Spatial and Spatio-temporal Epidemiology

Aflatoxins are carcinogenic toxins produced by fungi, and many countries legislate limits in food. Previous research suggests elevated liver cancer (LC) mortality in some areas may be due to aflatoxin exposure, but this has not been investigated spatially. We investigate links between aflatoxin legislation, climate, and LC mortality and other covariates globally. Comparison tests of LC mortality showed expected patterns with legislation and climate. They also showed associations between high LC mortality and high Hepatitis, low alcohol consumption, low health expenditure and high family agriculture rates...

Acute respiratory infections (ARI), diarrhea, and fever are three common childhood illnesses, especially in sub-Saharan Africa. This study investigates the marginal and pairwise correlated effects of these diseases across Western African countries in a single analytical framework. Using data from nationally representative cross-sectional Demographic and Health Surveys, the study analyzed specific and correlated effects of each pair of childhood morbidity from ARI, diarrhea, and fever using copula regression models in fourteen contiguous Western African countries...

The United States experienced at least five COVID-19 waves linked with different mutated SARS-CoV-2 variants including Alpha, Delta and Omicron. In addition to the variants, the intensity, geographical distribution, and risk factors related to those waves also vary within socio-demographic characteristics and timeframes. In this project, we have examined the spatial and temporal pattern of COVID-19 in the USA and its associations with Social Determinants of Health (SDoH) by utilizing the County Health Rankings & Roadmaps (CHRR) dataset...

The American Community Survey (ACS) is one of the most vital public sources for demographic and socioeconomic characteristics of communities in the United States and is administered by the U.S. Census Bureau every year. The ACS publishes 5-year estimates of community characteristics for all geographical areas and 1-year estimates for areas with population of at least 65,000. Many epidemiological and public health studies use 5-year ACS estimates as explanatory variables in models. However, doing so ignores the uncertainty and averages over variability during the time-period which may lead to biased estimates of covariate effects of interest...

Recent studies and reports suggest an increased mortality rate of undocumented border crossers (UBCs) in Arizona is the result of heat extremes and climatic change. Conversely, others have shown that deaths have occurred in cooler environments than in previous years. We hypothesized that human locomotion plays a greater role in heat-related mortality and that such events are not simply the result of exposure. To test our hypothesis, we used a postmortem geographic application of the human heat balance equation for 2,746 UBC deaths between 1990 and 2022 and performed regression and cluster analyses to assess the impacts of ambient temperature and exertion...

The aim of this study was to describe, through spatial analysis, the cases of arboviruses (dengue and chikungunya), including deaths, during the first epidemic after the circulation of the chikungunya virus (CHIKV) in the state of Pernambuco, Northeastern Brazil. This was an ecological study in both Pernambuco and the state capital, Recife, from 2015 to 2018. The odds ratios (OR) were estimated, and the statistical significance was considered p≤0.05. For the spatial analysis, Kulldorff's space-time scan statistics method was adopted to identify spatial clusters and to provide the relative risk (RR)...

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BACKGROUND: In the past, deprivation has been mostly captured through simple and univariate measures such as low income or poor educational attainment in research on health and social inequalities in Belgium. This paper presents a shift towards a more complex, multidimensional measure of deprivation at the aggregate level and describes the development of the first Belgian Indices of Multiple Deprivation (BIMDs) for the years 2001 and 2011. METHODS: The BIMDs are constructed at the level of the smallest administrative unit in Belgium, the statistical sector...

COVID-19 health impacts and risks have been disproportionate across social, economic, and racial gradients (Chen et al., 2021; Thompson et al., 2021; Mamuji et al., 2021; COVID-19 and Ethnicity, 2020). By examining the first five waves of the pandemic in Ontario, we identify if Forward Sortation Area (FSAs)based measures of sociodemographic status and their relationship to COVID-19 cases are stable or vary by time. COVID-19 waves were defined using a time-series graph of COVID-19 case counts by epi-week...

While the extant literature has established that transgender people face significant barriers to accessing healthcare, no studies to date have offered an explicitly spatial analysis of their access to trans-specific care. This study aims to fill that gap by providing a spatial analysis of access to gender-affirming hormone therapy (GAHT) using Texas as a case study. We used the three-step floating catchment area method, which relies on census tract-level population data and location data for healthcare facilities to quantify spatial access to healthcare within a specific drive-time window, in our case 120 min...

Unmatched spatially stratified random sampling (SSRS) of non-cases selects geographically balanced controls by dividing the study area into spatial strata and randomly selecting controls from all non-cases within each stratum. The performance of SSRS control selection was evaluated in a case study spatial analysis of preterm birth in Massachusetts. In a simulation study, we fit generalized additive models using controls selected by SSRS or simple random sample (SRS) designs. We compared mean squared error (MSE), bias, relative efficiency (RE), and statistically significant map results to the model results with all non-cases...

Lung cancer is the most common type of cancer worldwide. This study assessed the spatio-temporal variations of the incidence rate of lung cancer between 2014 and 2020 in Chlef, a province in the North West of Algeria. Case data recoded by municipality, sex and age were collected from the oncology department in a local hospital. A hierarchical Bayesian spatial model, adjusted by urbanization level, with zero inflated Poisson distribution was used to study the variation of lung cancer incidence. A total of 250 lung cancer cases were registered during the study period, with a crude incidence rate of 4...

Childhood cancer incidence is known to vary by age, sex, and race/ethnicity, but evidence is limited regarding external risk factors. We aim to identify harmful combinations of air pollutants and other environmental and social risk factors in association with the incidence of childhood cancer based on 2003-2017 data from the Georgia Cancer Registry. We calculated the standardized incidence ratios (SIR) of Central Nervous System (CNS) tumors, leukemia and lymphomas based on age, gender and ethnic composition in each of the 159 counties in Georgia, USA...

Bogota, the capital and largest city of Colombia, constantly fights against easily transmitted and endemic-epidemic diseases that lead to enormous public health problems. Pneumonia is currently the leading cause of mortality attributable respiratory infections in the city. Its recurrence and impact have been partially explained by biological, medical, and behavioural factors. Against this background, this study investigates Pneumonia mortality rates in Bogota from 2004 and 2014. We identified a set of environmental, socioeconomic, behavioural, and medical care factors whose interaction in space could explain the occurrence and impact of the disease in the Iberoamerican city...

Our study investigated the spatial distribution of tuberculosis and the influence of social determinants in Russia between 2006 and 2018 using the regional incidence of multi-drug resistance tuberculosis, HIV-TB coinfection, and mortality data. The "space-time cube" method identified the uneven geographical distribution of the tuberculosis burden. There is a clear distinction between a healthier European Russia, where a statistically significant stable trend towards a decrease in incidence and mortality was found, and the eastern part of the country, where there is no such trend...

This paper investigated the spatiotemporal pattern of COVID-19 mortality and its socioeconomic and environmental determinants in the first and second wave of the pandemic in England. The COVID-19 mortality rates for middle super output areas from March 2020 to April 2021 were used in the analysis. SaTScan was used in the analysis of spatiotemporal pattern of COVID-19 mortality and geographically weighted Poisson regression (GWPR) was used to investigate the association with socioeconomic and environmental factors...

Anaemia which is a condition that describes low haemoglobin (Hb) levels has been recognized as a major public health problem amongst pregnant women in many sub-Saharan African countries including Nigeria. The causes of maternal anaemia which are interconnected and complex vary between countries and can vary within a country. This study aimed to investigate the spatial pattern and identify demographic and socio-economic determinants associated with anaemia amongst Nigerian pregnant women aged 15-49 years using data from the 2018 Nigeria Demographic and Health Survey (NDHS)...

Despite close monitoring of HIV infections amongst MSM (MSMHIV), the true prevalence can be masked for areas with small population density or lack of data. This study investigated the feasibility of small area estimation with a Bayesian approach to improve HIV surveillance. Data from EMIS-2017 (Dutch subsample, n = 3,459) and the Dutch survey SMS-2018 (n = 5,653) were utilized. We applied a frequentist calculation to compare the observed relative risk of MSMHIV per Public Health Services (GGD) region in the Netherlands and a Bayesian spatial analysis and ecological regression to quantify how spatial heterogeneity in HIV amongst MSM is related to determinants while accounting for spatial dependence to obtain more robust estimates...

Nepal aims to eliminate malaria by 2026. This study analyzed district-level spatio-temporal patterns of malaria in Nepal from 2005 to 2018, following the introduction of Long-Lasting Insecticidal Nets (LLINs) for vector control intervention. The spatial variation in a temporal trend (SVTT) method in SaTScan was used to detect significantly high or low temporal trends of five malaria indicators: Indigenous, Imported, PV (Plasmodium vivax), PF (Plasmodium falciparum), and Total Malaria; results were mapped as clusters with associated trends...

Cardiovascular disease (CVD) is the leading cause of death globally, coronary heart disease (CHD) is the main category of it. It has been shown that the urban built environment affects the occurrence of CHD, but most focus on single environmental factors. This study developed two multicomponent Urban Heart Health Environment (UHHE) Indexes (unweighted index and weighted index), which were based on the four main behavioral risk factors for CHD (unhealthy diet, lack of physical activity, smoking, and drinking)...