Mapping malaria incidence using routine health facility surveillance data in Uganda

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  • Adrienne Epstein
  • Jane Frances Namuganga
  • Isaiah Nabende
  • Emmanuel Victor Kamya
  • Moses R. Kamya
  • Grant Dorsey
  • Hugh Sturrock
  • Bhatt, Samir
  • Isabel Rodriguez-Barraquer
  • Bryan Greenhouse

IntroductionMaps of malaria risk are important tools for allocating resources and tracking progress. Most maps rely on cross-sectional surveys of parasite prevalence, but health facilities represent an underused and powerful data source. We aimed to model and map malaria incidence using health facility data in Uganda.MethodsUsing 24 months (2019-2020) of individual-level outpatient data collected from 74 surveillance health facilities located in 41 districts across Uganda (n=445 648 laboratory-confirmed cases), we estimated monthly malaria incidence for parishes within facility catchment areas (n=310) by estimating care-seeking population denominators. We fit spatio-temporal models to the incidence estimates to predict incidence rates for the rest of Uganda, informed by environmental, sociodemographic and intervention variables. We mapped estimated malaria incidence and its uncertainty at the parish level and compared estimates to other metrics of malaria. To quantify the impact that indoor residual spraying (IRS) may have had, we modelled counterfactual scenarios of malaria incidence in the absence of IRS.ResultsOver 4567 parish-months, malaria incidence averaged 705 cases per 1000 person-years. Maps indicated high burden in the north and northeast of Uganda, with lower incidence in the districts receiving IRS. District-level estimates of cases correlated with cases reported by the Ministry of Health (Spearman's r=0.68, p

Original languageEnglish
Article number011137
JournalBMJ Global Health
Volume8
Issue number5
Number of pages10
ISSN2059-7908
DOIs
Publication statusPublished - 2023

    Research areas

  • malaria, geographic information systems, epidemiology

ID: 352196867