Zero-inflated spatio-temporal models for disease mapping.

In this paper, our aim is to analyze geographical and temporal variability of disease incidence when spatio-temporal count data have excess zeros. To that end, we consider random effects in zero-inflated Poisson models to investigate geographical and temporal patterns of disease incidence. Spatio-temporal models that employ conditionally autoregressive smoothing across the spatial dimension and B-spline smoothing over the temporal dimension are proposed. The analysis of these complex models is computationally difficult from the frequentist perspective. On the other hand, the advent of the Markov chain Monte Carlo algorithm has made the Bayesian analysis of complex models computationally convenient. Recently developed data cloning method provides a frequentist approach to mixed models that is also computationally convenient. We propose to use data cloning, which yields to maximum likelihood estimation, to conduct frequentist analysis of zero-inflated spatio-temporal modeling of disease incidence. One of the advantages of the data cloning approach is that the prediction and corresponding standard errors (or prediction intervals) of smoothing disease incidence over space and time is easily obtained. We illustrate our approach using a real dataset of monthly children asthma visits to hospital in the province of Manitoba, Canada, during the period April 2006 to March 2010. Performance of our approach is also evaluated through a simulation study.