Bayesian spatio-temporal and joint modelling of malaria and anaemia among Nigerian children aged under five years, including estimation of the effects of risk factors.

Abstract

Childhood mortality and morbidity in Nigeria have been linked to malaria and anaemia. This thesis focused on exploring the risk factors and the complexity of the relationship between malaria and anaemia in under 5 Nigerian children. Data from the 2010 and 2015 Nigeria Malaria Indicator Survey conducted by Demographic Health Survey were used. In 2010, the prevalence of malaria and anaemia was 48% and 72%, respectively, while in 2015, 27% and 68% were the respective prevalences of malaria and anaemia diseases. Machine learning-based exploratory classification methods were used to explain the relationship and patterns between the independent variables and the two dependent variables, namely malaria and anaemia. Decisions made by the public health body are centered on the administrative units (i.e., states) within the country. Therefore, the development of disease mapping and a brief overview of limiting assumptions and ways of tackling them was explained. Consequently, malaria and anaemia spatial variation for 2010 and 2015 was analyzed with the inclusion of their respective risk factors. A separate multivariate hierarchical Bayesian logistic model for each disease was adopted to investigate the spatial pattern of malaria and anaemia and adjust for the risk factors associated with each disease. Furthermore, a multilevel model analysis was applied to independently investigate the spatio-temporal distribution of malaria and anaemia. A joint model was further adopted to check for the relationship between malaria and anaemia and their common risk factors and relax the nonlinearity assumption. In the 2010 data, type of place of residence, mother’s highest educational level, source of drinking water, type of toilet facility, child’s sex, main floor material, and households that have electricity, radio, television, and water were significantly associated with malaria and anaemia. While in the 2015 data, the type of place of residence, source of drinking water, type of toilet facility, households with radio, main roof material, wealth index, child’s sex, and mother’s highest educational level had a significant relationship with malaria and anaemia. The results from this study can guide policymakers to tailor-make effective interventions to reduce or prevent malaria and anaemia diseases. This will help adequately distribute limited state health system resources, such as personnel, funds and facilities within the country.