Geography Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2773
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Item A DISCOURSE ON CHILD MALNUTRITION: ANTHROPOMETRY, EMERGENT THEMES, QUALITY CONTROL MAXIMS, AND CLIMATIC AND ECONOMIC DETERMINANTS(2021) Sandler, Austin; Sun, Laixiang; Geography; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Malnutrition is a detrimental and significant plight for young children, responsible for 45% of all deaths among children worldwide. The aim of my dissertation is to assess the history of the science of anthropometry, synthesize the cumulative findings within the contemporary child malnutrition literature, dispute certain quality control maxims of anthropometric child-health surveys, and quantify the responsible latent factors of child malnutrition. These efforts are in service of a better characterization of malnutrition, a more reliable estimate of how many children are malnourished, and a better understanding of the geographical distribution and dynamic stochastic characteristics of malnutrition. It is essential to better understand malnutrition and its causes to suggest appropriate corrective policy. This dissertation consists of four principal essays, each from a unique conceptual perspective. The first essay is a historical and epistemological perspective of the science of anthropometry. I contextualize the legacy of child malnutrition efforts, including the link between eugenics and contemporary notions of “normal” child growth, the institutional power-struggle for child growth chart superiority, the obfuscated distinction between growth references and standards of growth, and the consequences of universal standards that do not reflect observable populations. The second essay is a systematic review of the literature, the largest of its kind to date. I synthesize 184 disaggregate empirical studies of the determinants of child malnutrition in Africa published since 1990. I find numerous opportunities for development within this corpus, in particular opportunities to enrich the scope, scale, and quantification of the field. The third essay is an analytical perspective on the quality control mechanisms applied to anthropometric surveys. I challenge the practice of rejecting datasets based on overlarge z-score standard deviation values and offer an alternative approach. The fourth essay is an econometric empirical analysis in Kenya and Nigeria of child malnutrition determinants. I use spatial Bayesian kriging and four-level random intercept hierarchical logit models to show the spatial heterogeneity of malnutrition prevalence, and to quantify various socio-economic and climatic determinants of child malnutrition. I find significant spatial and hierarchical relationships and determinants, which can move malnutrition rates by over 50%.Item Interdisciplinary Geospatial Assessment of Malaria Exposure in Ann Township, Myanmar(2020) Hall, Amanda Hoffman; Loboda, Tatiana V; Geography; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Despite considerable progress toward malaria elimination in Myanmar, challenges remain owing to the persistence of complex focal transmission reservoirs. Nearly all remaining infections are clinically silent, rendering them invisible to routine monitoring. Moreover, limited knowledge of population distributions and human activity on the landscape in remote regions of Myanmar hinders the development of targeted malaria elimination approaches, as advocated by the World Health Organization (WHO). This is especially true for Ann Township, a remote region of Myanmar with a high malaria burden, where a comprehensive understanding of local exposure, which includes the characterization of environmental settings and land use activities, is crucial to developing successful malaria elimination strategies. In this dissertation, I present an interdisciplinary approach that combines satellite earth observations with two separate on-the-ground surveys to assess human exposure to malaria at multiple scales. First, I mapped rural settlements using a fusion of Landsat imagery and multi-temporal auxiliary data sensitive to human activity patterns with a classification accuracy of 93.1%. A satellite data-based map of land cover and land use was then used to assess landscape-scale malaria exposure as a function of environmental settings for a subset of ten villages where a malaria prevalence survey was carried out. While multiple significant associations were discovered, the relationship found between malaria exposure and satellite-measured village forest cover was the most significant. Finally, a separate detailed survey that explored a variety of land use activities, including their frequency and duration along with testing for clinical or subclinical malaria, was used to identify and quantify factors promoting an individual’s likelihood of malaria infection regardless of the environmental settings. This analysis established strong associations between malaria and individual land use activities that bring respondents into direct contact with forested areas. These results highlight that the current Myanmar malaria elimination strategies, which focus on prevention from within the home (i.e., bednets and indoor spraying), are no longer sufficient to remove remaining malaria reservoirs in the country. A paradigm shift in malaria elimination strategies towards targeted interventions that can disrupt malaria transmission in the settings where the exposure occurs are critical to achieving country-wide malaria elimination.