Background: Urbanization is an urban change process which alters the structure and function of urban environment. The alteration in the quality of urban environmental quality conditions has significant implications for urban health both in terms of change of vector ecology and infectious disease transmission. Methods: Study objectives: To investigate the relationship between infectious disease (malaria and diarrhea) mortality and spatial change in neighborhood urban environmental quality in a rapidly urbanizing area in a low income economy. Design: A time-point spatial analysis of cluster-level environmental and mortality data using Principal Component Analytic (PCA) and multiple linear regression models. Methods: Environmental variables were extracted from the Ghana Census 2000 database and mortality data were obtained and pooled together from the Ghana Births and Deaths Registry in Accra over the period 1998-2002. Results: While there was a very strong evidence of a difference in the risk of urban malaria mortality across urban environmental zones of differing neighborhood environmental quality conditions, no such evidence of a difference in urban diarrhea mortality risk was observed across these zones. Additionally, whereas bivariate analyses showed a weak to very strong evidence of association between the environmental variables and malaria mortality, not the least evidence of association was observed between urban diarrhea mortality and the environmental variables. Conclusion: We conclude that environmental management initiatives intended for infectious disease control might substantially reduce and/or lower the neighborhood urban environmental quality attributable fraction of the risk of urban malaria mortality more than that for urban diarrhea mortality in rapidly urbanizing areas in a low income setting.
Fobil, J., Fobil, J., Kraemer, A., & May, J. (2010). Neighborhood urban environmental quality conditions probably drive malaria and diarrhea mortality in Accra, Ghana. International Journal of Infectious Diseases, 14, e205. https://doi.org/10.1016/j.ijid.2010.02.1943