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. (June 2020)

• Record Type: Journal Article
• Authors: Rouamba, Toussaint; Samadoulougou, Sekou; Tinto, Halidou; Alegana, Victor A.; Kirakoya‑Samadoulougou, Fati
• Is Part Of: Spatial and spatio-temporal epidemiology. Volume 33(2020)
• Publication Date: 2020-06
• Subjects: Severe-malaria -- Deaths -- Pregnancy -- Readiness -- Spatio-temporal -- Burkina-Faso; Epidemiology -- Statistical methods -- Periodicals; Epidemiology -- Periodicals; 614.4072
• DOI: 10.1016/j.sste.2020.100333
• Languages: English
• ISSNs: 1877-5845

Abstract

Highlights: Severe-malaria during pregnancy was heterogeneous spatially and temporally. There was no sustained increasing or decreasing trend in severe malaria incidence during pregnancy between 2013 and 2018. Data showed an increase of risk in malaria fatality at about 2.5 fold in low-readiness districts compared to high-readiness. Severe malaria risk is reduced about 10% by increasing coverage of three doses of sulfadoxine-pyrimethamine by 1%. Abstract: Fine-scale hotspots detection is crucial for optimum delivery of essential health-services for reducing severe malaria in pregnancy (MiP) and death cases in Burkina Faso. 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 August and November. 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.