Micro-scale Spatial Clustering of Cholera Risk Factors in Urban Bangladesh
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Bi, Q, et al. Micro-scale Spatial Clustering of Cholera Risk Factors In Urban Bangladesh. Public Library of Science, 2016. https://doi.org/10.17615/c0n9-2k82APA
Bi, Q., Azman, A., Satter, S., Khan, A., Ahmed, D., Riaj, A., Gurley, E., & Lessler, J. (2016). Micro-scale Spatial Clustering of Cholera Risk Factors in Urban Bangladesh. Public Library of Science. https://doi.org/10.17615/c0n9-2k82Chicago
Bi, Q, A.S Azman, S.M Satter, A.I Khan, D Ahmed, A.A Riaj, E.S Gurley et al. 2016. Micro-Scale Spatial Clustering of Cholera Risk Factors In Urban Bangladesh. Public Library of Science. https://doi.org/10.17615/c0n9-2k82- Creator
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Bi, Q
- Other Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Azman, A.S
- Other Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Satter, S.M
- Other Affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Khan, A.I
- Other Affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Ahmed, D
- Other Affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Riaj, A.A
- Other Affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Gurley, E.S
- Other Affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Lessler, J
- Affiliation: Gillings School of Global Public Health, Department of Epidemiology
- Other Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Abstract
- Close interpersonal contact likely drives spatial clustering of cases of cholera and diarrhea, but spatial clustering of risk factors may also drive this pattern. Few studies have focused specifically on how exposures for disease cluster at small spatial scales. Improving our understanding of the micro-scale clustering of risk factors for cholera may help to target interventions and power studies with cluster designs. We selected sets of spatially matched households (matched-sets) near cholera case households between April and October 2013 in a cholera endemic urban neighborhood of Tongi Township in Bangladesh. We collected data on exposures to suspected cholera risk factors at the household and individual level. We used intra-class correlation coefficients (ICCs) to characterize clustering of exposures within matched-sets and households, and assessed if clustering depended on the geographical extent of the matched-sets. Clustering over larger spatial scales was explored by assessing the relationship between matched-sets. We also explored whether different exposures tended to appear together in individuals, households, and matched-sets. Household level exposures, including: drinking municipal supplied water (ICC = 0.97, 95%CI = 0.96, 0.98), type of latrine (ICC = 0.88, 95%CI = 0.71, 1.00), and intermittent access to drinking water (ICC = 0.96, 95%CI = 0.87, 1.00) exhibited strong clustering within matched-sets. As the geographic extent of matched-sets increased, the concordance of exposures within matched-sets decreased. Concordance between matched-sets of exposures related to water supply was elevated at distances of up to approximately 400 meters. Household level hygiene practices were correlated with infrastructure shown to increase cholera risk. Co-occurrence of different individual level exposures appeared to mostly reflect the differing domestic roles of study participants. Strong spatial clustering of exposures at a small spatial scale in a cholera endemic population suggests a possible role for highly targeted interventions. Studies with cluster designs in areas with strong spatial clustering of exposures should increase sample size to account for the correlation of these exposures.
- Date of publication
- 2016
- Keyword
- very elderly
- Cholera
- Urban Population
- questionnaire
- Spatial Analysis
- bootstrapping
- Middle Aged
- Risk Factors
- sanitation
- Child, Preschool
- Child
- human
- Drinking Water
- child
- aged
- Family Characteristics
- cluster analysis
- Risk Assessment
- drinking water
- Young Adult
- family size
- middle aged
- urban population
- risk assessment
- Aged
- case control study
- adult
- young adult
- hygiene
- exposure
- Humans
- risk factor
- Case-Control Studies
- water supply
- preschool child
- correlation coefficient
- spatial analysis
- female
- Article
- cholera
- Adolescent
- household
- Aged, 80 and over
- adolescent
- Male
- Adult
- Bangladesh
- male
- Female
- Cluster Analysis
- DOI
- Identifier
- Resource type
- Article
- License
- Attribution 4.0 International
- Journal title
- PLoS Neglected Tropical Diseases
- Journal volume
- 10
- Journal issue
- 2
- Language
- English
- Version
- Publisher
- Funder
- National Institutes of Health, NIH
- U.S. Department of Homeland Security, DHS
- Fogarty International Center, FIC
- Publisher
- Public Library of Science
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