Spatial Analysis of Risk Factors for Childhood Morbidity in Nigeria

Ngianga-Bakwin Kandala Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; Health Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom

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Chen Ji Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; Health Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom

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Nigel Stallard Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; Health Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom

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Saverio Stranges Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; Health Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom

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Francesco P. Cappuccio Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom; Health Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom

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Recent Demographic and Health Surveys (DHS) from Sub-Saharan Africa (SSA) indicate a decline in childhood vaccination coverage but a high prevalence of childhood diarrhea, cough, and fever. We used Nigerian DHS data to investigate the impact of geographical factors and other important risk factors on diarrhea, cough, and fever using geoadditive Bayesian semiparametric models. A higher prevalence of childhood diarrhea, cough, and fever is observed in the northern and eastern states, while lower disease prevalence is observed in the western and southern states. In addition, children from mothers with higher levels of education and those from poor households had a significantly lower association with diarrhea; children delivered in hospitals, living in urban areas, or from mothers having received prenatal visits had a significantly lower association with fever. Our maps are a novel and relevant tool to help local governments to improve health-care interventions and achieve Millennium Development Goals (MDG4).

Author Notes

Reprint requests: Ngianga-Bakwin Kandala, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, U.K., Telephone: +44 (0)24 76968669, Fax: +44 (0)24 76968660, E-mail: N-B.Kandala@warwick.ac.uk.
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