Background: Childhood stunting is a major indicator of child malnutrition and a focus area of Global Nutrition Targets for 2025 and Sustainable Development Goals. Risk factors for childhood stunting are well studied and well known and could be used in a risk prediction model for assessing whether a child is stunted or not. However, the selection of child stunting predictor variables is a critical step in the development and performance of any such prediction model.
View Article and Find Full Text PDFAddiction
November 2023
Background And Aims: Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART).
Design, Setting And Participants: This study used a two-arm multi-centre randomized controlled trial with follow-up to 6 months.
Matern Child Health J
November 2022
Introduction: Consumption of unhealthy foods in children contributes to high levels of childhood obesity globally. In developing countries there is paucity of empirical studies on the association. This study employed propensity-score methods to evaluate the effect of unhealthy foods on overweight among children in Malawi using observational data.
View Article and Find Full Text PDFFront Public Health
June 2022
The estimates of contiguousness parameters of an epidemic have been used for health-related policy and control measures such as non-pharmaceutical control interventions (NPIs). The estimates have varied by demographics, epidemic phase, and geographical region. Our aim was to estimate four contagiousness parameters: basic reproduction number (), contact rate, removal rate, and infectious period of coronavirus disease 2019 (COVID-19) among eight African countries, namely Angola, Botswana, Egypt, Ethiopia, Malawi, Nigeria, South Africa, and Tunisia using Susceptible, Infectious, or Recovered (SIR) epidemic models for the period 1 January 2020 to 31 December 2021.
View Article and Find Full Text PDFAlthough under-five mortality (U5M) rates have declined worldwide, many countries in sub-Saharan Africa still have much higher rates. Detection of subnational areas with unusually higher U5M rates could support targeted high impact child health interventions. We propose a novel group outlier detection statistic for identifying areas with extreme U5M rates under a multivariate survival data model.
View Article and Find Full Text PDFAppropriate complementary foods have been found to provide infants and young children with nutritional needs for their growth and development. In the absence of a randomized control trial (RCT), this study used observational data to evaluate the effect of appropriate complementary feeding practices on the nutritional status of children aged 6-23 months in Malawi using a propensity score matching statistical technique. Data on 4,722 children aged 6 to 23 months from the 2015-16 Malawi Demographic and Health Survey (MDHS) were analyzed.
View Article and Find Full Text PDFBackground: Multilevel logistic regression models are widely used in health sciences research to account for clustering in multilevel data when estimating effects on subject binary outcomes of individual-level and cluster-level covariates. Several measures for quantifying between-cluster heterogeneity have been proposed. This study compared the performance of between-cluster variance based heterogeneity measures (the Intra-class Correlation Coefficient (ICC) and the Median Odds Ratio (MOR)), and cluster-level covariate based heterogeneity measures (the 80% Interval Odds Ratio (IOR-80) and the Sorting Out Index (SOI)).
View Article and Find Full Text PDFThe ongoing highly contagious coronavirus disease 2019 (COVID-19) pandemic, which started in Wuhan, China, in December 2019, has now become a global public health problem. Using publicly available data from the COVID-19 data repository of Our World in Data, we aimed to investigate the influences of spatial socio-economic vulnerabilities and neighbourliness on the COVID-19 burden in African countries. We analyzed the first wave (January-September 2020) and second wave (October 2020 to May 2021) of the COVID-19 pandemic using spatial statistics regression models.
View Article and Find Full Text PDFMarriage formation and dissolution are important life-course events which impact psychological well-being and health of adults and children experiencing the events. Family studies have usually concentrated on analyzing single transitions including to and to . This does not allow understanding and interrogation of dynamics of these life changing events and their effects on individuals and their families.
View Article and Find Full Text PDFInt J Environ Res Public Health
September 2017
Most mortality maps in South Africa and most contried of the sub-Saharan region are static, showing aggregated count data over years or at specific years. Lack of space and temporral dynamanics in these maps may adversely impact on their use and application for vigorous public health policy decisions and interventions. This study aims at describing and modeling sub-national distributions of age-gender specific all-cause mortality and their temporal evolutions from 1997 to 2013 in South Africa.
View Article and Find Full Text PDFMeta-analysis of longitudinal studies combines effect sizes measured at pre-determined time points. The most common approach involves performing separate univariate meta-analyses at individual time points. This simplistic approach ignores dependence between longitudinal effect sizes, which might result in less precise parameter estimates.
View Article and Find Full Text PDFBackground: Little research has examined whether alcohol reduction interventions improve antiretroviral therapy (ART) adherence and HIV treatment outcomes. This study assesses the efficacy of an intervention for reducing alcohol use among HIV patients on ART who are hazardous/harmful drinkers. Specific aims include adapting a blended Motivational Interviewing (MI) and Problem Solving Therapy (PST) intervention for use with HIV patients; evaluating the efficacy of the intervention for reducing alcohol consumption; and assessing counsellors' and participants' perceptions of the intervention.
View Article and Find Full Text PDFIntroduction: Pregnancy is contraindicated in vaginal microbicide trials for the prevention of HIV infection in women due to the unknown maternal and fetal safety of the microbicides. Women who become pregnant are taken off the microbicide during pregnancy period but this result in reduction of the power of the trials. Strategies to reduce the pregnancy rates require an understanding of the incidence and associated risk factors of pregnancy in microbicide trials.
View Article and Find Full Text PDFAn analysis of the ecological association between the human immunodeficiency virus (HIV) and syphilis was undertaken using joint mapping modelling based on data from South African national HIV and syphilis sentinel surveillance surveys carried out between 2007 and 2009. The syphilis prevalence, taken as proxy for sexual behaviour and increased HIV transmission, was first used with health district-level deprivation and population density as a covariate in a HIV prevalence spatial regression model and, secondly, together with HIV as a bivariate outcome. HIV is more highly prevalent in deprived and populated areas than elsewhere, while syphilis has a high prevalence in less deprived and less populated areas.
View Article and Find Full Text PDFChildhood acute lymphoblastic leukaemia (ALL) and Type 1 diabetes (T1D) share some common epidemiological features, including rising incidence rates and links with an infectious aetiology. Previous work has shown a significant positive correlation in incidence between the two conditions both at the international and small-area level. The aim was to extend the methodology by including shared spatial and temporal trends using a more extensive dataset among individuals diagnosed with ALL and T1D in Yorkshire (UK) aged 0-14 years from 1978-2003.
View Article and Find Full Text PDFThe four models proposed for exploring the foetal origins of adult disease (FOAD) hypothesis use the product term between size at birth and current size to determine the relative importance of pre- and post-natal growth on disease in later life. This is a common approach for testing the interaction between an exposure (in this instance size at birth) and an effect modifier (in this instance current size)--incorporating the product term obtained by multiplying the exposure and effect modifier variables within a statistical regression model. This study examines the mathematical basis for this approach and uses computer simulations to demonstrate two potential statistical flaws that might generate misleading findings.
View Article and Find Full Text PDFBackground: In many laboratory-based high throughput microarray experiments, there are very few replicates of gene expression levels. Thus, estimates of gene variances are inaccurate. Visual inspection of graphical summaries of these data usually reveals that heteroscedasticity is present, and the standard approach to address this is to take a log2 transformation.
View Article and Find Full Text PDFSurvival analysis methods are increasingly used in dental research to measure risk of tooth eruption and caries as well as life spans of amalgam restorations. Analyses have been extended to account for lack of independence in the data, which arises from the clustering of observations within units such as tooth-surfaces, teeth and subjects. There are various analytical strategies and modelling approaches now available to us in dealing with clustered dental data.
View Article and Find Full Text PDFChildhood acute lymphoblastic leukemia and diabetes mellitus, type 1, have common epidemiologic and etiologic features, including correlated international incidence and associations with infections. The authors examined whether the diseases' similar large-scale distributions are reflected in small geographic areas while also examining the influence of sociodemographic characteristics. Details of 299 children (0-14 years) with acute lymphoblastic leukemia and 1,551 children with diabetes diagnosed between 1986 and 1998 were extracted from two registers in Yorkshire, United Kingdom.
View Article and Find Full Text PDFIn medical studies, we commonly encounter multiple events data such as recurrent infection or attack times in patients suffering from a given disease. A number of statistical procedures for the analysis of such data use the Cox proportional hazards model, modified to include a random effect term called frailty which summarizes the dependence of recurrent times within a subject. These unobserved random frailty effects capture subject effects that are not explained by the known covariates.
View Article and Find Full Text PDFAfter ST-elevation myocardial infarction, the association between left ventricular sphericity (measured by biplane ventriculography) and survival rate at a median of 6.5 years was determined in 825 patients. The highest tertile of sphericity (vs the lowest and middle tertiles) was associated with a decreased 10-year survival rate in patients who had anterior myocardial infarction (p = 0.
View Article and Find Full Text PDFA Bayesian methodology is developed to investigate the homogeneity of the treatment effects in a multi-centre clinical trial with an ordinal response. A hierarchical model is formulated for the ordinal response, and the marginal posterior distributions of the covariates, overall treatment and the centre effects are calculated using the Gibbs sampler. The methodology is applied to data arising from a multi-centre clinical trial of therapies for acute myocardial infarction.
View Article and Find Full Text PDFBackground: Early resolution of ST-segment deviation (ST recovery) on the postthrombolytic electrocardiograms and restoration of "normal" blood flow in the infarct-related artery are associated with improved outcomes after myocardial infarction (MI).
Methods And Results: To evaluate the relationships between ST recovery, infarct-related artery flow, and late survival we studied 766 patients with electrocardiograms recorded at a median of 167 minutes after thrombolytic therapy. Angiography was performed at 3 weeks, and follow-up was done at a median of 6.