title: Space-time mapping of wasting among children under the age of five years in Somalia from 2007 to 2010.
abstract: OBJECTIVE
  To determine the sub-national seasonal prevalence and trends in wasting from 2007 to 2010 among children aged 6-59 months in Somalia using remote sensing and household survey data from nutritional surveys.
  
  
  METHODS
  Bayesian hierarchical space-time model was implemented using a stochastic partial differential equation (SPDE) approach in integrated nested Laplace approximations (INLA) to produce risk maps of wasting at 1 × 1 km(2) spatial resolution and predict to seasons in each year of study from 2007 to 2010.
  
  
  RESULTS
  The prevalence of wasting was generally at critical levels throughout the country, with most of the areas remaining in the upper classes of critical and very critical levels. There was minimal variation in wasting from year-to-year, but a well-defined seasonal variation was observed. The mean difference of the prevalence of wasting between the dry and wet season ranges from 0% to 5%. The risks of wasting in the South Central zone were highest in the Gedo (37%) and Bay (32%) regions. In North East zone the risk was highest in Nugaal (25%) and in the North West zone the risk was high in Awdal and Woqooyi Galbeed regions with 23%.
  
  
  CONCLUSIONS
  There was a clear seasonal variation in wasting with minimal year-to-year variability from 2007 to 2010 in Somalia. The prevalence was high during the long dry season, which affects the prevalence in the preceding long rainy season. Understanding the seasonal fluctuations of wasting in different locations and at different times is important to inform timely interventions.
authors.affiliation: Spatial Health Metrics Group, INFORM Project, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi P.O. Box 43640-00100, Kenya. Electronic address: DKinyoki@kemri-wellcome.org.
authors.forename: Damaris K
authors.initials: DK
authors.lastname: Kinyoki
authors.affiliation: Kenya Medical Research Institute/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (coast), Kilifi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, CCVTM, Oxford OX3 7LJ, UK. Electronic address: JBerkley@kemri-wellcome.org.
authors.forename: James A
authors.initials: JA
authors.lastname: Berkley
authors.affiliation: Nutrition Section, United Nations Children's Fund (UNICEF), Kenya Country Office, UN Complex Gigiri, Nairobi, Kenya. Electronic address: gmmoloney@unicef.org.
authors.forename: Grainne M
authors.initials: GM
authors.lastname: Moloney
authors.affiliation: Food Security and Nutrition Analysis Unit (FSNAU) - Somalia, United Nations Food and Agricultural Organization, Ngecha Road Campus, Nairobi, Kenya . Electronic address: Elijah.Odundo@fao.org.
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Odundo
authors.affiliation: Warwick Medical School, Health Sciences Research Institute, University of Warwick, Warwick Evidence, Gibbet Hill, CV4 7AL Coventry, UK; Department of Mathematics and Information sciences Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK; Health Economics and Evidence Synthesis Research Unit, Department of Population Health, Luxembourg Institute of Health L-1445 Strassen, Luxembourg. Electronic address: N-B.Kandala@warwick.ac.uk.
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
authors.affiliation: Spatial Health Metrics Group, INFORM Project, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi P.O. Box 43640-00100, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, CCVTM, Oxford OX3 7LJ, UK. Electronic address: ANoor@kemri-wellcome.org.
authors.forename: Abdisalan M
authors.initials: AM
authors.lastname: Noor
mesh_terms: D001499:Bayes Theorem; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011891:Rain; D012307:Risk Factors; D012621:Seasons; D012998:Somalia / Q000453:epidemiology; D062211:Spatio-Temporal Analysis; D019282:Wasting Syndrome / Q000453:epidemiology*
keywords: Bayesian; Malnutrition; Seasonality; Space–time model; Wasting