Unveiling Spatial Disparities: Exploring High-Risk Diarrhea Among Children Under Five Using Geographically Weighted Quantile Regression


  • Wara Alfa Syukrilla State Islamic University Syarif Hidayatullah Jakarta
  • Yudhie Andriyana
  • Anneleen Verhasselt




geographically weighted quantile regression, toddlers, diarrhea, Indonesia


We investigate the impact of the percentage of clean water access, the percentage of handwashing habits, and the toilet category factors on the upper quantile of toddlers’ diarrhea risks in Bandung City, Indonesia, using the Geographically Weighted Quantile Regression model on the 75th percentile. The breusch-Pagan test was used to detect spatial heterogeneity. The results show that the significance, strength, and direction of the relationship between diarrhea and its risk factors depend on the location. At the upper quantile, the Panyileukan district is predicted to have the highest diarrhea risk. In this district, all three predictors significantly affect the toddlers’ diarrhea risk, with the variable of the percentage of houses practicing hand washing habits observed to reduce diarrhea risk the most. In conclusion, clean water access, handwashing habits, and toilet category are the potential risk factors for high-risk childhood diarrhea. This method is powerful as it would allow the decision maker to handle the diarrhea problem aptly based on which predictor has a substantial effect at a specific district of interest. And it can be used to investigate the effect of various intervention strategies and effectively allocate the limited available resources according to the most important locations.


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Alsayed, Ahmed RM, Zaidi Isa, Sek Siok Kun, and Giancarlo Manzi. 2020. Quantile Regression to Tackle the Heterogeneity on the Relationship Between Economic Growth, Energy Consumption, and CO2 Emissions . Environmental Modeling and Assessment 25(2), 251–58.

Andriyana, Y, I Gijbels, and A Verhasselt. 2014. P-splines quantile regression estimation in varying coefficient models . Test 23(1), 153–94.

Azage, Muluken, Abera Kumie, Alemayehu Worku, and Amvrossios C Bagtzoglou. 2015. Childhood Diarrhea Exhibits Spatiotemporal Variation in Northwest Ethiopia: A SaTScan Spatial Statistical Analysis . PLoS ONE 10(12), 1–18.

Bandung Public Relations. 2020. ODF di Kota Bandung Terus Membaik membaik [ODF (Open Defecation Free) in Bandung Continues to Improve]. https://humas.bandung.go.id/layanan/odf-di-kota-bandung-terus-membaik.

Beyerlein, A, AM Toschke, and R Von Kries. 2010. Risk factors for childhood overweight: Shift of the mean body mass index and shift of the upper percentiles: Results from a cross-sectional study . International Journal of Obesity 34(4), 642–48.

Black, Robert, Olivier Fontaine, Laura Lamberti, Maharaj Bhan, Luis Huicho, Shams El Arifeen, Honorati Masanja, Christa Fischer Walker, Tigest Ketsela Mengestu, Luwei Pearson, Mark Young, Nosa Orobaton, Yue Chu, Bianca Jackson, Massee Bateman, Neff Walker, and Michael Merson. 2019. Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030 . Journal of Global Health 9(2), 1–9.

Bogale, Getahun Gebre, Kassahun Alemu Gelaye, Degefie Tibebe Degefie, and Yalemzewod Assefa Gelaw. 2017. Spatial patterns of childhood diarrhea in Ethiopia: Data from Ethiopian demographic and health surveys (2000, 2005, and 2011) . BMC Infectious Diseases 17(1), 1–10.

Brunsdon, Chris, A Stewart Fotheringham, and Martin E Charlton. 1996. Geographically Weighted Regression . Geographical Analysis 28(4), 281–98.

Carrel, Margaret, Veronica Escamilla, Jane Messina, Sophia Giebultowicz, Jennifer Winston, Mohammad Yunus, P Kim Streatfield, and Michael Emch. 2011. Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: A zero-inflated and geographically weighted analysis . International Journal of Health Geographics 10, 1–9.

Centers for Diseases Control and Prevention (CDC). 2018. Diarrhea: Common Illness, Global Killer.

Chen, Colin, and Ying Wei. 2005. Computational issues for quantile regression . Sankhya: The Indian Journal of Statistics 67(2), 399–417.

Chen, Vivian Yi Ju, Wen Shuenn Deng, Tse Chuan Yang, and Stephen A Matthews. 2012. Geographically Weighted Quantile Regression (GWQR): An Application to U.S. Mortality Data . Geographical Analysis 44(2), 134–50.

Dunn, Gillian, Glen D Johnson, Deborah L Balk, and Grace Sembajwe. 2020. Spatially varying relationships between risk factors and child diarrhea in West Africa, 2008-2013 . Mathematical Population Studies 27(1), 8–33.

Fotheringham, A Stewart, Chris Brunsdon, and Martin Charlton. 2003. Geographically Weighted Regression: The Analysis of Spatially Varying Relationships. Chichester: John Wiley & Sons.

Hothorn, Torsten, Achim Zeileis, and Roger Bivand. 2017. bptest.sarlm: Breusch-Pagan test for spatial models. https://rdrr.io/rforge/spdep/src/R/bptest.sarlm.R.

Hu, Liangyuan, Jiayi Ji, Yan Li, Bian Liu, and Yiyi Zhang. 2021. Quantile Regression Forests to Identify Determinants of Neighborhood

Stroke Prevalence in 500 Cities in the USA: Implications for Neighborhoods with High Prevalence . Journal of Urban Health 98(2), 259–70.

Indonesian Ministry of Health. 2011. Situasi Diare di Indonesia (Diarrhea Situation in Indonesia) . Jurnal Buletin Jendela Data & Informasi Kesehatan 2, 1–44.

KEMENKES. 2014. Peraturan Menteri Kesehatan Republik Indonesia Nomor 3 Tahun 2014 tentang Sanitasi Total Berbasis Masyarakat. Indonesia.

KEMENKES. 2017. Profil Kementerian Kesehatan Indonesia 2017 (Indonesian Health Profile in 2017). Jakarta.

International Vaccine Access Center (IVAC), and Johns Hopkins Bloomberg School of Public Health. 2018. Pneumonia & diarrhea progress report 2018.

International Vaccine Access Center (IVAC), and Johns Hopkins Bloomberg School of Public Health. 2020. Pneumonia and Diarrhea Progress Report 2020.

Kandala, Ngianga-bakwin, Ji., Nigel Chen Stallard, Saverio Stranges, and Francesco P Cappuccio. 2007. Spatial Analysis of Risk Factors for Childhood Morbidity in Nigeria . The American Society of Tropical Medicine and Hygiene Spatial 77(4), 770–78.

Khoirunnisa, Anis, I Gede Nyoman, and Mindra Jaya. 2019. Modelling and Mapping The Average of Incidence Rate Diarrhea Among Toddlers in Bandung City in 2013-2018 Using Geographically Weighted Regression . International Journal of Innovative Science, Engineering & Technology 6(11), 115–19.

Koenker, Roger. 2005. Quantile Regression (Econometric Society Monographs; No. 38) . Nature Methods. Vol. 16. New York: Cambridge University Press.

Koenker, Roger, and Gilbert Bassett. 1978. Regression Quantiles . Econometrica 46(1), 33.

Li Liu, Hope L Johnson, Simon Cousens, Jamie Perin, Susana Scott, Joy E Lawn, Igor Rudan, Harry Campbell, Richard Cibulskis, Mengying Li, Colin Mathers, Robert E Black, Child Health Epidemiology Reference Group of WHO and UNICEF. 2013. Global Diarrhea Burden Diarrhea: Common Illness, Global Killer . U.S. Department of Health and Human Services, 1.

Stakhovych, Stanislav, Tammo HA Bijmolt, and Michel Wedel. 2012. Spatial Dependence and Heterogeneity in Bayesian Factor Analysis: A Cross-National Investigation of Schwartz Values . Multivariate Behavioral Research 47(6), 803–39.

UNICEF. 2018. Every child survives and thrives Global Annual.

UNICEF. 2019. Water under Fire: For every child, water and sanitation in complex emergencies.

West Java Department of Health. 2017. Profil Kesehatan Dinas Kesehatan Provinsi Jawa Barat 2017 (The Health Pofile of West Java Province in 2017) . Diskes Jabarprov.

Yilgwan, CS, and SN Okolo. 2012. Prevalence of diarrhea disease and risk factors in Jos University Teaching Hospital, Nigeria . Annals of African Medicine 11(4), 217–21.




How to Cite

Syukrilla, W. A., Andriyana, Y., & Verhasselt, A. (2023). Unveiling Spatial Disparities: Exploring High-Risk Diarrhea Among Children Under Five Using Geographically Weighted Quantile Regression. Jurnal Aplikasi Statistika & Komputasi Statistik, 15(2), 31–42. https://doi.org/10.34123/jurnalasks.v15i2.536