|Research Project Title
Modelling the spatial heterogeneity of infectious diseases in sub-Saharan Africa
|Research Project Description
In Ethiopia, every year millions of people are infected by infectious diseases. Evidence emerged by epidemiological studies of different kind and related to various diseases have shown that a greater distance from health facilities is associated with lower hospitalization rates [1-3] and higher mortality [1,2,4,5]. However, the burden of infectious diseases is still often estimated on the basis of observed hospitalized cases, which represent an incomplete and biased sample of what is really occuring in the community .The role of distance as a barrier to health care access and its influence on individuals’ mortality has been already documented [1-3]. For instance, a cross sectional survey recently conducted in Ethiopia has shown that children who live more than 30km from the health center has a two to three fold greater risk of death than children who live near to an health facility . A recent study focusing on repeated measles epidemics occurred between 2013 and 2017 in this country has highlighted a high heterogeneity in the access to health care and that this phenomenon may dramatically affect the estimation of the burden of measles disease in low-income settings . During these epidemics, the overall number of measles infections in the community might have been more than 8 times higher than the ones recorded at the hospital and the case fatality rate may remarkably increase with travel distance from the well-resourced health facilities: ranging from 0.6% to more than 19% at 20 km from the nearest hospital.
The research project focuses on the investigation of the complex interplay between the heterogeneous access to primary health care and the mortality rate associated with infectious diseases and on the study of spatio-temporal patterns of epidemic spread in low-income settings. The main challenges of the project will be: