Ghana is among the top 10 highest malaria burden countries, with about 20,000 children dying annually, 25% of which were under five years. This study aimed to produce interactive web-based disease spatial maps and identify the high-burden malaria districts in Ghana. The study used 2016–2021 data extracted from the routine health service nationally representative and comprehensive District Health Information Management System II (DHIMS2) implemented by the Ghana Health Service. Bayesian geospatial modelling and interactive web-based spatial disease mapping methods were employed to quantify spatial variations and clustering in malaria risk across 260 districts. For each district, the study simultaneously mapped the observed malaria counts, district name, standardized incidence rate, and predicted relative risk and their associated standard errors using interactive web-based visualization methods. A total of 32,659,240 malaria cases were reported among children < 5 years from 2016 to 2021. For every 10% increase in the number of children, malaria risk increased by 0.039 (log-mean 0.95, 95% credible interval = − 13.82–15.73) and for every 10% increase in the number of males, malaria risk decreased by 0.075, albeit not statistically significant (log-mean − 1.82, 95% credible interval = − 16.59–12.95). The study found substantial spatial and temporal differences in malaria risk across the 260 districts. The predicted national relative risk was 1.25 (95% credible interval = 1.23, 1.27). The malaria risk is relatively the same over the entire year. However, a slightly higher relative risk was recorded in 2019 while in 2021, residing in Keta, Abuakwa South, Jomoro, Ahafo Ano South East, Tain, Nanumba North, and Tatale Sanguli districts was associated with the highest malaria risk ranging from a relative risk of 3.00 to 4.83. The district-level spatial patterns of malaria risks changed over time. This study identified high malaria risk districts in Ghana where urgent and targeted control efforts are required. Noticeable changes were also observed in malaria risk for certain districts over some periods in the study. The findings provide an effective, actionable tool to arm policymakers and programme managers in their efforts to reduce malaria risk and its associated morbidity and mortality in line with the Sustainable Development Goals (SDG) 3.2 for limited public health resource settings, where universal intervention across all districts is practically impossible.

中文翻译：

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2016-2021 年加纳五岁以下疟疾风险时空变化建模

加纳是疟疾负担最高的 10 个国家之一，每年约有 20,000 名儿童死亡，其中 25% 为五岁以下儿童。本研究旨在制作基于网络的交互式疾病空间地图并确定加纳的高负担疟疾地区。该研究使用了从加纳卫生服务机构实施的具有全国代表性的综合地区卫生信息管理系统 II (DHIMS2) 中提取的 2016-2021 年数据。采用贝叶斯地理空间建​​模和基于网络的交互式空间疾病绘图方法来量化 260 个地区疟疾风险的空间变化和聚类。对于每个地区，该研究同时绘制了观察到的疟疾计数、地区名称、标准化发病率，并使用基于网络的交互式可视化方法预测相对风险及其相关标准误差。 2016年至2021年，5岁以下儿童中总共报告了32,659,240例疟疾病例。儿童数量每增加10%，疟疾风险增加0.039（对数均值0.95，95%可信区间 = − 13.82–15.73）男性数量每增加 10%，疟疾风险就会降低 0.075，尽管统计上并不显着（对数平均值 − 1.82，95% 可信区间 = − 16.59–12.95）。研究发现 260 个地区的疟疾风险存在显着的空间和时间差异。预测的全国相对风险为 1.25（95% 可信区间 = 1.23, 1.27）。全年疟疾风险相对相同。然而，2019 年的相对风险略高，而 2021 年，居住在 Keta、Abuakwa South、Jomoro、Ahafo Ano South East、Tain、Nanumba North 和 Tatale Sanguli 地区的疟疾风险最高，范围从相对风险到3.00 至 4.83。疟疾风险的区级空间格局随时间而变化。这项研究确定了加纳的疟疾高风险地区，需要采取紧急和有针对性的控制措施。在研究的某些时期内，还观察到某些地区的疟疾风险发生了显着变化。研究结果提供了一个有效、可操作的工具，帮助政策制定者和项目管理者根据可持续发展目标 (SDG) 3.2 在有限的公共卫生资源环境中努力降低疟疾风险及其相关发病率和死亡率，其中对所有人群进行普遍干预区实际上是不可能的。