Spatial analysis of women employment status in Nigeria

This study considered the nature of employment that women engage in as a multi-categorical response. A multinomial logistic model with geo-additive predictors was used to examine the determinants and geographical variations using data from the 2008 Nigeria Demographic and Health Survey. Diffuse priors were assumed for modelling fixed effects, Bayesian p-spline for the nonlinear smooth functions and intrinsic conditional autoregressive prior for the spatial effects. Results showed that while a north-south divide existed in the likelihood of women engaging in all-year employment against not working, an east-west divide was found in seasonal/occasional jobs. Other important factors found to be significantly associated with employment status included women's age, educational level, marital status, sex of household head, and type of place of residence. Policymakers need to develop appropriate strategies to address the observed imbalance in the spatial distributions of women employment status in the country

Modeling fertility curves in Africa

The modeling of fertility patterns is an essential method researchers use to understand world-wide population patterns. Various types of fertility models have been reported in the literature to capture the patterns specific to developed countries. While much effort has been put into reducing fertility rates in Africa, models which describe the fertility patterns have not been adequately described. This article presents a flexible parametric model that can adequately capture the varying patterns of the age-specific fertility curves of African countries. The model has parameters that are interpretable in terms of demographic indices. The performance of this model was compared with other commonly used models and Akaike’s Information Criterion was used for selecting the model with best fit. The presented model was able to reproduce the empirical fertility data of 11 out of 15 countries better than the other models considered.African countries, age-specific fertility rates, Akaikes Information Criterion, complementary error function, cubic/quadratic spline, polynomial model

Spatial modelling of contribution of individual level risk factors for mortality from Middle East respiratory syndrome coronavirus in the Arabian Peninsula.

Middle East respiratory syndrome coronavirus is a contagious respiratory pathogen that is contracted via close contact with an infected subject. Transmission of the pathogen has occurred through animal-to-human contact at first followed by human-to-human contact within families and health care facilities. This study is based on a retrospective analysis of the Middle East respiratory syndrome coronavirus outbreak in the Kingdom of Saudi Arabia between June 2012 and July 2015. A Geoadditive variable model for binary outcomes was applied to account for both individual level risk factors as well spatial variation via a fully Bayesian approach. Out of 959 confirmed cases, 642 (67%) were males and 317 (33%) had died. Three hundred and sixty four (38%) cases occurred in Ar Riyad province, while 325 (34%) cases occurred in Makkah. Individuals with some comorbidity had a significantly higher likelihood of dying from MERS-CoV compared with those who did not suffer comorbidity [Odds ratio (OR) = 2.071; 95% confidence interval (CI): 1.307, 3.263]. Health-care workers were significantly less likely to die from the disease compared with non-health workers [OR = 0.372, 95% CI: 0.151, 0.827]. Patients who had fatal clinical experience and those with clinical and subclinical experiences were equally less likely to die from the disease compared with patients who did not have fatal clinical experience and those without clinical and subclinical experiences respectively. The odds of dying from the disease was found to increase as age increased beyond 25 years and was much higher for individuals with any underlying comorbidities. Interventions to minimize mortality from the Middle East respiratory syndrome coronavirus should particularly focus individuals with comorbidity, non-health-care workers, patients with no clinical fatal experience, and patients without any clinical and subclinical experiences.The authors received no specific funding for this work. All data analyzed in this study were publicly available

Joint Spatial Analysis of Low Birth Weight and Stunting in West African Countries

Introduction The burden of childhood morbidity and mortality are still huge in most sub-Saharan African countries with West African sub-region contributing largely to the burden. Previous findings have demonstrated strong link between early life events such as low birth weight (LBW) with later events particularly malnutrition. We aim at estimating the specific and shared spatial patterns of LBW and stunting among under-five children in multiple West African countries. Method Data set for the study was sourced from the Demographic and Health Surveys conducted in fourteen West African countries. We used a Bayesian shared component model allows us to split the spatial surface into those specific to each of the outcomes and one shared by the two, with inference based on a Bayesian approximation procedure through the integrated nested Laplace approximation.  Results The findings show spatial clustering in the shared and specific effects of the health outcomes, demonstrating high likelihood in northern Nigeria spanning through Niger and that the spatial pattern for the shared effects are similar to those of the specific effects of stunting. Furthermore, mother’s level of education, attendance in antenatal care and household wealth index are strongly associated with the shared health outcomes.  Conclusion The study provides insight into the spatial pattern of LBW and stunting among West African children and can be useful in targeted interventions in regions with high burden of LBW and malnutrition which may include more advocacy that promote the use of antenatal care services during pregnancy

Statistical Approaches to Infectious Diseases Modelling in Developing Countries: A Case of COVID-19

Essential skills required for both statistical consulting and collaboration are mostly informal and are rarely taught in the training institutions in developing countries. These critical skills constitute a significant missing gap and a major hindrance to the growth and development of capacity in statistics and data science practice in developing countries. The advent of LISA 2020 initiative is bridging this gap with a fast-growing network of “stat labs” spread across higher education institutions in Africa, India, Brazil and other parts of the world. This chapter will highlight how LISA 2020 Stat Labs (and other potential labs outside LISA 2020) engage in building capacity to improve informal statistical skills through training and collaborations. In addition, the chapter will review the activities and programs of the stat labs and the contributions being made to bring data science to bear on real-world problems. The chapter plans to draw out lessons that are unique and common to the different stat labs in the network

Spatial modelling of the shared impact of sexual health knowledge and modern contraceptive use among women with disabilities in Africa

Background Women with disabilities remain highly vulnerable to sexual and reproductive health problems, particularly in sub-Saharan Africa (SSA), where their sexual and reproductive rights, such as access to sexual health information and contraception, are often neglected. This study investigated the spatial patterns of the shared impact of sexual health knowledge and modern contraceptive use among women with disabilities in Africa. Methods We used the most recent Demographic and Health Survey (DHS) data involving 16,157 women with disabilities from ten African countries for this study. The data were analysed using both spatial and Bayesian inference to account for the shared component model patterns between sexual health knowledge and modern contraceptive use among women with disabilities while accounting for factors unique to each outcome. Bayesian inference via the Integrated Nested Laplace Approximation (INLA) was used for implementation. Priors for shared effects ​were set as log-normal distributions, while Gaussian priors were assigned to fixed effects. Intrinsic Conditional Autoregressive (ICAR) priors modelled spatial dependencies between districts, introducing spatial autocorrelation based on shared boundaries. Penalised Complexity (PC) priors controlled precision parameters to balance model complexity. Results The study revealed low sexual health knowledge (ranging from 3% in Nigeria to 27% in Uganda) and modern contraceptive use (ranging from 1% in DR Congo and Chad to 27% in Uganda) among women with disabilities across the countries surveyed. The spatial patterns showed diverse intra-country and inter-country disparities of sexual health knowledge and modern contraceptive use among the women, with lower shared impact observed in Mauritania, Nigeria, Uganda, Chad, and DR Congo relative to Kenya, Malawi, Mali, South Africa, and Rwanda. Factors that influence sexual health knowledge and modern contraceptive use among women with disabilities include education, marital status, place of residence, community literacy level, community socio-economic status, and age. Conclusions and recommendations Sexual health knowledge and modern contraceptive use among women with disabilities in Africa remain low, albeit with varied intra-country and inter-country spatial disparities. Therefore, spatial areas with low sexual health knowledge and modern contraceptive use should be given more attention when implementing measures to promote the use of modern contraceptives among women with disabilities. Promoting sexual health knowledge and modern contraceptive use among women with disabilities in Africa could significantly contribute towards the realisation of the 2030 Sustainable Development Goal agenda of “leaving no one behind”. Background Globally, women with disabilities are highly exposed to sexual and reproductive health problems due to systemic barriers and discrimination with respect to their sexual and reproductive rights [1, 2]. Despite the various legal frameworks, protocols, and agreements at national and international levels, women with disabilities continue to experience various forms of sexual and reproductive health violations, including forced sterilisations, forced abortions, lack of access to contraceptive choices, forced marriages, limited access to sexual health information, sexual violence, and sexual abuse [1, 3, 4]. These issues contribute to the increased risk of sexual and reproductive health problems among women with disabilities. For instance, lack of access to modern contraceptive choices and limited sexual health information has been associated with an increased risk of unintended pregnancies, unsafe abortions, and sexually transmitted infections (STIs), including HIV, among women with disabilities [5,6,7]. Yet, there is a lack of attention to the sexual and reproductive health problems of women with disabilities, particularly in sub-Saharan Africa (SSA), although women with disabilities have the same sexual and reproductive health needs as those without disabilities [8]. Sexual health knowledge is important in equipping individuals with the right information, skills, and attitudes to make informed sexual and reproductive decisions and protect their health [9]. Most women with disabilities lack knowledge of sexuality and sexual health, which often limits their capacity to make informed sexual and reproductive health decisions [5, 10]. Lack of access to both formal and informal education on sexuality and sexual health [11] and limited availability of sexual and reproductive health information in disability-appropriate formats such as brailles, audios, and sign interpreters [1] often contribute to poor sexual health knowledge among women with disabilities. Other factors include hesitancy to approach carers on sexual health matters due to societal prejudice and lack of trained or experienced care providers [3, 12]. Meanwhile, limited sexual education and information predispose many women with disabilities to risky sexual behaviours, including having multiple sexual partners and lack of modern contraceptive use [5, 13], thereby increasing their risk of sexual and reproductive health problems. Despite the importance of contraception in reducing unintended pregnancies, maternal morbidity and mortality, and preventing STIs, including HIV [14], women with disabilities face significant barriers to accessing modern contraceptives, especially in SSA [15, 16]. Access to modern contraceptives among women with disabilities is often limited by a lack of knowledge and education on contraception, poor socio-economic status, lack of disability-friendly healthcare facilities and policies, societal stigma, and discriminatory practices of some healthcare providers [15, 17]. Besides, evidence suggests that women with disabilities have a higher burden of sexual and reproductive health problems due to the lower prevalence of contraceptive use and higher unmet need for modern contraceptives in low- and middle-income countries (LMICs), especially in SSA [18, 19]. The intersection of sexual health knowledge and modern contraceptive use remains an important research area in sexual and reproductive health [20]. Previous studies have shown that good sexual health knowledge increases the use of modern contraceptives due to an improved understanding of the available methods of contraception and how to access them [21, 22]. However, the intersection of sexual health knowledge and modern contraceptive use remains less investigated among women with disabilities in SSA, although they experience greater barriers in accessing sexual health education and information as well as modern contraceptives [15, 18, 23]. Besides, factors such as geographic location play a significant role in access to sexual health information and modern contraceptive use [24, 25]. For instance, previous studies revealed that rural-urban residency could influence sexual health knowledge and contraceptive use of women with disabilities [10, 26]. Nonetheless, the shared impact of spatial patterns of sexual health knowledge and modern contraceptive use among women with disabilities in Africa remain less known. Therefore, this study sought to investigate the spatial patterns of the shared impact of sexual health knowledge and modern contraceptive use among women with disabilities in SSA in order to highlight the geographic areas with increased vulnerability of women with disabilities to sexual and reproductive health problems, at the same time, utilising spatial pattern modelling will inform targeted interventions, that could improve healthcare accessibility, and promotes disability-inclusive policies

Spatial co-morbidity of childhood acute respiratory infection, diarrhoea and stunting in Nigeria

In low- and middle-income countries, children aged below 5 years frequently suffer from disease co-occurrence. This study assessed whether the co-occurrence of acute respiratory infection (ARI), diarrhoea and stunting observed at the child level could also be reflected ecologically. We considered disease data on 69,579 children (0–59 months) from the 2008, 2013, and 2018 Nigeria Demographic and Health Surveys using a hierarchical Bayesian spatial shared component model to separate the state-specific risk of each disease into an underlying disease-overall spatial pattern, common to the three diseases and a disease-specific spatial pattern. We found that ARI and stunting were more concentrated in the north-eastern and southern parts of the country, while diarrhoea was much higher in the northern parts. The disease-general spatial component was greater in the northeastern and southern parts of the country. Identifying and reducing common risk factors to the three conditions could result in improved child health, particularly in the northeast and south of Nigeria.DATA AVAILABILITY STATEMENT : The dataset used in this study are available from the DHS website https://dhsprogram.com/Data/ upon request from the MEASURE DHS program team. Written permission to use the data was obtained from Measure DHS.The South African Medical Research Council.https://www.mdpi.com/journal/ijerphStatistic

Spatial pattern and decomposition analysis of the place of residence and sexual violence among women with disabilities in sub-Saharan Africa

Background: Sexual violence against women is highly pervasive worldwide and remains a major public health concern. Despite the global efforts to eliminate all forms of violence against women, recent estimates revealed that approximately 1 in 3 women have experienced physical or sexual violence in their lifetime, and women with disabilities have the greatest risk of sexual violence, particularly in Africa. Thus, this study investigates the spatial pattern and decomposition analysis of the place of residence and sexual violence among women with disabilities in sub-Saharan Africa. Methods: We used the most recent secondary data from demographic health surveys, including a disability module, conducted between 2013 and 2022 in 10 sub-Saharan African countries. The study sample comprised 16,517 women with disabilities. Spatial analysis was applied to identify patterns of sexual violence, and a multivariable Blinder-Oaxaca decomposition regression analysis was used to explore the disparities between place of residence and sexual violence. The analysis took into consideration the complex survey design, with results reported in terms of percentages and adjusted coefficients. Results: The spatial pattern of sexual violence among women with disabilities varies significantly across the sub-Saharan African countries included in the study, with prevalence rates ranging from 10 to 80%. The Democratic Republic of Congo reported the highest prevalence at 23%, while Mauritania reported 2%. No cases of sexual violence were reported in Nigeria and Chad. The analysis shows that the majority of the disparity in sexual violence (72.81%) is due to differences in characteristics, with 27.19% attributed to differences in coefficients. Overall, 79.77% of women with disabilities residing in rural areas reported experiencing sexual violence. Finally, the multivariable logistics regression shows that women with disabilities who were exposed to mass media exposure were associated with lower odds of experiencing sexual violence in urban areas [aOR = 0.69*; 95%(CI 0.49–0.97), p < 0.05] but with higher odds in rural areas [aOR = 1.26**; 95%(CI 1.08–1.47), p < 0.01]. Conclusions and recommendations: The study reveals that women with disabilities in sub-Saharan Africa are vulnerable to sexual violence in both rural and urban areas, with a particularly high prevalence in rural regions. These findings are crucial for guiding the design and implementation of targeted interventions to combat sexual violence in the region

Change in outbreak epicentre and its impact on the importation risks of COVID-19 progression: A modelling study

Background The outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that was first detected in the city of Wuhan, China has now spread to every inhabitable continent, but now the attention has shifted from China to other epicentres. This study explored early assessment of the influence of spatial proximities and travel patterns from Italy on the further spread of SARS-CoV-2 worldwide. Methods Using data on the number of confirmed cases of COVID-19 and air travel data between countries, we applied a stochastic meta-population model to estimate the global spread of COVID-19. Pearson's correlation, semi-variogram, and Moran's Index were used to examine the association and spatial autocorrelation between the number of COVID-19 cases and travel influx (and arrival time) from the source country. Results We found significant negative association between disease arrival time and number of cases imported from Italy (r = −0.43, p = 0.004) and significant positive association between the number of COVID-19 cases and daily travel influx from Italy (r = 0.39, p = 0.011). Using bivariate Moran's Index analysis, we found evidence of spatial interaction between COVID-19 cases and travel influx (Moran's I = 0.340). Asia-Pacific region is at higher/extreme risk of disease importation from the Chinese epicentre, whereas the rest of Europe, South-America and Africa are more at risk from the Italian epicentre. Conclusion We showed that as the epicentre changes, the dynamics of SARS-CoV-2 spread change to reflect spatial proximities