title: Household and community variations and nested risk factors for diarrhoea prevalence in southern Malawi: a binary logistic multi-level analysis.
abstract: This paper examines household and community-level influences on diarrhoeal prevalence in southern Malawi. A Bayesian multi-level modelling technique is used in the estimation of hierarchically built data from a survey of individuals nested within households nested within communities. Households have strong unobserved influence on diarrhoeal illness (sigma(2)(u) = 4.476; 95% CI: 2.081, 6.871). A joint Wald test of significance shows that an individual's age [chi(2)(4) = 55.921, p = 0.000] and school [chi(2)(2) = 18.203, p = 0.000] have strong influence on an individual's diarrhoeal prevalence. An individual's history of malarial-like illness also has a strong positive relationship with diarrhoeal prevalence [beta = 0.606, p = 0.000]. Household factors that influence diarrhoea include employment status of head of household [beta = -0.619, p < 0.021], maternal age [beta = -0.013, p < 0.003], and size of household [beta = -0.669, p = 0.000]. The positive relationship between diarrhoea and malaria-like episodes highlights common risk factors hence the need for common approaches to combat the diseases. Significant household effects underline the importance of household considerations in policy issues.
authors.affiliation: Department of Civil Engineering, University of Strathclyde, Glasgow, UK. salule.masangwi@strath.ac.uk
authors.forename: Salule Joseph
authors.initials: SJ
authors.lastname: Masangwi
authors.forename: N S
authors.initials: NS
authors.lastname: Ferguson
authors.forename: A M
authors.initials: AM
authors.lastname: Grimason
authors.forename: T D
authors.initials: TD
authors.lastname: Morse
authors.forename: G
authors.initials: G
authors.lastname: Zawdie
authors.forename: L N
authors.initials: LN
authors.lastname: Kazembe
mesh_terms: D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology*; D005191:Family Characteristics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008295:Malawi / Q000453:epidemiology; D008875:Middle Aged; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult