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. 2024 Apr 22;19(4):e0298259.
doi: 10.1371/journal.pone.0298259. eCollection 2024.

Modeling the shared risks of malaria and anemia in Rwanda

Pacifique Karekezi  1 , Jean Damascene Nzabakiriraho  2 , Ezra Gayawan  1   3
Affiliations

Modeling the shared risks of malaria and anemia in Rwanda

Pacifique Karekezi et al. PLoS One. .

Abstract

In sub-Saharan Africa, malaria and anemia contribute substantially to the high burden of morbidity and mortality among under-five children. In Rwanda, both diseases have remained public health challenge over the years in spite of the numerous intervention programs and policies put in place. This study aimed at understanding the geographical variations between the joint and specific risks of both diseases in the country while quantifying the effects of some socio-demographic and climatic factors. Using data extracted from Rwanda Demographic and Health Survey, a shared component model was conceived and inference was based on integrated nested Laplace approximation. The study findings revealed similar spatial patterns for the risk of malaria and the shared risks of both diseases, thus confirming the strong link between malaria and anaemia. The spatial patterns revealed that the risks for contracting both diseases are higher among children living in the districts of Rutsiro, Nyabihu, Rusizi, Ruhango, and Gisagara. The risks for both diseases are significantly associated with type of place of residence, sex of household head, ownership of bed net, wealth index and mother's educational attainment. Temperature and precipitation also have substantial association with both diseases. When developing malaria intervention programs and policies, it is important to take into account climatic and environmental variability in Rwanda. Also, potential intervention initiatives focusing on the lowest wealth index, children of uneducated mothers, and high risky regions need to be reinforced.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Posterior mean (Source: Authors’ creation).
Fig 2
Fig 2. Standard deviation (Source: Authors’ creation).
Fig 3
Fig 3. (Source: Authors’ creation).
Fig 4
Fig 4. 95% credible intervals for the shared effects of malaria and anemia (Figs 3 & 4) (Source: Authors’ creation).
Fig 5
Fig 5. Posterior mean of malaria (Source: Authors’ creation).
Fig 6
Fig 6. Standard deviation of malaria (Source: Authors’ creation).
Fig 7
Fig 7. (Source: Authors’ creation).
Fig 8
Fig 8. 95% credible intervals for the shared effects of malaria and anemia (Figs 7 & 8) (Source: Authors’ creation).
Fig 9
Fig 9. Posterior mean of anemia (Source: Authors’ creation).
Fig 10
Fig 10. Standard deviation of anemia (Source: Authors’ creation).
Fig 11
Fig 11. (Source: Authors’ creation).
Fig 12
Fig 12. 95% credible intervals for the shared effects of malaria and anemia (Figs 11 & 12) (Source: Authors’ creation).
Fig 13
Fig 13. Non-linear effects for the shared component of malaria and anaemia, child age (Source: Authors’ creation).
Fig 14
Fig 14. Non-linear effects for the shared component of malaria and anaemia, household age (Source: Authors’ creation).
Fig 15
Fig 15. Non-linear effects for the shared component of malaria and anaemia, mean temperature (Source: Authors’ creation).
Fig 16
Fig 16. Non-linear effects for the shared component of malaria and anaemia, annual precipitation (Source: Authors’ creation).
Fig 17
Fig 17. Non-linear effects for malaria, child age (Source: Authors’ creation).
Fig 18
Fig 18. Non-linear effects for malaria, household age (Source: Authors’ creation).
Fig 19
Fig 19. Non-linear effects for malaria, mean temperature (Source: Authors’ creation).
Fig 20
Fig 20. Non-linear effects for malaria, annual precipitation (Source: Authors’ creation).
Fig 21
Fig 21. Non-linear effects for anemia, child age (Source: Authors’ creation).
Fig 22
Fig 22. Non-linear effects for anemia, household age (Source: Authors’ creation).
Fig 23
Fig 23. Non-linear effects for anemia, mean temperature (Source: Authors’ creation).
Fig 24
Fig 24. Non-linear effects for anemia, annual precipitation (Source: Authors’ creation).
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Grants and funding

The authors received no specific funding for this work.