title: Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines.
abstract: BACKGROUND
  Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality worldwide. Currently, most developing countries assign resources at a district level, and yet District Medical Officers have few tools for directing targeted interventions to high mortality or morbidity areas. Mapping of ALRI at the local level can guide more efficient allocation of resources, coordination of efforts and targeted interventions, which are particularly relevant for health management in resource-scarce settings.
  
  
  METHODS
  An efficacy study of 11-valent pneumococcal vaccine was conducted in six municipalities in the Bohol Province of central Philippines from July 2000 to December 2004. Geocoded under-five pneumonia cases (using WHO classifications) were mapped to create spatial patterns of pneumonia at the local health unit (barangay) level.
  
  
  RESULTS
  There were 2951 children with WHO-defined clinical pneumonia, of whom 1074 were severe or very severely ill, 278 were radiographic, and 219 were hypoxaemic. While most children with pneumonia were from urban barangays, there was a disproportionately higher distribution of severe/very severe pneumonia in rural barangays and the most severe hypoxaemic children were concentrated in the northern barangays most distant from the regional hospital.
  
  
  CONCLUSIONS
  Mapping of ALRI at the local administrative health level can be performed relatively simply. If these principles are applied to routinely collected IMCI classification of disease at the district level in developing countries, such efforts can form the basis for directing public health and healthcare delivery efforts in a targeted manner.
authors.affiliation: Department of Geography & Environmental Sciences, University of Colorado, Denver, CO, USA.
authors.forename: Deborah S K
authors.initials: DS
authors.lastname: Thomas
authors.affiliation: Department of Geography & Environmental Sciences, University of Colorado, Denver, CO, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Anthamatten
authors.affiliation: Department of Geography and Institute of Behavioral Sciences, University of Colorado, Boulder, CO, USA.
authors.forename: Elisabeth Dowling
authors.initials: ED
authors.lastname: Root
authors.affiliation: Research Institute for Tropical Medicine, Metro Manila, Philippines.
authors.forename: Marilla
authors.initials: M
authors.lastname: Lucero
authors.affiliation: Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Nohynek
authors.affiliation: Research Institute for Tropical Medicine, Metro Manila, Philippines.
authors.forename: Veronica
authors.initials: V
authors.lastname: Tallo
authors.affiliation: School of Population Health, University of Queensland, Brisbane, Qld, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases, University of Colorado, School of Medicine, Aurora, CO, USA.|Department of Epidemiology and Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simões
keywords: Filipinas; Mapeo geográfico; Philippines; analyse spatiale; análisis espacial; cartographie géographique; childhood pneumonia; geographic mapping; neumonía infantil; pneumonie infantile; spatial analysis