Correlates of Hookworm Infection in Selected Provinces of Mindanao, Philippines. A Multilevel Analysis (PDF)

Master's Thesis from the year 2017 in the subject Medicine - Epidemiology, Philippine Normal University, language: English, abstract: The risk factors for hookworm infection are multi-factorial and they operate on different levels. Typical analyses of hookworm infection disparities have focused largely on either individual- or ecologic-level determinants, and none has analyzed them on both levels simultaneously. Hence, this study aimed to fill the need of simultaneously analyzing the correlates of hookworm infection on different levels, using the multilevel model.

The general objective of the study was to identify the individual-level, barangay-level and provincial-level factors associated with hookworm infection in selected provinces in Mindanao. This thesis was a cross-sectional study that uses several secondary datasets. Individual-level variables were age, gender and hookworm infection status. The level 2 variables were land cover type (or also known as vegetation), barangay income classification, literacy rate and percentage of households without any form of toilet facility. The level 3 variables were climate type, average monthly rainfall and average monthly maximum temperature. The Mindanao provinces that were included in the study were Agusan del Sur, Davao del Sur, South Cotabato, Surigao del Sur, Misamis Oriental, Bukidnon, Surigao del Norte.

Descriptive and crude analyses of hookworm infection were done using Microsoft Excel 2007 and Stata 10. Multilevel modeling was done using the Generalized Linear Latent and Mixed Models (GLLAMM) in Stata. The significant correlates of hookworm infection at the individual level are older age and male gender. While at the barangay level, it is a predominantly cultivated land cover. At the provincial level, these are average rainfall =100mm during LAR, average rainfall =100mm during HAR and Type 3 climate (seasons are not very pronounced). The significant factors at the barangay and provincial level can be used as criteria for selecting target areas for specific STH interventions. The STH interventions, which is primarily deworming, could expand its coverage and include as beneficiaries the older individuals.