ArticlePublic health action2026
Mapping malaria hotspots through spatial and spatio-temporal analysis in Sierra Leone, 2021-2024.
Article in Public health action, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
settingSierra Leone, using data from the District Health Information System 2 (DHIS2) database.
objectiveThis 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.
methodA 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's I, significant district-level clusters were identified through space-time Poisson models (α = 0.05; 999 permutations), and the relationship between malaria incidence and rainfall in surrounding areas was assessed using bivariate Moran's I, implemented in Python.
resultsBetween 2021 and 2024, 7.4 million malaria cases were reported. Chiefdom-level incidence ranged from 21.2 to >750 per 1,000 population. Significant spatial clustering was observed (Moran's I > 0;
conclusionMalaria transmission remains spatially and temporally heterogeneous, with persistent hotspots that require tailored subnational interventions to accelerate progress towards elimination.
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