Preponderance of vaccine-preventable diseases hotspots in northern Ghana: a spatial and space-time clustering analysis from 2010 to 2014

Abstract

Background Vaccine-preventable diseases (VPDs) persist globally with a disproportionately high burden in Low and Middle-Income Countries (LMICs). Although this might be partly due to the failure to sustain vaccination coverage above 90% in some WHO regions, a more nuanced understanding of VPD transmission beyond vaccination coverage may unveil other important factors in VPD transmission and control. This study identified VPDs hotspots and explored their relationships with ecology, urbanicity and land-use variations (Artisanal and Small-scale Gold Mining (ASGM) activities) in Ghana. Methods District-level disease count data from 2010 to 2014 from the Ghana Health Service (GHS) and population data from the Ghana Population and Housing Census (PHC) were used to determine clustering patterns of six VPDs (Measles, Meningitis, Mumps, Otitis media, Pneumonia and Tetanus). Spatial and space-time cluster analyses were implemented in SaTScan using the discrete Poisson model. P-values were estimated using a combination of sequential Monte Carlo, standard Monte Carlo, and Gumbel approximations. Results The study found a preponderance for VPD hotspots in the northern parts of Ghana and northernmost ecological zones (Sudan Savannah and Guinea Savannah). Incidence of meningitis was higher in the Sudan Savannah ecological zone relative to: Tropical Rain Forest (p = 0.001); Semi Deciduous Forest (p < 0.0001); Transitional Zone (p < 0.0001); Coastal Savannah (p < 0.0001) and Guinea Savannah (p = 0.033). Except for mumps, which recorded a higher incidence in urban districts (p = 0.045), incidence of the other five VPDs did not differ across the urban-rural divide. Whereas spatial analysis suggested that some VPD hotspots (tetanus and otitis media) occur more frequently in mining districts in the southern part of the country, a Mann-Whitney U test revealed a higher incidence of meningitis in non-mining districts (p = 0.019). Pneumonia and meningitis recorded the highest (722.8 per 100,000) and least (0.8 per 100,000) incidence rates respectively during the study period. Conclusion This study shows a preponderance of VPD hotspots in the northern parts of Ghana and in semi-arid ecoclimates. The relationship between ASGM activities and VPD transmission in Ghana remains blurred and requires further studies with better spatial resolution to clarify.

Spatiotemporal Patterns of African Swine Fever in Wild Boar in the Russian Federation (2007–2022): Using Clustering Tools for Revealing High-Risk Areas

“…A discrete spatial-temporal Poisson probability model was used to identify clusters of increased ASF incidence in the wild boar population. The null hypothesis for this model assumes that the expected number of disease cases within some areas is Poisson distributed depending on the population size (i.e., is proportional to the wild boar population size) at the same area [34,36,37]. The p-value for all clusters was estimated using 999 Monte Carlo simulations.…”

Systematic Mapping of Research on Vaccine-Preventable Diseases in Children in Sub-Saharan Africa: A Decennial Scientometric Analysis

“…Several factors contribute to the high burden of VPDs in sub-Saharan Africa, including inadequate vaccination coverage, poor access to health care, and underlying socioeconomic and environmental conditions [ 2 , 5 ]. To address this burden and improve the health of children in the region, it is important to understand the current state of knowledge about VPDs in sub-Saharan Africa and identify the research gaps.…”