Joint Bayesian modeling of time to malaria and mosquito abundance in Ethiopia

BACKGROUND: This paper studies the effect of mosquito abundance and malaria incidence in the last 3 weeks, and their interaction, on the hazard of time to malaria in a previously studied cohort of children in Ethiopia. METHODS: We model the mosquito abundance and time to malaria data jointly in a Bayesian framework. RESULTS: We found that the interaction of mosquito abundance and incidence plays a prominent role on malaria risk. We quantify and compare relative risks of various factors, and determine the predominant role of the interaction between incidence and mosquito abundance in describing malaria risk. Seasonal rain patterns, distance to a water source of the households, temperature and relative humidity are all significant in explaining mosquito abundance, and through this affect malaria risk. CONCLUSION: Analyzing jointly the time to malaria data and the mosquito abundance allows a precise comparison of factors affecting the spread of malaria. The effect of the interaction between mosquito abundances and local presence of malaria parasites has an important effect on the hazard of time to malaria, beyond abundance alone. Each additional one km away from the dam gives an average reduction of malaria relative risk of 5.7%. The importance of the interaction between abundance and incidence leads to the hypothesis that preventive intervention could advantageously target the infectious population, in addition to mosquito control, which is the typical intervention today.