Spatiotemporal clusters of acute respiratory infections associated with socioeconomic, meteorological, and air pollution factors in South Punjab, Pakistan | BMC Public Health
Liu WK, Liu Q, Chen DH, Liang HX, Chen XK, Chen MX, et al. Epidemiology of Acute Respiratory Infections in Children in Guangzhou: A Three-Year Study. PLOS ONE. 2014;9(5):e96674. https://doi.org/10.1371/journal.pone.0096674.
Bulla A, Hitze KL. Acute respiratory infections: a review. Bull World Health Organ. 1978;56(3):481–98.
Google Scholar
Mansbach JM, Camargo CA. Acute Respiratory Infections. In: Litonjua AA, editor. Vitamin D and the Lung: Mechanisms and Disease Associations; Totowa, NJ: Humana Press; 2012. p. 181–200.
山岸良匡, ヤマギシ カ. Global burden of 369 diseases and injuries in 204 countries and territories, 1990? 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Respir Med. 2020;396(10258):1204–22,
WHO. The top 10 causes of death: World Health Organization; 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.
Jolliffe DA, Griffiths CJ, Martineau AR. Vitamin D in the prevention of acute respiratory infection: Systematic review of clinical studies. J Steroid Biochem Mole Biol. 2013;136:321–9. https://doi.org/10.1016/j.jsbmb.2012.11.017.
Google Scholar
Hassen S, Getachew M, Eneyew B, Keleb A, Ademas A, Berihun G, et al. Determinants of acute respiratory infection (ARI) among under-five children in rural areas of Legambo District, South Wollo Zone, Ethiopia: A matched case–control study. Int J Infect Dis. 2020;96:688–95. https://doi.org/10.1016/j.ijid.2020.05.012.
Google Scholar
Ghimire P, Gachhadar R, Piya N, Shrestha K, Shrestha K. Prevalence and factors associated with acute respiratory infection among under-five children in selected tertiary hospitals of Kathmandu Valley. PLoS ONE. 2022;17(4):e0265933. https://doi.org/10.1371/journal.pone.0265933.
Google Scholar
Reed KD. Respiratory Tract Infections: A Clinical Approach. Molecular Medical Microbiology: Elsevier; 2015. p. 1499-506
Ujunwa F, Ezeonu C. Risk factors for acute respiratory tract infections in under-five children in enugu Southeast Nigeria. Ann Med Health Sci Res. 2014;4(1):95–9.
Google Scholar
Merera AM. Determinants of acute respiratory infection among under-five children in rural Ethiopia. BMC Infect Dis. 2021;21(1):1203. https://doi.org/10.1186/s12879-021-06864-4.
Google Scholar
Islam MA, Hasan MN, Ahammed T, Anjum A, Majumder A, Siddiqui MN-E, et al. Association of household fuel with acute respiratory infection (ARI) under-five years children in Bangladesh. Front Public Health. 2022;10:985445
Liu Q, Qin C, Du M, Wang Y, Yan W, Liu M, et al. Incidence and Mortality Trends of Upper Respiratory Infections in China and Other Asian Countries from 1990 to 2019. Viruses. 2022;14(11). https://doi.org/10.3390/v14112550.
DHIS. District Health Information System (Annual Report of Punjab 2019). Lahore: Directorate General Health services Punjab, Lahore; 2019.
Murarkar S, Gothankar J, Doke P, Dhumale G, Pore PD, Lalwani S, et al. Prevalence of the acute respiratory infections and associated factors in the rural areas and Urban Slum Areas of Western Maharashtra, India: A community-based cross-sectional study. Front Public Health. 2021;9:723807. https://doi.org/10.3389/fpubh.2021.723807.
Google Scholar
Morabito M, Crisci A, Moriondo M, Profili F, Francesconi P, Trombi G, et al. Air temperature-related human health outcomes: Current impact and estimations of future risks in Central Italy. Sci Total Environ. 2012;441:28–40. https://doi.org/10.1016/j.scitotenv.2012.09.056.
Google Scholar
Tang JW. The effect of environmental parameters on the survival of airborne infectious agents. J Royal Soc Interface. 2009;6(suppl_6):S737-S46
Dadbakhsh M, Khanjani N, Bahrampour A, Haghighi PS. Death from respiratory diseases and temperature in Shiraz, Iran (2006–2011). Int J Biometeorol. 2017;61(2):239–46. https://doi.org/10.1007/s00484-016-1206-z.
Google Scholar
Moriyama M, Hugentobler WJ, Iwasaki A. Seasonality of respiratory viral infections. Annual review of virology. 2020;7(1):annurev-virology-012420–22445,
Moriyama M, Hugentobler WJ, Iwasaki A. Seasonality of respiratory viral infections. Ann Rev Virol. 2020;7:83–101.
Google Scholar
Mailepessov D, Aik J, Seow WJ. A time series analysis of the short-term association between climatic variables and acute respiratory infections in Singapore. Int J Hyg Environ Health. 2021;234:113748. https://doi.org/10.1016/j.ijheh.2021.113748.
Google Scholar
Xu B, Wang J, Li Z, Xu C, Liao Y, Hu M, et al. Seasonal association between viral causes of hospitalised acute lower respiratory infections and meteorological factors in China: a retrospective study. Lancet Planet Health. 2021;5(3):e154–63. https://doi.org/10.1016/S2542-5196(20)30297-7.
Google Scholar
Song H, Jin Z, Shan C, Chang L. The spatial and temporal effects of Fog–Haze pollution on the influenza transmission. Int J Biomath. https://doi.org/10.1142/S1793524522500966.
Aghababaeian H, Ostadtaghizadeh A, Ardalan A, Asgary A, Akbary M, Yekaninejad MS, et al. Global health impacts of dust storms: a systematic review. Environ Health Insights. 2021;15:11786302211018390.
Google Scholar
Soleimani Z, Teymouri P, Darvishi Boloorani A, Mesdaghinia A, Middleton N, Griffin DW. An overview of bioaerosol load and health impacts associated with dust storms: A focus on the Middle East. Atmospheric Environ. 2020;223:117187. https://doi.org/10.1016/j.atmosenv.2019.117187.
Google Scholar
Chen T-M, Kuschner WG, Gokhale J, Shofer S. Outdoor air pollution: nitrogen dioxide, sulfur dioxide, and carbon monoxide health effects. Am J Med Sci. 2007;333(4):249–56. https://doi.org/10.1097/MAJ.0b013e31803b900f.
Google Scholar
Merera AM. Determinants of acute respiratory infection among under-five children in rural Ethiopia. BMC Infect Dis. 2021;21(1):1203. https://doi.org/10.1186/s12879-021-06864-4.
Google Scholar
Aftab A, Noor A, Aslam M. Housing quality and its impact on Acute Respiratory Infection (ARI) symptoms among children in Punjab, Pakistan. PLOS Global Public Health. 2022;2(9):e0000949. https://doi.org/10.1371/journal.pgph.0000949.
Google Scholar
Yaya S, Bishwajit G. Burden of acute respiratory infections among under-five children in relation to household wealth and socioeconomic status in Bangladesh. Trop Med Infect Dis. 2019;4(1):36.
Google Scholar
Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI) in under-fives in a rural hospital of Central India. J Pediatric Neonatal Individual Med. 2016;5(1):e050105-e.
Mansouritorghabeh H, Bagherimoghaddam A, Eslami S, Raouf-Rahmati A, Hamer DH, Kiani B, et al. Spatial epidemiology of COVID-19 infection through the first outbreak in the city of Mashhad. Iran Spatial Inform Res. 2022;30(5):585–95. https://doi.org/10.1007/s41324-022-00454-5.
Google Scholar
Amsalu ET, Akalu TY, Gelaye KA. Spatial distribution and determinants of acute respiratory infection among under-five children in Ethiopia: Ethiopian Demographic Health Survey 2016. PLoS ONE. 2019;14(4):e0215572. https://doi.org/10.1371/journal.pone.0215572.
Google Scholar
Zhang A, Zhou F, Jiang L, Qi Q, Wang J. Spatiotemporal analysis of ambient air pollution exposure and respiratory infections cases in Beijing. Cent Eur J Public Health. 2015;23(1):73.
Google Scholar
Chakrabarti S, Khan MT, Kishore A, Roy D, Scott SP. Risk of acute respiratory infection from crop burning in India: estimating disease burden and economic welfare from satellite and national health survey data for 250 000 persons. Int J Epidemiol. 2019;48(4):1113–24. https://doi.org/10.1093/ije/dyz022.
Google Scholar
Sulekan A, Suhaila J, Wahid NAA. Assessing the effect of climate factors on dengue incidence via a generalized linear model. Open J Appl Sci. 2021;11(No.04):15. https://doi.org/10.4236/ojapps.2021.104039.
Google Scholar
Islam ARMT, Hasanuzzaman M, Shammi M, Salam R, Bodrud-Doza M, Rahman MM, et al. Are meteorological factors enhancing COVID-19 transmission in Bangladesh? Novel findings from a compound Poisson generalized linear modeling approach. Environ Sci Pollut Res. 2021;28(9):11245–58. https://doi.org/10.1007/s11356-020-11273-2.
Google Scholar
Mohammadi A, Pishgar E, Fatima M, Lotfata A, Fanni Z, Bergquist R, et al. The COVID-19 mortality rate is associated with illiteracy, age, and air pollution in urban neighborhoods: A spatiotemporal cross-sectional analysis. 2023;8(2):85
Janjua NZ, Mahmood B, Dharma VK, Sathiakumar N, Khan MI. Use of biomass fuel and acute respiratory infections in rural Pakistan. Public Health. 2012;126(10):855–62. https://doi.org/10.1016/j.puhe.2012.06.012.
Maheen H, Dharmalingam A. Social determinants of acute respiratory infections in babies and infants in Pakistan: a population based study. Pak J Life Soc Sci. 2014;12(2):57–63.
Ahmad SS, Aziz N, Butt A, Shabbir R, Erum S. Spatio-temporal surveillance of water based infectious disease (malaria) in Rawalpindi, Pakistan using geostatistical modeling techniques. Environ Monit Assess. 2015;187(9):555. https://doi.org/10.1007/s10661-015-4779-9.
Google Scholar
Fatima M, Butt I, Arshad S. Geospatial clustering and hot spot detection of malaria incidence in Bahawalpur district of Pakistan. GeoJournal. 2022;87(6):4791–806.
Google Scholar
Mahmood S, Irshad A, Nasir JM, Sharif F, Farooqi SH. Spatiotemporal analysis of dengue outbreaks in Samanabad town, Lahore metropolitan area, using geospatial techniques. Environ Monit Assess. 2019;191(2):55. https://doi.org/10.1007/s10661-018-7162-9.
Google Scholar
Mahmood S, Irshad A. Employing Geographic Information System and Spatiotemporal Analysis of Dengue Outbreaks in a Metropolitan Area in Pakistan. In: Ahmad SI, editor. Human Viruses: Diseases, Treatments and Vaccines : The New Insights; Cham: Springer International Publishing; 2021. p. 81–91.
Fatima M, Butt I, Firouraghi N, Khalil M, Kiani B. Space-time analysis of tuberculosis (2016–2020) in South Punjab. Pakistan GeoJournal. 2024;89(1):1–13.
Google Scholar
Fatima M, Butt I, Arshad S. Spatial Patterns of Diarrhea Incidence In District Bahawalpur, Pakistan. Pak Geograph Rev. 2022;77(1):46–59.
Zeb I, Qureshi NA, Shaheen N, Zafar MI, Ali A, Hamid A, et al. Spatiotemporal patterns of cutaneous leishmaniasis in the district upper and lower Dir, Khyber Pakhtunkhwa, Pakistan: A GIS-based spatial approaches. Acta Trop. 2021;217:105861.
Google Scholar
Fatima M, Khattak RM, Grady SC, Butt I, Arshad S, Ittermann T, et al. Spatial and temporal analysis of acute respiratory infections (Aris) in southern Punjab Pakistan. Spatial Inform Res. 2022;30(4):477–87.
Google Scholar
Sajid Rasul, Muhammad Mumtaz Ahmad, Syed Wasim Abbas, Sana Gull, Marryam Pervez, FiazAhmad. South Punjab Developmenal Statistics 2020. Lahore: BUREAU OF STATISTICS:Planning & Development Board Government of the Punjab, Punjab PDBGot; 2021.
Fatima M, Butt I, Nasar-u-Minallah M, Atta A, Cheng G. Assessment Of Air Pollution And Its Association With Population Health: Geo-Statistical Evidence From Pakistan. Geography Environ Sustain. 2023;16(2):93–101.
Google Scholar
UNP. High-level deep dive on South Punjab. United Nations of Pakistan; 2022 9–10 MARCH 2022.
DHIS. District health information system (Annual report 2019. Director Health Services. 2020.
ESRI. Desktop 10.4.1 Redlands CESRI: ESRI; 2018 [Available from: https://support.esri.com/en/download/7382.
GEE. Earth Engine Data Catalog: Google earth Engine; 2022 Available from: https://developers.google.com/earth-engine/datasets/catalog/sentinel-5p.
GOP. Multiple Indicator Cluster Survey Punjab (MICS). In: Punjab BoSPDBGo, editor.: Bureau of Statistics Punjab; 2018.
PBS. Census -2017 Islamabad pakistan: Pakistan Bureau of Statistics; 2017 Available from: https://www.pbs.gov.pk/content/brief-census-2017#:~:text=According%20to%20the%20final%20results,males%20and%20101.3%20million%20females.
IBM. IBM SPSS Statistics: IBM; 2023 Available from: https://www.ibm.com/products/spss-statistics.
Kuldorff M. SaTScan User Guide for version 10. 2021.
Kiani B, Fatima M, Amin NH, Hesami A. Comparing geospatial clustering methods to study spatial patterns of lung cancer rates in urban areas: A case study in Mashhad, Iran. GeoJournal. 2023;88(2):1659–69. https://doi.org/10.1007/s10708-022-10707-3.
Venables W, Ripley B. Modern Applied Statistics with S, Springer, New York: ISBN 0–387–95457–0. 2002.
Olivoto T, Lúcio ADC. metan: An R package for multi-environment trial analysis. Methods Ecol Evol. 2020;11(6):783–9. https://doi.org/10.1111/2041-210X.13384.
Google Scholar
Wickham H, Averick M, Bryan J, Chang W, McGowan LDA, François R, et al. Welcome to the Tidyverse. J Open Source Software. 2019;4(43):1686.
Google Scholar
Fox J, Weisberg S. An R companion to applied regression: Sage publications; 2018.
Guo B, Wang Y, Pei L, Yu Y, Liu F, Zhang D, et al. Determining the effects of socioeconomic and environmental determinants on chronic obstructive pulmonary disease (COPD) mortality using geographically and temporally weighted regression model across Xi’an during 2014–2016. 2021;756:143869
Jung K, Shah NH. Implications of non-stationarity on predictive modeling using EHRs. J Biomed Inform. 2015;58:168–74. https://doi.org/10.1016/j.jbi.2015.10.006.
Google Scholar
Imai C, Hashizume M. A systematic review of methodology: time series regression analysis for environmental factors and infectious diseases. Trop Med Health. 2015;43(1):1–9.
Google Scholar
Sulekan A, Suhaila J, Wahid NAA. Assessing the effect of climate factors on dengue incidence via a generalized linear model. J Open J Appl Sci. 2021;11(No.04):15. https://doi.org/10.4236/ojapps.2021.104039.
Google Scholar
Lin S, Lu Y. The spatial patterns of adverse health effects of ozone pollution on childhood respiratory diseases in urban Houston. Ann GIS. 2009;15(2):127–40. https://doi.org/10.1080/19475680903271133.
Farah C, Hosgood HD, Hock JM. Spatial prevalence and associations among respiratory diseases in Maine. Spatial Spatio-Temp Epidemiol. 2014;11:11–22. https://doi.org/10.1016/j.sste.2014.07.004.
Kumarihamy R, Tripathi N. Geostatistical predictive modeling for asthma and chronic obstructive pulmonary disease using socioeconomic and environmental determinants. Environ Mon Assess. 2019;191:1–21.
Google Scholar
Brunsdon C, Fotheringham AS, Charlton ME. Geographically weighted regression: a method for exploring spatial nonstationarity. Geogr Anal. 1996;28(4):281–98.
Google Scholar
Guo B, Wang Y, Pei L, Yu Y, Liu F, Zhang D, et al. Determining the effects of socioeconomic and environmental determinants on chronic obstructive pulmonary disease (COPD) mortality using geographically and temporally weighted regression model across Xi’an during 2014–2016. Sci Total Environ. 2021;756:143869. https://doi.org/10.1016/j.scitotenv.2020.143869.
Google Scholar
Elliot AJ, Cross KW, Fleming DM. Acute respiratory infections and winter pressures on hospital admissions in England and Wales 1990–2005. Journal of Public Health. 2008;30(1):91–8. https://doi.org/10.1093/pubmed/fdn003.
Nichols GL, Gillingham EL, Macintyre HL, Vardoulakis S, Hajat S, Sarran CE, et al. Coronavirus seasonality, respiratory infections and weather. BMC Infect Dis. 2021;21(1):1101. https://doi.org/10.1186/s12879-021-06785-2.
Google Scholar
Nastos PT, Matzarakis A. Weather impacts on respiratory infections in Athens, Greece. International journal of biometeorology. 2006;50:358–69. https://doi.org/10.1007/s00484-006-0031-1.
Qazi SH, Saleem A, Pirzada AN, Hamid L-R, Dogar SA, Das JK. Challenges to delivering pediatric surgery services in the midst of COVID 19 crisis: experience from a tertiary care hospital of Pakistan. Pediatr Surg Int. 2020;36:1267–73.
Google Scholar
Panovska-Griffiths J, Kerr CC, Waites W, Stuart RM, Mistry D, Foster D, et al. Modelling the potential impact of mask use in schools and society on COVID-19 control in the UK. Sci Rep. 2021;11(1):8747. https://doi.org/10.1038/s41598-021-88075-0.
Kim S, Ko Y, Kim Y-J, Jung E. The impact of social distancing and public behavior changes on COVID-19 transmission dynamics in the Republic of Korea. PLOS ONE. 2020;15(9):e0238684. https://doi.org/10.1371/journal.pone.0238684.
Saleem F, Hina S, Ullah I, Habib A, Hina A, Ilyas S, et al. Impacts of irregular and strategic lockdown on air quality over Indo-Pak Subcontinent: Pre-to-post COVID-19 analysis. Chaos, Solitons Fractals. 2024;178: 114255.
Google Scholar
DHIS. District Health Information System (Annual Report of Punjab 2016). Lahore: Directorate General Health Services Punjab; 2016.
DHIS. DHIS Annual Report 2017. Lahore: Directorate General Health Services, Punjab; 2017.
DHIS. DHIS Annual Report 2018. Lahore: Director General Health Services Punjab Lahore; 2018.
DHIS. District Health Information System (Annual Report of Punjab 2019. Lahore: Directorate General Health Services, Punjab; 2019.
DHIS. District Health Information System (Annual Report of Punjab 2019). Lahore: Directorate General Health services Punjab, Lahore; 2021.
Chen W, Zhang N, Wei J, Yen H-L, Li Y. Short-range airborne route dominates exposure of respiratory infection during close contact. Building and Environment. 2020;176:106859. https://doi.org/10.1016/j.buildenv.2020.106859.
Pica N, Bouvier NM. Environmental factors affecting the transmission of respiratory viruses. Current Opinion in Virology. 2012;2(1):90–5. https://doi.org/10.1016/j.coviro.2011.12.003.
du Prel J-B, Puppe W, Gröndahl B, Knuf M, Weigl F, Schaaff F, et al. Are meteorological parameters associated with acute respiratory tract infections? Clinical infectious diseases. 2009;49(6):861–8. https://doi.org/10.1086/605435.
Mäkinen TM, Juvonen R, Jokelainen J, Harju TH, Peitso A, Bloigu A, et al. Cold temperature and low humidity are associated with increased occurrence of respiratory tract infections. Respiratory medicine. 2009;103(3):456–62. https://doi.org/10.1016/j.rmed.2008.09.011.
Athicha U, Kayo U, Xerxes S, Joel Msafiri F. Association between extreme rainfall and acute respiratory infection among children under-5 years in sub-Saharan Africa: an analysis of Demographic and Health Survey data, 2006–2020. BMJ Open. 2023;13(4):e071874. https://doi.org/10.1136/bmjopen-2023-071874.
Costilla-Esquivel A, Corona-Villavicencio F, Velasco-Castañón J, Medina-De La Garza C, Martinez-Villarreal R, Cortes-Hernandez D, et al. A relationship between acute respiratory illnesses and weather. Epidemiology Infection. 2014;142(7):1375–83. https://doi.org/10.1017/S0950268813001854.
Falagas ME, Theocharis G, Spanos A, Vlara LA, Issaris EA, Panos G, et al. Effect of meteorological variables on the incidence of respiratory tract infections. Respiratory medicine. 2008;102(5):733–7. https://doi.org/10.1016/j.rmed.2007.12.010.
Agrawal AS, Sarkar M, Chakrabarti S, Rajendran K, Kaur H, Mishra AC, et al. Comparative evaluation of real-time PCR and conventional RT-PCR during a 2 year surveillance for influenza and respiratory syncytial virus among children with acute respiratory infections in Kolkata, India, reveals a distinct seasonality of infection. J Med Microbiol. 2009;58(12):1616–22. https://doi.org/10.1099/jmm.0.011304-0.
Google Scholar
Khan AA, Fatima M, Arshad S, Khan K. Spatio-temporal analysis of hazardous fog: a case study of Bahawalpur Pakistan. Arab World Geographer. 2014;17(4):357–75.
Raza W, Saeed S, Saulat H, Gul H, Sarfraz M, Sonne C, et al. A review on the deteriorating situation of smog and its preventive measures in Pakistan. J Cleaner Product. 2021;279:123676. https://doi.org/10.1016/j.jclepro.2020.123676.
Google Scholar
Mahmood S, Ali A, Jumaah HJ. Geo-visualizing the hotspots of smog-induced health effects in district Gujranwala, Pakistan: a community perspective. Environ Mon Assess. 2024;196(5):1–14.
Google Scholar
Fatima M. Environmental Epidemiology And Spatial Modelling Of Respiratory Infections In Southern Punjab Pakistan: University of Punjab, Pakistan; 2022.
Sadeghimoghaddam A, Khankeh H, Norozi M, Fateh S, Farrokhi M. Investigating the effects of dust storms on morbidity and mortality due to cardiovascular and respiratory diseases: A systematic review. J Educ Health Promot. 2021;10(1):191. https://doi.org/10.4103/jehp.jehp_1272_20.
Google Scholar
Al-Hemoud A, Al-Dousari A, Al-Shatti A, Al-Khayat A, Behbehani W, Malak M. Health Impact Assessment Associated with Exposure to PM10 and Dust Storms in Kuwait. Atmosphere. 2018;9(1):6. https://doi.org/10.3390/atmos9010006.
Google Scholar
Syed A, Liu X, Moniruzzaman M, Rousta I, Syed W, Zhang J, et al. Assessment of Climate Variability among Seasonal Trends Using In Situ Measurements: A Case Study of Punjab, Pakistan. Atmosphere. 2021;12(8):939. https://doi.org/10.3390/atmos12080939.
Google Scholar
Fatima M, Ahmad A, Butt I, Arshad S, Kiani B. Geospatial modelling of ambient air pollutants and chronic obstructive pulmonary diseases at regional scale in Pakistan. Environ Mon Assess. 2024;196(10):929.
Google Scholar
Subhanullah M, Hassan N, Rahman G, Rawan B, Ullah W, Ilyas M. Concentration of particulate matter and its impact on public health in different cities in Pakistan-a review. Environ Forensics. 2024:1–17. https://doi.org/10.1080/15275922.2024.2366794.
Sen KK, Karmaker SC, Hosan S, Chapman AJ, Saha BB. Thinking of the children: Energy poverty and acute respiratory infections among young children in South Asia. Energy Res Soc Sci. 2023;105:103271.
Google Scholar
Islam M, Islam K, Dalal K, Hossain Hawlader MD. In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh. BMC Pediatr. 2024;24(1):38.
Google Scholar
Swarthout J, Ram PK, Arnold CD, Dentz HN, Arnold BF, Kalungu S, et al. Effects of individual and combined water, sanitation, handwashing, and nutritional interventions on child respiratory infections in rural Kenya: a cluster-randomized controlled trial. Am J Trop Med Hyg. 2020;102(6):1286.
Google Scholar
Ashraf S, Islam M, Unicomb L, Rahman M, Winch PJ, Arnold BF, et al. Effect of improved water quality, sanitation, hygiene and nutrition interventions on respiratory illness in young children in rural Bangladesh: a multi-arm cluster-randomized controlled trial. Am J Trop Med Hyg. 2020;102(5):1124.
Google Scholar
Vatsa R, Ranjan M, Bhandari P, Gayawan E. Analyzing effect of WASH practices and district-level spatial effects on acute respiratory infections and diarrhoea among under-five children in India. Appl Spatial Analysis Policy. 2023;16(4):1299–316.
Google Scholar
Nelson JK, Brewer CA. Evaluating data stability in aggregation structures across spatial scales: revisiting the modifiable areal unit problem. Cartography Geographic Inform Sci. 2017;44(1):35–50. https://doi.org/10.1080/15230406.2015.1093431.
Google Scholar
Fotheringham AS, Wong DW. The modifiable areal unit problem in multivariate statistical analysis. Environ Plann A. 1991;23(7):1025–44.
Google Scholar
link
