Detection of High Risk Clusters of Diarrhoea, Fever and Cough in Tanzania: Results from Tanzania Demographic and Health Surveys, 1999 to 2016

Amina Suleiman Msengwa, Wiggins Aaron Kyatikila


Demographic and health surveys provide useful nation-wide data for assessing the impact of maternal and child health in developing countries. Using Tanzania demographic and health survey data for the period of 1999 to 2016, the current study aimed at assessing the spatial distribution of childhood illnesses in Tanzania. The Kulldorff’s Spatial Scan Statistic was applied to identify clusters with the high risk of childhood diarrhoea, fever and cough. Results indicate that one cluster has been identifed for any of the childhood illnesses (diarrhoea, fever and cough) in 1999. The identifed clusters with the high risk of childhood illnesses (diarrhoea, fever and cough) showed a decrease of sample points with time specifcally in high risk clusters for 2004-05, 2009-10 and 2015-16 Tanzania Demographic and Health Surveys. Also, the radii of high risk clusters were decreasing with increase in time. These results suggest improvements in child health status and indicate narrow concentration of childhood illness to some specifc areas in the country. The small area estimation is required to guide interventions effectively in order to alleviate common risk factors within the location.

Keywords: Childhood illnesses, spatial scan statistic, high risk clusters, Tanzania demographic and health surveys

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Anderson, C., Lee, D., & Dean, N. (2014). Identifying clusters in Bayesian disease mapping. Biostatistics, 15(3), 457-469. doi:10.1093/biostatistics/kxu005

Filmer, D. (2005). Fever and its treatment among the more and less poor in sub-Saharan Africa.Health Policy and Planning, 20(6), 337-346. doi:10.1093/heapol/czi043

Gupta, M. D. (1990). Death Clustering, Mothers Education and the Determinants of Child Mortality in Rural Punjab, India. Population Studies, 44(3), 1-1. doi:10.1080/759053720

Kandala, N., Ji, C., Stallard, N., Stranges, S., & Cappuccio, F. P. (2008). Morbidity from diarrhoea,

cough and fever among young children in Nigeria. Annals of Tropical Medicine & Parasitology,

(5), 427-445. doi:10.1179/136485908x300797

Kandala, N., Magadi, M. A., & Madise, N. J. (2006). An investigation of district spatial variations

of childhood diarrhoea and fever morbidity in Malawi. Social Science & Medicine, 62(5), 1138-


Khatab, K., & Fahrmeir, L. (2009). Analysis of Childhood Morbidity with Geoadditive Probit and

Latent Variable Model: A Case Study for Egypt. The American Journal of Tropical Medicine

and Hygiene, 81(1), 116-128. doi:10.4269/ajtmh.2009.81.116

Kuate-Defo, B., & Diallo, K. (2002). Geography of child mortality clustering within African families.

Health & Place, 8(2), 93-117. doi:10.1016/s1353-8292(01)00038-7

Kulldorff, M., Heffernan, R., Hartman, J., Assunção, R., & Mostashari, F. (2005). A Space–Time Permutation Scan Statistic for Disease Outbreak Detection. PLoS Medicine, 2(3). Doi:10.1371/journal.pmed.0020059

Lugangira, K., Kazaura, M., & Kalokola, F. (2017). Morbidity and mortality of children aged 2–59 months admitted in the Tanzania Lake Zone’s public hospitals: A cross-sectional study.

BMC Research Notes, 10(1). doi:10.1186/s13104-017-2818-z

Lungu, E. A., Biesma, R., Chirwa, M., & Darker, C. (2018). Is the Urban Child Health Advantage Declining in Malawi?: Evidence from Demographic and Health Surveys and Multiple Indicator

Cluster Surveys. Journal of Urban Health, 96(1), 131-143. Doi:10.1007/s11524-018-0270-6

Mashoto, K. O., Malebo, H. M., Msisiri, E., & Peter, E. (2014). Prevalence, one week incidence and knowledge on causes of diarrhea: Household survey of under-fves and adults in Mkuranga

District, Tanzania. BMC Public Health, 14(1). doi:10.1186/1471-2458-14-985

Manesh, A. O., Sheldon, T. A., Pickett, K. E., & Carr-Hill, R. (2007). Accuracy of child morbidity data in demographic and health surveys. International Journal of Epidemiology, 37(1), 194-200.


Mustafa, M., Zakar, R., Zakar, M. Z., Chaudhry, A., & Nasrullah, M. (2017). Under-Five Child Mortality and Morbidity Associated with Consanguineous Child Marriage in Pakistan: Retrospective

Analysis using Pakistan Demographic and Health Surveys, 1990–91, 2006–07, 2012–13. Maternal and Child Health Journal, 21(5), 1095-1104. doi:10.1007/s10995-016-2208-5

Mclafferty, S. (2015). Disease cluster detection methods: Recent developments and public health implications. Annals of GIS, 21(2), 127-133. doi:10.1080/19475683.2015.1008572

Mohammed, S. (2013). Morbidity and Associated Factors of Diarrheal Diseases Among Under Five Children in Arba-Minch District, Southern Ethiopia, 2012. Science Journal of Public Health,

(2), 102. doi:10.11648/j.sjph.20130102.19


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