LB-5412
#Division of Allergy and Infectious Disease University of Washington UW Box 356423, 1959 Pacific St, Seattle, WA, 98195 Email:
[email protected]
Joint Geospatial Modeling of HIV and Malaria in Kenya and Uganda to Estimate Impact of Cotrimoxazole on Malaria Burden Jennifer M.
#1 Ross ,
3 Achwoka ,
4 Namale ,
1,2 Walson ,
Dunstan Alice Judd L. Ann M. Buff5, Abraham K. Katana3, Thomas Achia3
BK
5 Kapella ,
-
1Department
of Medicine and 2Department of Global Health, University of Washington, Seattle, USA; 3U.S. Centers for Disease Control and Prevention, Kenya; 4U.S. Centers for Disease Control and Prevention, Uganda; 5U.S. Centers for Disease Control and Prevention, Atlanta, USA.
Background • HIV and malaria are each leading causes of morbidity and mortality in Kenya and
Results
Results
Figure 1. Assessment of spatial clustering of HIV and malaria using Moran’s I
• HIV prevalence exhibited significant spatial clustering in Kenya (Moran’s I=0.41, p=
values for RR2
(41)
=>= 3.0
values for RR1
(20)
= 1.25
< 0.5 0.5 – 1.0 1.0 – 1.5 1.5 – 2.0 >= 2.0
Equation 1. log µik = log Eik + αk + υik + νik Variable
200.0km
0
100
200 km
0
100
200 km
Figure 3. Posterior relative risk maps for HIV (A) and malaria (B) in Ugandan districts.
• We developed joint spatial models of HIV and malaria in Kenya and Uganda to assess the degree to which these two infections exhibit spatial correlation at the subnational level. • Despite HIV and malaria each causing a high burden of disease, we detected minimal subnational spatial correlation. • Classical regression methods would be more appropriate for estimating the impact of cotrimoxazole prophylaxis on malaria burden for each country. References 1Murray CJ, et al. Lancet. 2014;384(9947):1005-70. 2Bhatt S, et al. Nature. 2015;526(7572):207-11. 3Uganda Ministry of Health. Kampala, Uganda. 4Kenya National AIDS and STI Control Program. Nairobi, Kenya. 5Mbeye NM, et al. Trop Med & Int Health. 2014;19(9):1057-67. 6Anselin L, et al. Geographical Analysis. 2006;38(1):5-22. 7Anselin L. Geographical Analysis. 1995;27(2):93-115. Funding JMR acknowledges funding from the Fogarty International Center, U.S. National Institutes of Health (NIH, R25 TW009345).
