BACKGROUND: In the temperate world, Lyme disease (LD) is the most common vector-borne disease affecting humans. In North America, LD surveillance and research have revealed an increasing territorial expansion of hosts, bacteria and vectors that has accompanied an increasing incidence of the disease in humans. To better understand the factors driving disease spread, predictive models can use current and historical data to predict disease occurrence in populations across time and space. Various prediction methods have been used, including approaches to evaluate prediction accuracy and/or performance and a range of predictors in LD risk prediction research. With this scoping review, we aim to document the different modelling approaches including types of forecasting and/or prediction methods, predictors and approaches to evaluating model performance (eg, accuracy).
METHODS: This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines. Electronic databases will be searched via keywords and subject headings (eg, Medical Subject Heading terms). The search will be performed in the following databases: PubMed/MEDLINE, EMBASE, CAB Abstracts, Global Health and SCOPUS. Studies reported in English or French investigating the risk of LD in humans through spatial prediction and temporal forecasting methodologies will be identified and screened. Eligibility criteria will be applied to the list of articles to identify which to retain. Two reviewers will screen titles and abstracts, followed by a full-text screening of the articles\' content. Data will be extracted and charted into a standard form, synthesised and interpreted.
BACKGROUND: This scoping review is based on published literature and does not require ethics approval. Findings will be published in peer-reviewed journals and presented at scientific conferences.

BACKGROUND: Using health facility types as a measure of service availability is a common approach in international standards for health system policy and planning. However, this proxy may not accurately reflect the actual availability of specific health services.
OBJECTIVE: This study aims to evaluate the reliability of health facility typology as an indicator of specific health service availability and explore whether certain facility types consistently provide particular services.
METHODS: We analysed a comprehensive dataset containing information from 1725 health facilities in Mali. To uncover and visualise patterns within the dataset, we used two analytical techniques: Multiple Correspondence Analysis and Between-Class Analysis. These analyses allowed us to quantitatively measure the influence of health facility types on the variation in health service provisioning. Additionally, we developed and calculated a Consistency Index, which assesses the consistency of a health facility type in providing specific health services. By examining various health facilities and services, we sought to determine the accuracy of facility types as indicators of service availability.
METHODS: The study focused on the health system in Mali as a case study.
RESULTS: Our findings indicate that using health facility types as a proxy for service availability in Mali is not an accurate representation. We observed that most of the variation in service provision does not stem from differences between facility types but rather within facility types. This suggests that relying solely on health facility typology may lead to an incomplete understanding of health service availability.
CONCLUSIONS: These results have significant implications for health policy and planning. The reliance on health facility types as indicators for health system policy and planning should be reconsidered. A more nuanced and evidence-based understanding of health service availability is crucial for effective health policy and planning, as well as for the assessment and monitoring of health systems.

Building networks is an essential part of health promotion. However, network analysis remains relatively unexplored in this field. This study introduces a new technique that maps thematic agendas and geographical locations of health promotion actors.
This case study used elements of quantitative and qualitative methods to analyse network data. We used empirical data from two networks in Bavaria, a federal state of Germany.
We identified a total of 55 actors in the first network and 64 actors in the second. We categorized the thematic agenda of actors according to their main field of work: \"healthy childhood development,\" \"healthy middle age phase,\" \"healthy ageing,\" \"health equity in all phases of life.\" One network showed a significant surplus of actors that focus on \"healthy ageing.\" We combined and analysed data from both networks collectively. Two districts with no health promotion actors within their geographical borders were identified. To put geographical gaps into context, data about deprivation and age was included.
Results identified geographical areas with high need for support from health promotion actors. Through comparison of our results with existing literature, we derived potential network strategies for further successful networking. This study adds a new perspective to characterize health promotion networks by mapping them thematically and geographically. The concept can be used to give health promotion organisations relevant insight into network structures. This can improve decision-making processes concerning partnership strategy and finally lead to a positive health impact. Hence, our findings encourage further development of this technique and other networking methods in the field of health equity and health promotion.

Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100-250 m \'ring\' around primary outbreak cases.
We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance.
The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings.

This study aimed to investigate the spatial distributions and determinants of anaemia among adolescent girls in Ethiopia. Exploring the spatial epidemiology of anaemia and identifying the risk factors would inform policymakers to come up with evidence-based prevention strategies for anaemia, especially in adolescent girls, who are the most affected segment of the population.
Secondary analysis of the Ethiopian Demographic and Health Survey 2016 was conducted. A total of 3172 adolescents were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify hotspot areas and the geospatial pattern and prediction of anaemia were mapped using ArcGIS V.10.8. A multilevel logistic regression model was fitted to identify factors associated with anaemia among adolescent girls. Adjusted OR with 95% CI was calculated and variables having a p value less than 0.05 were statistically significant factors of anaemia.
The overall prevalence of anaemia among adolescent girls in Ethiopia was 23.8 (22.4 to 25.3), with significant spatial variations across the country. The SaTScan analysis identified a primary cluster in the eastern, northeastern and southeastern parts of Ethiopia (loglikelihood ratio=39, p<0.001). High anaemia prevalence was observed in eastern parts of the country. In the multivariable multilevel logistic regression analysis, no formal education (adjusted OR (AOR)=1.49, 95% CI 1.05 to 2.12), Afar (AOR=3.36, 95% CI 1.87 to 6.05), Somali (AOR=4.63, 95% CI 2.61 to 8.23), Harari (AOR=1.90, 95% CI 1.32 to 4.10), Dire Dawa (AOR=2.32, 95% CI 1.32 to 4.10) and high cluster altitude (AOR=1.37, 95% CI 1.03 to 1.82) were significantly associated with anaemia.
The national distributions of anaemia varied substantially across Ethiopia. Educational status, region and cluster altitude were significantly associated with anaemia in the multivariable logistic regression model. Thus, targeted public health interventions for adolescent girls should be implemented in the hotspot areas.

Global prevalence rates of psoriasis differ significantly, with lowest rates in the equator region and increasing tendencies towards the north but also differences within-country. Information on regional variations in Germany is missing. This study aims to analyse the change of psoriasis prevalence in Germany over time and to detect regional variations.
Cross sectional, spatio-epidemiological study on regional psoriasis prevalence in Germany.
Claims data study based on nationwide outpatient billing data on county level.
Analyses based on outpatient billing data for 2010-2017 derived from all people insured in statutory health insurances (about 72.8 million). We performed descriptive spatio-temporal analyses of prevalence rates using probability mapping and statistical smoothing methods, identified spatial clusters and examined a north-south gradient using spatial statistics.
The prevalence increased from 147.4 per 10 000 in 2010 to 173.5 in 2017. In 2017, counties\' prevalence rates ranged between 93.8 and 340.9. Decreased rates occurred mainly in southern counties, increased rates in northern and eastern counties. Clusters of low rates occur in southern and south-western Germany, clusters of high rates in the north and north-east. The correlation between counties\' latitudes and their prevalence rates was high with Pearson\'s r=0.65 (p<0.05).
Increased prevalence of psoriasis over time and marked regional variations in Germany were observed which need further investigation.

UNASSIGNED: Obesity, as a risk factor for many noncommunicable diseases, is a common public health problem in developed and developing countries. Among Iranian children and adolescents, the prevalence of being overweight has increased by almost 50% in the past two decades.
UNASSIGNED: To visualize the geographic differences in general and abdominal obesity risks and related determinants among Iranian children and adolescents.
UNASSIGNED: Participants consisted of 14 880 students, aged 7-19 years, living in urban and rural areas of the Islamic Republic of Iran. Spatial patterns of obesity and its association with related risk factors were identified using Bayesian spatial modeling.
UNASSIGNED: The highest spatial risks of general obesity (odds ratio 1.21-1.66 for males and 1.81-2.02 for females) and abdominal obesity (odds ratio 1.20-1.82 for males and 1.25-1.78 for females) were observed in the north, northwest and southwest of the country. Risk of obesity was significantly higher in areas with a higher rate of urban residence, active current smokers and prolonged screen time.
UNASSIGNED: Identification of high-risk regions for obesity and spatially related risk factors can be used as informative tools for decision-making and planning in health systems at national and subnational levels.
الخطر الجغرافي للإصابة بالسمنة العامة وسمنة البطن والمُحدِّدات وثيقة الصلة لدى الأطفال والمراهقين الإيرانيين: دراسة CASPIAN–IV.
مريم يزدى، رويا كليشادي، فولكر شميد، محمد إسماعيل متلاغ، رامين حشمت، مرجان مانسوريان.
UNASSIGNED: تُعد السمنة، باعتبارها عامل خطر للعديد من الأمراض غير السارية، أحد مشاكل الصحة العامة الشائعة في البلدان المتقدمة والنامية. وقد زاد معدل انتشار زيادة الوزن بين الأطفال والمراهقين الإيرانيين بنسبة ٪50 تقريباً خلال العقدَيْن الماضيَيْ.
UNASSIGNED: هدفت هذه الدراسة إلى توضيح الاختلافات الجغرافية في مخاطر السمنة العامة وسمنة البطن والمُحدِّدات وثيقة الصلة بين الأطفال والمراهقين الإيرانيين.
UNASSIGNED: تألَّف المشاركون من 14880 طالباً، تتراوح أعمارهم بين 7 سنوات و 19 سنة، يعيشون في المناطق الحضرية والريفية في جمهورية إيران الإسلامية. وحُدِّدت الأنماط المكانية للسمنة، وارتباطها بعوامل الخطر وثيقة الصلة باستخدام نماذج بايز المكانية.
UNASSIGNED: لوحظت أعلى المخاطر المكانية للسمنة العامة (حيث تراوحت نسبة الأرجحية للإناث من 1.21 إلى 1.66، وللذكور من 1.81 إلى 2.02) ولسمنة البطن (حيث تراوحت نسبة الأرجحية من 1.25 إلى 1.78 للإناث، و 1.20 إلى 1.82 للذكور) في الشمال والشمال الغربي والجنوب الغربي من البلد. وارتفع خطر الإصابة بالسمنة بكثير في المناطق التي ترتفع فيها معدلات الإقامة في المناطق الحضرية، والمدخنون الحاليون النشطون، ومعدلات قضاء وقت طويل أمام الشاشات.
UNASSIGNED: يمكن الاستفادة من تحديد المناطق ذات الخطر المرتفع للإصابة بالسمنة، وعوامل الخطر المرتبطة بها مكانياً كأدوات يُسترشَد بها في اتخاذ القرارات والتخطيط في النُّظم الصحية على الصعيدَيْن الوطني ودون الوطني.
Risque géographique lié à l’obésité générale et abdominale et ses facteurs déterminants chez les enfants et les adolescents iraniens : l’étude CASPIAN-IV.
UNASSIGNED: L\'obésité, en tant que facteur de risque de nombreuses maladies non transmissibles est un problème de santé publique courant dans les pays développés et en développement. La prévalence du surpoids chez les enfants et les adolescents iraniens a augmenté de près de 50 % au cours des deux dernières décennies.
UNASSIGNED: Visualiser les différences géographiques dans les risques d\'obésité générale et abdominale et les déterminants connexes chez les enfants et les adolescents iraniens.
UNASSIGNED: Les participants se composaient de 14 880 élèves et étudiants, âgés de 7 à 19 ans, vivant dans les zones urbaines et rurales de la République islamique d\'Iran. Les schémas spatiaux de l\'obésité et son association avec des facteurs de risque connexes ont été identifiés à l\'aide d\'une modélisation spatiale bayésienne.
UNASSIGNED: Les risques spatiaux les plus élevés d\'obésité générale (odds ratio 1,21-1,66 pour les hommes et de 1,81-2,02 pour les femmes) et d\'obésité abdominale (odds ratio 1,20-1,82 pour les hommes et 1,25-1,78 pour les femmes) ont été observés dans le nord, le nord-ouest et le sud-ouest du pays. Le risque d\'obésité était significativement plus important dans les zones à forte densité urbaine, où le nombre des fumeurs actifs est plus élevé et où le temps passé devant un écran est plus long.
UNASSIGNED: L’identification des régions à haut risque d\'obésité et des facteurs de risque ayant une association spatiale peut être utilisée comme outils d\'information pour la planification et la prise de décision au sein des systèmes de santé aux niveaux national et infranational.

Two pertussis outbreaks occurred in Olmsted County, Minnesota, during 2004-2005 and 2012 (5-10 times higher than other years), with significantly higher incidence than for the State. We aimed to assess whether there were similar spatio-temporal patterns between the two outbreaks.
Olmsted County, Minnesota, USA PARTICIPANTS: We conducted a population-based retrospective cohort study of all Olmsted County residents during the 2004-2005 and 2012 outbreaks, including laboratory-positive pertussis cases.
For each outbreak, we estimated (1) age-specific incidence rate using laboratory-positive pertussis cases (numerator) and the Rochester Epidemiology Project Census (denominator), a medical record-linkage system for virtually all Olmsted County residents, and (2) pertussis case density using kernel density estimation to identify areas with high case density. To account for population size, we calculated relative difference of observed density and expected density based on age-specific incidence.
We identified 157 and 195 geocoded cases in 2004-2005 and 2012, respectively. Incidence was the highest among adolescents (ages 11 to <14 years) for both outbreaks (9.6 and 7.9 per 1000). The 2004-2005 pertussis outbreak had higher incidence in winter (52% of cases) versus summer in 2012 (53%). We identified a consistent area with higher incidence at the beginning (ie, first quartile) of two outbreaks, but it was inconsistent for later quartiles. The relative difference maps for the two outbreaks suggest a greater role of neighbourhood population size in 2012 compared with 2004-2005.
Comparing spatio-temporal patterns between two pertussis outbreaks identified a consistent geographical area with higher incidence of pertussis at the beginning of outbreaks in this community. This finding can be tested in future outbreaks, and, if confirmed, can be used for identifying epidemiological risk factors clustered in such areas for geographically targeted intervention.

It is well known that climate variability and trends have an impact on human morbidity and mortality, especially during the winter. However, there are only a handful of studies that have undertaken quantitative investigations into this impact. We evaluate the association between the UK winter asthma mortality data to a well-established feature of the climate system, the Scandinavian (SCA) pattern.
Time series analysis of monthly asthma mortality through the period of January 2001 to December 2015 was conducted, where the data were acquired from the UK\'s Office for National Statistics. The correlations between indices of important modes of climate variability impacting the UK such as the North Atlantic Oscillation as well as the SCA and the asthma mortality time series were computed. A grid point correlation analysis was also conducted with the asthma data with sea level pressure, surface wind and temperature data acquired from the European Centre for Medium-Range Weather Forecasts.
We find that sea level pressure and temperature fluctuations associated with the SCA explain ~20% (>95% CL) of variance in the UK asthma mortality through a period of 2001-2015. Furthermore, the highest winter peak in asthma mortality occurred in the year 2015, during which there were strong northwesterly winds over the UK that were the result of a sea level pressure pattern similar to that associated with the SCA.
Our study emphasises the importance of incorporating large-scale geospatial analyses into future research of understanding diseases and its environmental impact on human health.

Patterns of infection among children with varying levels of iron status in a malaria endemic area may vary spatially in ways requiring integrated infection and iron deficiency control programmes. The objective of this secondary analysis was to determine the geospatial factors associated with malaria and non-malaria infection status among young Ghanaian children at the end of a 5-month iron intervention trial.
Cluster-randomised controlled trial.
Rural Ghana PARTICIPANTS: 1943 children (6-35 months of age) with geocoded compounds.
Point-of-use fortification with micronutrient powders containing vitamins and minerals with or without iron.
Generalised linear geostatistical models with a Matern spatial correlation function were used to analyse four infection response variables, defined using different combinations of inflammation (C-reactive protein, CRP >5 mg/L) and malaria parasitaemia. Analyses were also stratified by treatment group to assess the independent effects of the iron intervention.
The by-group and combined-group analyses both showed that baseline infection status was the most consistent predictor of endline infection risk, particularly when infection was defined using parasitaemia. In the No-iron group, age above 24 months and weight-for-length z-score at baseline were associated with high CRP at endline. Higher asset score was associated with a 12% decreased odds of endline infection, defined as CRP >5 mg/L and/or parasitaemia (OR 0.88, 95% credible interval 0.78 to 0.98), regardless of group. Maps of the predicted risk and spatial random effects showed a defined low-risk area around the District centre, regardless of how infection was defined.
In a clinical trial setting of iron fortification, where all children receive treated bed nets and access to malaria treatment, there may be geographical variation in the risk of infection with distinct high-risk and low-risk areas, particularly around municipal centres.
clinicaltrials.gov, NCT01001871.