Spatio-temporal patterns of under-five mortality in Matlab HDSS in rural Bangladesh

Article English OPEN
Alam, Nurul ; Zahirul Haq, M. ; Kim Streatfield, Peter (2010)
  • Publisher: CoAction Publishing
  • Journal: Global Health Action, volume 3 (issn: 1654-9716, eissn: 1654-9880)
  • Related identifiers: pmc: PMC2935919, doi: 10.3402/gha.v3i0.5252
  • Subject: Matlab | children | mortality | Supplement 1, 2010 | INDEPTH Mortality Clustering Supplement | clustering | Clustering; Children; Mortality; Rural; Bangladesh. | Public Health; population Health | Bangladesh

Background: Knowledge of spatial and temporal distributions of mortality and morbidity is important to prioritise areas for adjusting the public health system where people need services most. A Health and Demographic Surveillance System (HDSS) plays an important role where accurate national vital events are not available in identifying areas and periods with excess mortality risks. Methods: The HDSS in Matlab, a rural area of Bangladesh, provided data on yearly number of deaths and children aged below 5 years for each of 90 villages during 1998-2007, along with village location points, longitudes and latitudes. Kulldorff ’s space-time scan statistic was used to identify villages and periods that experienced high mortality risks in the HDSS area with a statistical significance of pB0.001. Logistic regression was conducted to examine if village-level education and economic status explained village-level mortality risks. Results: There were 3,434 deaths among children aged below 5 years in the HDSS area during 1998-2007 with an average yearly rate of 13 deaths per 1,000 under-five child-years. The mortality rate showed a declining trend with high concentration in 1998-2002, but not in 2003-2007. Two clusters of villages had significantly higher mortality risks in 1998-2002, but not later, and the mortality risks in the high-risk clusters reduced little, but remained significant after controlling for adult education and economic status at village level. Conclusions: Spatial clustering of childhood mortality observed during 1998-2002 had disappeared in subsequent years with a decline in mortality rates. Space-time scanning helps identify high-risk areas and periods to enhance public health actions. Keywords: clustering; children; mortality; Matlab; Bangladesh (Published: 30 August 2010) Citation: Global Health Action Supplement 1, 2010. DOI: 10.3402/gha.v3i0.5252
  • References (13)
    13 references, page 1 of 2

    1. Multiple Indicator Cluster Survey. Bangladesh Bureau of Statistics, Ministry of Planning, Government of Bangladesh; 2009. Available from: http://www.bbs.gov.bd/pub/MICS_09.pdf [cited 15 June 2010].

    2. Health and Demographic Surveillance System Annual Report 2007. Scientific Report No. 41, 2009. ICDDR, B, Dhaka, Bangladesh.

    3. Amin S, Diamond I, Steele F. Contraception and religious practice in Bangladesh. Policy Research Division Working Papers No. 83. New York: The Population Council; 1996.

    4. Goldman N, Pebley AR, Beckett M. Diffusion of ideas about personal hygiene and contamination in poor countries: evidence from Guatemala. In Workshop on social processes underlying fertility change in developing countries, Washington, DC, 29 30 January 1998. Papers/communications compiled by National Research Council. Committee on Population. Washington, DC.

    5. Kulldorff M. A spatial scan statistic. Commun Stat Theory Methods 1997; 26: 1481 96.

    6. Kulldorff M. Information Management Services, Inc: software for the spatial and space time scan statistics; 2006. Available from: http://www:satscan.org [cited 2 February 2010].

    7. Sankoh OA, Ye Y, Sauerborn R, Mu¨ ller O, Becher H. Clustering of childhood mortality in rural Burkina Faso. Int J Epidemiol 2001; 30: 485 92.

    8. Geographic Information System (GIS) and Demographic and Health Surveys Data. Available from: http://www.measuredhs. com [cited 3 May 2010].

    9. Chaikaew N, Tripathi NK, Hara S. Exploring spatial and spatio-temporal clusters of malaria in Chiang Mai, Thailand. International Symposium on Geoinformatics for Spatial Infrastructure Development in Earth and Applied Sciences, 4 6 December, 2008, Hanoi, Vietnam.

    10. Alam N. Women's position in the household and society and care of sick children in rural Bangladesh. PhD thesis (unpublished). Centre for Population Studies, London School of Hygiene and Tropical Medicine, University of London; 2000.

  • Metrics
    No metrics available
Share - Bookmark