Spatiotemporal Clustering Analysis of Malaria Infection in Pakistan

Muhammad Farooq Umer, Shumaila Zofeen, Abdul Majeed, Wenbiao Hu, Xin Qi and Guihua Zhuang
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Muhammad Farooq Umer: School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
Shumaila Zofeen: School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
Abdul Majeed: Directorate of Malaria Control Program, Islamabad 44000, Pakistan
Wenbiao Hu: School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
Xin Qi: School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
Guihua Zhuang: School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China

IJERPH, 2018, vol. 15, issue 6, 1-15

Abstract: Despite tremendous progress, malaria remains a serious public health problem in Pakistan. Very few studies have been done on spatiotemporal evaluation of malaria infection in Pakistan. The study aimed to detect the spatiotemporal pattern of malaria infection at the district level in Pakistan, and to identify the clusters of high-risk disease areas in the country. Annual data on malaria for two dominant species ( Plasmodium falciparum , Plasmodium vivax ) and mixed infections from 2011 to 2016 were obtained from the Directorate of Malaria Control Program, Pakistan. Population data were collected from the Pakistan Bureau of Statistics. A geographical information system was used to display the spatial distribution of malaria at the district level throughout Pakistan. Purely spatiotemporal clustering analysis was performed to identify the high-risk areas of malaria infection in Pakistan. A total of 1,593,409 positive cases were included in this study over a period of 6 years (2011–2016). The maximum number of P . vivax cases (474,478) were reported in Khyber Pakhtunkhwa (KPK). The highest burden of P . falciparum (145,445) was in Balochistan, while the highest counts of mixed Plasmodium cases were reported in Sindh (22,421) and Balochistan (22,229), respectively. In Balochistan, incidence of all three types of malaria was very high. Cluster analysis showed that primary clusters of P . vivax malaria were in the same districts in 2014, 2015 and 2016 (total 24 districts, 12 in Federally Administered Tribal Areas (FATA), 9 in KPK, 2 in Punjab and 1 in Balochistan); those of P . falciparum malaria were unchanged in 2012 and 2013 (total 18 districts, all in Balochistan), and mixed infections remained the same in 2014 and 2015 (total 7 districts, 6 in Balochistan and 1 in FATA). This study indicated that the transmission cycles of malaria infection vary in different spatiotemporal settings in Pakistan. Efforts in controlling P . vivax malaria in particular need to be enhanced in high-risk areas. Based on these findings, further research is needed to investigate the impact of risk factors on transmission of malaria in Pakistan.

Keywords: malaria; incidence rate; spatiotemporal clustering; spatial cluster analysis; Pakistan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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