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BAYESIAN SPATIAL RISK PREDICTION OF SCHISTOSOMA MANSONI INFECTION IN WESTERN CÔTE D’IVOIRE USING A REMOTELY-SENSED DIGITAL ELEVATION MODEL

An important epidemiologic feature of schistosomiasis is the focal distribution of the disease. Thus, the identification of high-risk communities is an essential first step for targeting interventions in an efficient and cost-effective manner. We used a remotely-sensed digital elevation model (DEM), derived hydrologic features (i.e., stream order, and catchment area), and fitted Bayesian geostatistical models to assess associations between environmental factors and infection with Schistosoma mansoni among more than 4,000 school children from the region of Man in western Côte d’Ivoire. At the unit of the school, we found significant correlations between the infection prevalence of S. mansoni and stream order of the nearest river, water catchment area, and altitude. In conclusion, the use of a freely available 90 m high-resolution DEM, geographic information system applications, and Bayesian spatial modeling facilitates risk prediction for S. mansoni, and is a powerful approach for risk profiling of other neglected tropical diseases that are pervasive in the developing world.

Received December 7, 2006. Accepted for publication February 6, 2007.

Acknowledgments: We thank the education officers, directors, teachers, children of the schools surveyed, and the field and laboratory team (A. Allangba, A. Fondio, K. L. Lohourignon, F. Sangaré, B. Sosthène, and M. Traoré) for their participation in the study.

Financial support: This study was supported by the Swiss National Science Foundation through grants to C. Beck-Wörner and J. Utzinger (PP00B-102883), G. Raso (PBBSB-109011) and P. Vounatsou (3252B0-102136). Giovanna Raso was supported by the Novartis Foundation.

^* Address correspondence to Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland. E-mail: juerg.utzinger{at}unibas.ch

Authors’ addresses: Christian Beck-Wörner, Penelope Vounatsou, and Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland. Giovanna Raso, Molecular Parasitology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia. Eliézer K. N’Goran, Centre Suisse de Recherches Scientifiques, BP 1303, Abidjan 01, Côte d’Ivoire and UFR Biosciences, Université d’Abidjan-Cocody, Abidjan, Côte d’Ivoire. Gergely Rigo and Eberhard Parlow, Institute of Meteorology, Climatology and Remote Sensing, Department of Environmental Sciences, University of Basel, Klingelbergstrasse 27, CH-4056 Basel, Switzerland.

Reprint requests: Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH–4002 Basel, Switzerland, Telephone: 41-61-284-8129, Fax: 41-61-284-8105, E-mail: juerg.utzinger{at}unibas.ch.