Modelling malaria treatment practices in Bangladesh using spatial statistics

The spatial patterns of treatment-seeking practices were first examined using hot-spot analysis (Local Getis-Ord Gi statistic) and then modelled using regression. Ordinary least squares (OLS) regression identified key factors explaining more than 80% of the variation in control programme and vendor treatment preferences. Geographically weighted regression (GWR) was then used to assess where each factor was a strong predictor of treatment-seeking preferences.Several factors including tribal affiliation, housing materials, household densities, education levels, and proximity to the regional urban centre, were found to be effective predictors of malaria treatment-seeking preferences. The predictive strength of each of these factors, however, varied across the study area. While education, for example, was a strong predictor in some villages, it was less important for predicting treatment-seeking outcomes in other villages.Understanding where each factor is a strong predictor of treatment-seeking outcomes may help in planning targeted interventions aimed at increasing control programme usage. Suggested strategies include providing additional training for the Building Resources across Communities (BRAC) health workers, implementing educational programmes, and addressing economic factors.Malaria is the most widespread parasitic disease in the world today and a major health burden in many tropical and sub-tropical regions of Africa, the Americas, Eurasia, and Oceania. It is endemic in 106 countries, putting half of the world's population (3.3 billion people) at risk [1]. In 2009, an estimated 225 million cases of malaria worldwide accounted for approximately 781,000 deaths [2].In Bangladesh, malaria is endemic in 13 of the 64 administrative districts. Over the last five years, Bangladesh has received more than $80 million USD from the Global Fund to support a National Malaria Control Programme (NMCP) integrating rapid diagnostic tests (RDTs), new drug regimes using artemisi