Spatial Co-Morbidity of Childhood Acute Respiratory Infection, Diarrhoea and Stunting in Nigeria

Abstract

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 north-eastern 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.

Keywords: Bayesian analysis; Nigeria; acute respiratory infection; diarrhoea; shared component.

Figure A1

Maps showing posterior estimates of ARI-specific spatial effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A2

Maps showing posterior estimates of diarrhoea-specific spatial effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A2

Maps showing posterior estimates of diarrhoea-specific spatial effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A3

Maps showing posterior estimates of stunting-specific spatial effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A4

Maps showing posterior estimates of the ARI and diarrhoea spatial shared effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A5

Maps showing posterior estimates of the ARI and stunting spatial shared effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A5

Maps showing posterior estimates of the ARI and stunting spatial shared effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A6

Maps showing posterior estimates of the diarrhoea and stunting spatial shared effect by year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure A7

Maps showing posterior estimates of the ARI and diarrhoea and stunting spatial shared effect year of NDHS implementation; (A) 2008, (B) 2013, (C) 2018.

Figure 1

Pairwise scatter plots between the proportions of respiratory infection (ARI), diarrhoea, and stunting based on the 37 locations.

Figure 2

Maps showing posterior estimates of disease-specific spatial effects: (a) ARI; (b) diarrhoea; (c) stunting.

Figure 3

Maps showing posterior estimates of spatial shared effects: (a) ARI and diarrhoea; (b) ARI and stunting; (c) diarrhoea and stunting; (d) all three illnesses.