Methods for mapping regional trends of HIV prevalence from Demographic and Health Surveys (DHS)

Larmarange, Joseph; Vallo, Roselyne; Yaro, Seydou; Msellati, Philippe; Méda, Nicolas

doi:10.4000/cybergeo.24606

Cited by 42 publications

(73 citation statements)

References 16 publications

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“…The optimal N parameter (N opt ) used in these analyses is defined in Appendix 1, and has been published in detail elsewhere [22]. Figure 2a represents the percentage of women having their first birth before 16 years old, while Fig.…”

Section: Resultsmentioning

confidence: 99%

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

et al. 2016

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Background: Early adolescent pregnancy presents a major barrier to the health and wellbeing of young women and their children. Previous studies suggest geographic heterogeneity in adolescent births, with clear "hot spots" experiencing very high prevalence of teenage pregnancy. As the reduction of adolescent pregnancy is a priority in many countries, further detailed information of the geographical areas where they most commonly occur is of value to national and district level policy makers. The aim of this study is to develop a comprehensive assessment of the geographical distribution of adolescent first births in Uganda, Kenya and Tanzania using Demographic and Household (DHS) data using descriptive, spatial analysis and spatial modelling methods. Methods: The most recent Demographic and Health Surveys (DHS) among women aged 20 to 29 in Tanzania, Kenya, and Uganda were utilised. Analyses were carried out on first births occurring before the age of 20 years, but were disaggregated in to three age groups: <16, 16/17 and 18/19 years. In addition to basic descriptive choropleths, prevalence maps were created from the GPS-located cluster data utilising adaptive bandwidth kernel density estimates. To map adolescent first birth at district level with estimates of uncertainty, a Bayesian hierarchical regression modelling approach was used, employing the Integrated Nested Laplace Approximation (INLA) technique. Results: The findings show marked geographic heterogeneity among adolescent first births, particularly among those under 16 years. Disparities are greater in Kenya and Uganda than Tanzania. The INLA analysis which produces estimates from smaller areas suggest "pockets" of high prevalence of first births, with marked differences between neighbouring districts. Many of these high prevalence areas can be linked with underlying poverty. Conclusions: There is marked geographic heterogeneity in the prevalence of adolescent first births in East Africa, particularly in the youngest age groups. Geospatial techniques can identify these inequalities and provide policy-makers with the information needed to target areas of high prevalence and focus scarce resources where they are most needed.

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Section: Resultsmentioning

confidence: 99%

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

et al. 2016

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“…It is not possible to obtain a quantitative assessment of the accuracy of the ESP map (16), i.e., to generate a map of standard errors. Methods to generate such maps are under development (31).…”

Section: Discussionmentioning

confidence: 99%

“…To construct the mobility map we used data from the 2010 LDHS and spatial interpolation techniques (16) to map the percentage of individuals (15-49 years old) who made one or more overnight trips in the past 12 months.…”

Section: Methodsmentioning

confidence: 99%

Using geospatial mapping to design HIV elimination strategies for sub-Saharan Africa

Coburn

Blower

2017

Sci. Transl. Med.

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UNAIDS, and the WHO, plan to use “treatment as prevention” (TasP) to eliminate HIV. The rationale is that treating HIV-infected individuals reduces their infectivity. We present a novel geostatistical framework for implementing the rollout of TasP in sub-Saharan Africa. We focus on Lesotho, because UNAIDS has identified their epidemic as a priority for elimination. Our framework is based on a density of infection (DoI) map that we generate by gridding high-resolution demographic data, and spatially smoothing georeferenced HIV-testing data. The map reveals the geographic dispersion pattern of HIV-infected individuals, both diagnosed and undiagnosed. We use the map to design a treatment allocation strategy that optimizes, under resource constraints, the efficiency of resource utilization. Using this strategy (rather than the current treatment allocation strategy) would make it easier to find, diagnose and treat individuals. We also use our framework to evaluate the feasibility of UNAIDS’ elimination plan. We show the feasibility of reaching specific treatment coverage levels depends upon the geographic dispersion pattern of HIV-infected individuals, and that this pattern reflects the spatial demographics of Lesotho. Only 20% of HIV-infected individuals live in urban areas; most live in rural settlements where the DoI is less than six infected individuals/km2. Given these conditions, it will be almost impossible to reach a very high coverage of treatment. Therefore, the UNAIDS elimination plan is unlikely to succeed in Lesotho. Taken together, our results show that the spatial demographics of populations will significantly hinder, and may even prevent, the elimination of HIV in sub-Saharan Africa.

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“…Although the DHS data can be geo-referenced, the sampling method is not appropriate for spatial interpolation. Accordingly, a spatial interpolation methodology, developed by Larmarange et al (2011), was adopted for generating the smoothed trends of DHS data using R statistical software. This method uses kriging and smoothing techniques to estimate the regional variations in accordance with the accuracy of the data of each zone.…”

Section: Data Pre-processing: Creating Continuous Surfacesmentioning

confidence: 99%

Modelling homogeneous regions of social vulnerability to malaria in Rwanda

Bizimana¹,

Kienberger²,

Hagenlocher³

et al. 2016

Geospat Health

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Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection. IntroductionDespite various interventions to reduce the burden of malaria, the disease persists in many countries of the developing world. In 2012 there were approximately 562,000 malaria deaths in Africa, despite a slow decline since 2004 (WHO, 2014. Malaria decrease in Sub-Saharan Africa was generally associated with intense interventions and reduced vector density due to changing rainfall patterns (Meyrowitsch et al., 2011). Although considerable progress has been made in many countries, the general malaria burden remains high, particularly in young children and pregnant women (Roll Back Malaria, 2005). The Plasmodium (P.) falciparum prevalence rates in Rwanda increased until the late 1990s and early 2000s, after which a marked decrease was noted (Stern et al., 2011). Since 2004, interventions to prevent and control malaria in Rwanda have resulted in a substantial decline in malaria transmission, particularly as a result of improved access to effective treatment, increased use of bed nets, and indoor residual spraying (Karema et al., 2012). However, malaria incidence increased again between 2011 and 2012, revealing the fragility of the gains achieved (WHO, 2013). The results of an entomological survey of more than 50% exophile entomological inoculation rate (EIR) around Kigali City is also an indicator of potential transmission ga...

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Methods for mapping regional trends of HIV prevalence from Demographic and Health Surveys (DHS)

Cited by 42 publications

References 16 publications

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

Using geospatial mapping to design HIV elimination strategies for sub-Saharan Africa

Modelling homogeneous regions of social vulnerability to malaria in Rwanda

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