{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:09:40Z","timestamp":1779127780975,"version":"3.51.4"},"reference-count":23,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,2,10]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Sierra Leone, using data from the District Health Information System 2 (DHIS2) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study examined the spatial and spatio-temporal distribution of malaria incidence, and the relationship between malaria incidence and rainfall in surrounding areas in Sierra Leone from 2021 to 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHOD<\/jats:title>\n                    <jats:p>A cross-sectional geospatial study was conducted using malaria case data, mean rainfall data, population estimates, and chiefdom-level geographic coordinates. Spatial clustering was evaluated using Moran\u2019s I, significant district-level clusters were identified through space\u2013time Poisson models (\u03b1 = 0.05; 999 permutations), and the relationship between malaria incidence and rainfall in surrounding areas was assessed using bivariate Moran\u2019s I, implemented in Python.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Between 2021 and 2024, 7.4 million malaria cases were reported. Chiefdom-level incidence ranged from 21.2 to &gt;750 per 1,000 population. Significant spatial clustering was observed (Moran\u2019s I &gt; 0;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01). Persistent high\u2013high clusters (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) and low\u2013low clusters (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) were identified across the country. Space\u2013time analysis identified both high-risk (relative risk [RR] = 1.2\u20131.9;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01) and low-risk districts (RR = 0.5\u20130.9;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01). There was no significant association between malaria incidence and rainfall in surrounding areas at the national level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Malaria transmission remains spatially and temporally heterogeneous, with persistent hotspots that require tailored subnational interventions to accelerate progress towards elimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.25.0048","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:41:33Z","timestamp":1779126093000},"page":"99-105","source":"Crossref","is-referenced-by-count":0,"title":["Mapping malaria hotspots through spatial and spatio-temporal analysis in Sierra Leone, 2021\u20132024"],"prefix":"10.5588","volume":"16","author":[{"given":"A.M.","family":"Falama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Omoniwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.S.","family":"Kanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.K.","family":"Lahai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.R.Y.","family":"Kamara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Ameh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.F.","family":"Kamara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.D.","family":"Fofanah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Kenneh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.N.","family":"Kamara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.A.","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Kanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.A.","family":"Alwani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Thekkur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Zachariah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.S.","family":"Kanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Lakoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"2026051810412756000_16.2.99.1","doi-asserted-by":"crossref","unstructured":"World Health Organization . 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Global technical strategy for malaria 2016-2030, 2021 update. 1st ed. Geneva: WHO, 2021."},{"issue":"1","key":"2026051810412756000_16.2.99.6","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/s40249-020-00764-6","article-title":"Spatial and spatio-temporal analysis of malaria cases in Zimbabwe","volume":"9","author":"Gwitira","year":"2020","journal-title":"Infect Dis Poverty"},{"issue":"1","key":"2026051810412756000_16.2.99.7","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1186\/s12936-016-1646-2","article-title":"Spatial and space\u2013time distribution of Plasmodium vivax and Plasmodium falciparum malaria in China, 2005\u20132014","volume":"15","author":"Hundessa","year":"2016","journal-title":"Malar J"},{"issue":"7","key":"2026051810412756000_16.2.99.8","doi-asserted-by":"crossref","first-page":"e474","DOI":"10.1016\/S2214-109X(16)30073-0","article-title":"Estimating the most efficient allocation of interventions to achieve reductions in Plasmodium falciparum malaria burden and transmission in Africa: a modelling study","volume":"4","author":"Walker","year":"2016","journal-title":"Lancet Glob Health"},{"key":"2026051810412756000_16.2.99.9","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.88283"},{"key":"2026051810412756000_16.2.99.10","unstructured":"2015 Population and Housing Census . Summary of final results. Planning a better future. Freetown, Sierra Leone: Statistics Sierra Leone, 2016."},{"key":"2026051810412756000_16.2.99.11","unstructured":"Sierra Leone Geography . Country reports Pleasant Grove, UT, USA: Country Reports, 2026. https:\/\/www.countryreports.org\/country\/SierraLeone\/geography.htm."},{"issue":"1","key":"2026051810412756000_16.2.99.12","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s12936-025-05389-4","article-title":"Forecasting malaria cases using climate variability in Sierra Leone","volume":"24","author":"Jalloh","year":"2025","journal-title":"Malar J"},{"key":"2026051810412756000_16.2.99.13","unstructured":"World Health Organization . Malaria surveillance, monitoring and evaluation: a reference manual. 2nd ed. Geneva: WHO, 2025."},{"key":"2026051810412756000_16.2.99.14","unstructured":"World Health Organization . Global pulse survey on continuity of essential health services during the COVID-19 pandemic. 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Ministry of Health and Sanitation, Government of Sierra Leone: Freetown, Sierra Leone, 2026."},{"issue":"1","key":"2026051810412756000_16.2.99.23","doi-asserted-by":"crossref","first-page":"3373","DOI":"10.1038\/s41598-025-33236-8","article-title":"Spatial analysis of malaria incidence and environmental determinants in Hadiya zone, Ethiopia","volume":"16","author":"Abdo","year":"2025","journal-title":"Sci Rep"}],"container-title":["Public Health Action"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/pha.25.0048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:41:38Z","timestamp":1779126098000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/pha.25.0048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.5588\/pha.25.0048"],"URL":"https:\/\/doi.org\/10.5588\/pha.25.0048","relation":{},"ISSN":["2220-8372"],"issn-type":[{"value":"2220-8372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}