An Investigation of District Spatial Variations of Childhood Diarrhoea and Fever Morbidity in Malawi

Although diarrhoea and malaria are among the leading causes of child mortality and morbidity in Sub-Saharan Africa, few detailed studies have examined the patterns and determinants of these ailments in the most affected communities. In this paper, we investigate the spatial clustering of observed diarrhoea and fever morbidity in Malawi using the 2000 Malawi Demographic and Health survey. Clustering was achieved by mapping the residual district spatial effects using a Bayesian geo-additive logistic model that simultaneously control for spatial dependence in the data and potential nonlinear effects of covariates. For both ailments, we were able to identify a distinct district pattern of childhood morbidity. The spatial patterns emphasise the role of remoteness as well as climatic and geographic factors on morbidity. The fixed effects show the importance of exclusively breastfeeding for diarrhoea and maternal education for both ailments. Diarrhoea and fever were both observed to show an interesting association with a child’s age