Geospatial modelling of lymphatic filariasis and malaria co-endemicity in Nigeria.

ABSTRACT

BACKGROUND: Lymphatic filariasis (LF) and malaria are important vector-borne diseases that are co-endemic throughout Nigeria. These infections are transmitted by the same mosquito vector species in Nigeria and their transmission is similarly influenced by climate and sociodemographic factors. The goal of this study was to assess the relationship between the geospatial distribution of both infections in Nigeria to better coordinate interventions. METHODS: We used national survey data for malaria from the Demographic and Health Survey dataset and site-level LF mapping data from the Nigeria Lymphatic Filariasis Control Programme together with a suite of predictive climate and sociodemographic factors to build geospatial machine learning models. These models were then used to produce continuous gridded maps of both infections throughout Nigeria. RESULTS: The R2 values for the LF and malaria models were 0.68 and 0.59, respectively. Also, the correlation between pairs of observed and predicted values for LF and malaria models were 0.69 (95% confidence interval [CI] 0.61 to 0.79; p<0.001) and 0.61 (95% CI 0.52 to 0.71; p<0.001), respectively. However, we observed a very weak positive correlation between overall overlap of LF and malaria distribution in Nigeria. CONCLUSIONS: The reasons for this counterintuitive relationship are unclear. Differences in transmission dynamics of these parasites and vector competence may contribute to differences in the distribution of these co-endemic diseases.