General contextual effects on neglected tropical disease risk in rural Kenya

De Glanville, W. A., Thomas, L. F., Cook, E. A.J., Bronsvoort, B. M. d. C., Wardrop, N., Wamae, C. N., Kariuki, S. and Fèvre, E. M. (2018) General contextual effects on neglected tropical disease risk in rural Kenya. PLoS Neglected Tropical Diseases, 12(12), e0007016. (doi: 10.1371/journal.pntd.0007016) (PMID:30576335) (PMCID:PMC6342328)

179820.pdf - Published Version
Available under License Creative Commons Attribution.



The neglected tropical diseases (NTDs) are characterized by their tendency to cluster within groups of people, typically the poorest and most marginalized. Despite this, measures of clustering, such as within-group correlation or between-group heterogeneity, are rarely reported from community-based studies of NTD risk. We describe a general contextual analysis that uses multi-level models to partition and quantify variation in individual NTD risk at multiple grouping levels in rural Kenya. The importance of general contextual effects (GCE) in structuring variation in individual infection with Schistosoma mansoni, the soil-transmitted helminths, Taenia species, and Entamoeba histolytica/dispar was examined at the household-, sublocation- and constituency-levels using variance partition/intra-class correlation co-efficients and median odds ratios. These were compared with GCE for HIV, Plasmodium falciparum and Mycobacterium tuberculosis. The role of place of residence in shaping infection risk was further assessed using the spatial scan statistic. Individuals from the same household showed correlation in infection for all pathogens, and this was consistently highest for the gastrointestinal helminths. The lowest levels of household clustering were observed for E. histolytica/dispar, P. falciparum and M. tuberculosis. Substantial heterogeneity in individual infection risk was observed between sublocations for S. mansoni and Taenia solium cysticercosis and between constituencies for infection with S. mansoni, Trichuris trichiura and Ascaris lumbricoides. Large overlapping spatial clusters were detected for S. mansoni, T. trichiura, A. lumbricoides, and Taenia spp., which overlapped a large cluster of elevated HIV risk. Important place-based heterogeneities in infection risk exist in this community, and these GCEs are greater for the NTDs and HIV than for TB and malaria. Our findings suggest that broad-scale contextual drivers shape infectious disease risk in this population, but these effects operate at different grouping-levels for different pathogens. A general contextual analysis can provide a foundation for understanding the complex ecology of NTDs and contribute to the targeting of interventions.

Item Type:Articles
Glasgow Author(s) Enlighten ID:De Glanville, Dr William
Creator Roles:
de Glanville, W. A.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review and editing
Authors: De Glanville, W. A., Thomas, L. F., Cook, E. A.J., Bronsvoort, B. M. d. C., Wardrop, N., Wamae, C. N., Kariuki, S., and Fèvre, E. M.
College/School:College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN (Online):1935-2735
Published Online:21 December 2018
Copyright Holders:Copyright © 2018 de Glanville et al.
First Published:First published in PLoS Neglected Tropical Diseases 12(12): e0007016
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.17638/

University Staff: Request a correction | Enlighten Editors: Update this record