entire regions or countries.…”

Section: Bmj Public Healthmentioning

confidence: 99%

Assessing the impact of COVID-19 pandemic on maternal healthcare usage: evidence from routine health data in Kenya and Ethiopia

Chipeta,

Peterson,

Vellemu

et al. 2023

bmjph

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ObjectivesLockdowns and fear of COVID-19 may have reduced access to antenatal care (ANC) and skilled birth attendance (SBA) in sub-Saharan Africa, which could undermine progress towards maternal and child survival and the sustainable development goals (SDGs). We analysed COVID-19’s impact on maternal healthcare usage, focusing on subnational levels, to identify healthcare disruption hotspots that require targeted interventions and help policymakers prioritise resources to accelerate progress.Methods and analysisUsing monthly health management information system (HMIS) data, we tracked changes in healthcare access at subnational levels in Ethiopia and Kenya during the pandemic. We compared service usage before and during the pandemic, using interrupted time series and counterfactual analyses to evaluate the pandemic’s impact on healthcare usage trends. We also performed geospatial mapping of the affected regions to identify hotspots.ResultsOur results show significant changes at subnational levels. ANC declined in several Kenyan counties during the pandemic, with improvements observed in others. SBA disruptions were observed in two counties. In Ethiopia, ANC declined in the north but remained unchanged in the south, with some improvements observed in the two regions. Southern regions showed resilience in SBA, experiencing gains, while northern regions showed no change.ConclusionFuture disease outbreaks may continue to cause further disruptions to health service delivery, affecting maternal and child health outcomes. Our analysis highlights the low resilience of subnational health systems to shocks, underscoring the need to strengthen healthcare systems and HMIS data capture for better data quality. Evidence-based research is essential in identifying hotspots and supporting targeted interventions to achieve the SDGs and improve maternal and child health outcomes.

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Mapping local variation in household overcrowding across Africa from 2000 to 2018: a modelling study

Cited by 10 publications

References 52 publications

Mapping TB incidence across districts in Uganda to inform health program activities

Mapping TB incidence across districts in Uganda to inform health program activities

The Planetary Child Health & Enterics Observatory (Plan-EO): A protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs

Assessing the impact of COVID-19 pandemic on maternal healthcare usage: evidence from routine health data in Kenya and Ethiopia

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