scholarly journals Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

2020 ◽  
Author(s):  
Emmanuel Arinaitwe ◽  
Joaniter I. Nankabirwa ◽  
Paul Krezanoski ◽  
John Rek ◽  
Victor Kamya ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Generalized Estimating Equations ◽  
Regression Models ◽  
Estimating Equations ◽  
Factors Associated ◽  
Tororo District ◽  
Binomial Regression ◽  
Llin Use ◽  
Long Lasting Insecticidal Nets ◽  
At Home

Abstract Background: The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognised as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda.Methods: Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within four weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual.Results: Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI: 0.60-0.89, p=0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52-0.83, p=0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67-1.40, p=0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31-2.46, p<0.001) and duration of travel (>7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07-3.64, p=0.03).Conclusions: Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than one week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

scholarly journals Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Emmanuel Arinaitwe ◽  
Joaniter I. Nankabirwa ◽  
Paul Krezanoski ◽  
John Rek ◽  
Victor Kamya ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Generalized Estimating Equations ◽  
Regression Models ◽  
Estimating Equations ◽  
Factors Associated ◽  
Tororo District ◽  
Binomial Regression ◽  
Llin Use ◽  
Long Lasting Insecticidal Nets ◽  
At Home

Abstract Background The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognized as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda. Methods Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within 4 weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Results Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI 0.60–0.89, p = 0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52–0.83, p = 0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67–1.40, p = 0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31–2.46, p < 0.001) and duration of travel (> 7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07–3.64, p = 0.03). Conclusions Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than 1 week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

scholarly journals Association Between Recent Overnight Travel And Use Of Long-Lasting Insecticidal Nets In Rural Uganda: A Prospective Cohort Study In Tororo

2020 ◽  
Author(s):  
Emmanuel Arinaitwe ◽  
Joaniter I. Nankabirwa ◽  
Paul Krezanoski ◽  
John Rek ◽  
Victor Kamya ◽  
...  
Keyword(s):  
Cohort Study ◽  
Repeated Measures ◽  
Generalized Estimating Equations ◽  
Indoor Residual Spraying ◽  
Malaria Risk ◽  
Factors Associated ◽  
Tororo District ◽  
Llin Use ◽  
Long Lasting Insecticidal Nets ◽  
At Home

Abstract Background: The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognised as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda.Methods: Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using generalized estimating equations adjusting for repeated measures in the same individual. Results: Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI: 0.60-0.89, p=0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52-0.83, p=0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67-1.40, p=0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31-2.46, p<0.001) and duration of travel (>7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07-3.64, p=0.03).Conclusions: Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than one week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

State Conformity with Federal Tax Changes

2010 ◽  
Vol 32 (2) ◽  
pp. 27-51 ◽  
Author(s):  
Michaele Morrow ◽  
Robert Ricketts
Keyword(s):  
Federal Government ◽  
Generalized Estimating Equations ◽  
State Legislatures ◽  
Estimating Equations ◽  
The State ◽  
State Legislators ◽  
Factors Associated ◽  
Tax Legislation ◽  
Tax Changes ◽  
State Legislative

ABSTRACT: We examine the decisions by state legislatures to conform to or decouple from federal tax legislation. We use a generalized estimating equations (GEE) approach to estimate the parameters of a model of factors associated with the state legislative decisions to conform their own tax systems to accommodate 11 federal tax reductions implemented between 2002 and 2008. Our model predicts that state legislators consider political, budgetary, and ease of compliance factors when considering whether to adopt federal tax changes into their own states’ tax codes. Our results are generally consistent with expectations, identifying several factors that are associated with the probability that a state will incorporate revenue-reducing tax changes implemented by the federal government. Our results also suggest that although state legislators appear to value conformity with the tax initiatives of the federal government, given rising budgetary pressures, state conformity with such legislation is likely to decrease in coming years.

scholarly journals Assessment of a Modified Sandwich Estimator for Generalized Estimating Equations with Application to Opioid Poisoning in MIMIC-IV ICU Patients

Stats ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 650-664
Author(s):  
Paul Rogers ◽  
Julie Stoner
Keyword(s):  
Repeated Measures ◽  
Generalized Estimating Equations ◽  
Rare Event ◽  
Estimating Equations ◽  
Small Sample ◽  
Repeated Measurements ◽  
Regression Coefficients ◽  
Binary Outcomes ◽  
Sandwich Estimator ◽  
Generalized Estimating

Longitudinal data is encountered frequently in many healthcare research areas to include the critical care environment. Repeated measures from the same subject are expected to correlate with each other. Models with binary outcomes are commonly used in this setting. Regression models for correlated binary outcomes are frequently fit using generalized estimating equations (GEE). The Liang and Zeger sandwich estimator is often used in GEE to produce unbiased standard error estimation for regression coefficients in large sample settings, even when the covariance structure is misspecified. The sandwich estimator performs optimally in balanced designs when the number of participants is large with few repeated measurements. The sandwich estimator’s asymptotic properties do not hold in small sample and rare-event settings. Under these conditions, the sandwich estimator underestimates the variances and is biased downwards. Here, the performance of a modified sandwich estimator is compared to the traditional Liang-Zeger estimator and alternative forms proposed by authors Morel, Pan, and Mancl-DeRouen. Each estimator’s performance was assessed with 95% coverage probabilities for the regression coefficients using simulated data under various combinations of sample sizes and outcome prevalence values with independence and autoregressive correlation structures. This research was motivated by investigations involving rare-event outcomes in intensive care unit settings.

scholarly journals Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

2019 ◽  
Vol 24 (8) ◽  
pp. 3001-3012 ◽  
Author(s):  
Rafaela Jorge ◽  
Natália Calanzani ◽  
Adelaide Freitas ◽  
Rui Nunes ◽  
Liliana Sousa
Keyword(s):  
Older People ◽  
Associated Factors ◽  
Good Health ◽  
Place Of Death ◽  
Home Death ◽  
Factors Associated ◽  
Binomial Regression ◽  
Belo Horizonte ◽  
The City ◽  
At Home

Abstract We examined people’s preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting “choosing who makes decisions about your care” as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.

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