GIS-based spatial epidemiology of the top five infectious diseases in Ghana

Infectious diseases are general burdens in developing countries but within a country or region, specific areas can be experiencing elevated rates of infection. To address this and support public health policy, Geographic Information System (GIS) and other spatial techniques are used extensively in geo-health informatics.This study explored GIS-based spatial epidemiology to describe spatial patterns, identify hotspots and assessed the determinants responsible for spatio-temporal variations of infections in Ghana. The outpatient department data of Malaria, URTI, Diarrhoeal diseases, Intestinal worms and Typhoid fever from 2010-2014 were obtained from Ghana Health Service, health determinants processed from 2010 census and geo-coded per the 170 districts to create the GIS database. Incidence rates were estimated, smoothen and spatially analysed. The rates of the infectious diseases persistently showed significant spatial dynamics with different intensities (Moran's I > 0 and Z-score > 1.96, p< 0.05). The disease and yearly-specific hotspot analyses pinpointed a number of hotspot districts. The divergence in the intensities of clustering and the number of hotspots observed undoubtedly showed location and disease-specific disparities in health intervention programmes, resources allocation and/or spatial variability of determinants across the country. There is a critical need to further strengthen/improve and prioritise disease-specific control strategies in the identified hotspot districts and to also give broader and uniform attention to other leading infectious diseases, especially Intestinal worms and Typhoid fever. From the spatial lag regression model, policy and/or social interventions to increase basic education attainment but decreasing urbanisation, intermigration and sex ratio while considering neighbourhood-effects could reduce the rates of infections in the districts. Geo-health informatics should be included into health researches and reports in Ghana as data mining tool to enhance public health promotion and health policies.
A Thesis submitted to the Department of Computer Science Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Master of Philosophy in Health Informatics,