scholarly journals A Spatial Survival Model for Risk Factors of Under-Five Child Mortality in Kenya

2021 ◽  
Vol 19 (1) ◽  
pp. 399
Author(s):  
Kilemi Daniel ◽  
Nelson Owuor Onyango ◽  
Rachel Jelagat Sarguta
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Spatial Variation ◽  
Child Mortality ◽  
Frailty Model ◽  
Proportional Hazard ◽  
Under Five ◽  
Cox Proportional Hazard ◽  
Death Of A Child ◽  
Spatial Differences

Child mortality is high in Sub-Saharan Africa compared to other regions in the world. In Kenya, the risk of mortality is assumed to vary from county to county due to diversity in socio-economic and even climatic factors. Recently, the country was split into 47 different administrative regions called counties, and health care was delegated to those county governments, further aggravating the spatial differences in health care from county to county. The goal of this study is to evaluate the effects of spatial variation in under-five mortality in Kenya. Data from the Kenya Demographic Health Survey (KDHS-2014) consisting the newly introduced counties was used to analyze this risk. Using a spatial Cox Proportional Hazard model, an Intrinsic Conditional Autoregressive Model (ICAR) was fitted to account for the spatial variation among the counties in the country while the Cox model was used to model the risk factors associated with the time to death of a child. Inference regarding the risk factors and the spatial variation was made in a Bayesian setup based on the Markov Chain Monte Carlo (MCMC) technique to provide posterior estimates. The paper indicate the spatial disparities that exist in the country regarding child mortality in Kenya. The specific counties have mortality rates that are county-specific, although neighboring counties have similar hazards for death of a child. Counties in the central Kenya region were shown to have the highest hazard of death, while those from the western region had the lowest hazard of death. Demographic factors such as the sex of the child and sex of the household head, as well as social economic factors, such as the level of education, accounted for the most variation when spatial differences were factored in. The spatial Cox proportional hazard frailty model performed better compared to the non-spatial non-frailty model. These findings can help the country to plan health care interventions at a subnational level and guide social and health policies by ensuring that counties with a higher risk of Under Five Child Mortality (U5CM) are considered differently from counties experiencing a lower risk of death.

scholarly journals Determinants of Under-five Child Mortality: Evidence from Bangladesh Multiple Indicator Cluster Survey (MICS) 2019

2021 ◽  
Author(s):  
Md. Momin Islam ◽  
Farha Musharrat Noor ◽  
Md. Rokibul Hasan ◽  
Mohammad Ahsan Udddin
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Child Mortality ◽  
Proportional Hazard ◽  
Under Five ◽  
Cluster Survey ◽  
Cox Proportional Hazard ◽  
Multiple Indicator Cluster Survey ◽  
Multiple Indicator ◽  
Child Mortality Rate

Abstract Background: Every year millions of under-five children die due to different causes and some of those death could be prevented by proper awareness or taking steps. Though under-five child mortality rate has reduced by a remarkable rate for last decade in Bangladesh, the rate is still high to reach the expected level of Sustainable Development Goals (SDGs). Methods: The main aim of this study was to find out the socioeconomic and demographic determinants of under-five child mortality in Bangladesh. Nationally representative cross-sectional secondary data from the Multiple Indicator Cluster Survey (MICS) 2019, Bangladesh had been used in this study. Outcome variable was under-five child survival status (alive or dead). Kaplan–Meier log-rank test and Cox Proportional Hazard (PH) model with 95% confidence interval (CI) were fitted to identify associated risk factors for under-five child mortality. This analysis was performed by using STATA version 16.Results: The study showed that among 5112 under-five children, 170 (3.3%) were dead. Cox proportional hazard model revealed that mother’s education [secondary (HR: 0.53, 95%CI: (0.30, 0.94), p=0.03), higher (HR: 0.41, 95% CI: (0.21, 0.81), p=0.01)], higher birth order [HR: 1.43, 95% CI: (1.13, 1.89), p=0.007], size of child at birth [HR: 2.28, 95% CI: (1.22, 4.26), p=0.009], taking antenatal care [HR: 0.77, 95% CI: (0.52, 1.15), p= 0.091] had a significant effect on child mortality. Under-five child mortality rate was varied among division and highest mortality rate was found in Sylhet [HR: 2.13, 95% CI: (0.99, 4.55), p=0.054]. Conclusions: This study identified potential risk factors for under-five child mortality, which would help the policy makers to take proper steps as community-based educational programs for mother’s and public health interventions focused on birth to reduce under-five child mortality rate in Bangladesh.

Research title on Multilevel Modelling of Time to Death for Under-Five Children: 2016 Ethiopia Demographic and Health Survey, 2019

2020 ◽  
Author(s):  
Alemayehu Siffir Argawu ◽  
Gudeta Hirko
Keyword(s):  
Child Mortality ◽  
Wealth Index ◽  
Proportional Hazard ◽  
Survival Times ◽  
Under Five ◽  
Under Five Children ◽  
Cox Proportional Hazard ◽  
Random Intercept ◽  
Parametric Survival Model ◽  
Parametric Survival

Abstract Background: Reducing child mortality is now a global concern. Globally, Under-five child mortality rate was decreased by 58% in 2017. In the 2016 EDHS report, under-five mortality was declined to 60% in Ethiopia in 2016. Methods: The data for the study was obtained from EDHS data conducted in 2016. In the study, we analysed the data using stratified Cox proportional hazard model and multilevel lognormal parametric survival model. Results: From the total of 10,331 under-five children, 635 (6.1%) deaths had occurred in the 2016 EDHS data. And, the overall probability of survival value was near to 0.92 with the estimated mean survival time was 55.4 months. In the study we found that covariates like birth type of the child, family size, wealth index, frequency of listening radio, place of delivery, place of residence, and geographical region were significant factors for the death of under-five children in stratified Cox proportional hazard model. In the multilevel lognormal parametric survival model, we found that the random-intercept effects of variations between region and household levels on the mean survival times of the children were 1.7 and 0.9, respectively. These values indicated that we had enough evidence for the existence of unobserved heterogeneities between regions and households. Conclusion: The covariates like birth type of the child, family size, wealth index, frequency of listening radio, place of delivery, place of residence, and geographical region covariates were significant factors for under-five children mortality using stratified Cox proportional hazard regression model. In the random-intercept effects model, the two estimated variances of the random-intercept effects for regional and household levels were 1.7 and 0.9, respectively. The values indicate that we have enough evidence that there were unobserved heterogeneities on the mean survival times of the under-five children between regions and households levels. Further studies should be conducted to identify the individual, household, and community-level factors associated with infant and child mortality in Ethiopia.

scholarly journals Under-five child mortality in Bangladesh: Classical and Bayesian approaches to Cox proportional hazard model

2018 ◽  
Vol 30 (1-2) ◽  
pp. 45-54
Author(s):  
Shahnaz Nilima
Keyword(s):  
Child Mortality ◽  
Maternal Education ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Bayesian Approaches ◽  
Cox Regression Analysis ◽  
Under Five ◽  
Cox Proportional Hazard

This study examines the determinants of under-five child mortality in Bangladesh using the data extracted from the Bangladesh Demographic and Health Survey (BDHS), 2011 and 2014. Product-Limit method and Log-Rank test have been used for bivariate analysis. Cox proportional hazard model has been employed under both classical and Bayesian approaches. Cox regression analysis reveals that region (Barisal and Sylhet), maternal education (higher education), mother’s membership of NGO have significant impact on child mortality. The results obtained using Bayesian Cox PH model are almost similar except one key finding. Under Bayesian analysis, child’s size at birth appeared as potential determinant of under-five mortality whereas it has insignificant effect on child survival when classical Cox model has been applied.Bangladesh J. Sci. Res. 30(1&2): 45-54, December-2017

Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

2013 ◽  
Vol 25 (11) ◽  
pp. 1867-1876 ◽  
Author(s):  
Marianna Noale ◽  
Federica Limongi ◽  
Sabina Zambon ◽  
Gaetano Crepaldi ◽  
Stefania Maggi
Keyword(s):  
Risk Factors ◽  
Competing Risks ◽  
Depressive Symptomatology ◽  
Significant Risk ◽  
Effect Modification ◽  
Proportional Hazard ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Incidence Of Dementia

ABSTRACTBackground:Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable.Methods:Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65–84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia.Results:The incidence rate of dementia increased from 5.57/1,000 person-years at 65–69 years of age to 30.06/1,000 person-years at 80–84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m2. Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women.Conclusions:Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

Statistical Assessment of Malaria Risk Factors Using Cox Proportional Hazard Approach

2017 ◽  
Vol 60 (2-3) ◽  
pp. 106-116
Author(s):  
Ruffin Mutambayi ◽  
James Ndege ◽  
Adeboye Azeez ◽  
Yong Song Qin ◽  
Akinwumi Odeyemi
Keyword(s):  
Risk Factors ◽  
Malaria Risk ◽  
Proportional Hazard ◽  
Statistical Assessment ◽  
Cox Proportional Hazard ◽  
Malaria Risk Factors

scholarly journals Socio-demographic and environmental risk factors associated with multiple under-five child loss among mothers in Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rasel Kabir ◽  
Marwa Farag ◽  
Hyun Ja Lim ◽  
Nigatu Geda ◽  
Cindy Feng
Keyword(s):  
Risk Factors ◽  
Child Mortality ◽  
Economic Status ◽  
Reproductive Period ◽  
Age At First Birth ◽  
Child Loss ◽  
First Birth ◽  
Under Five ◽  
Factors Associated ◽  
Socio Economic Status

Abstract Background Despite the substantial decline in child mortality globally over the last decade, reducing neonatal and under-five mortality in Bangladesh remains a challenge. Mothers who experienced multiple child losses could have substantial adverse personal and public health consequences. Hence, prevention of child loss would be extremely desirable during women’s reproductive years. The main objective of this study was to determine the risk factors associated with multiple under-five child loss from the same mother in Bangladesh. Methods In this study, a total of 15,877 eligible women who had given birth at least once were identified from the 2014 Bangladesh Demographic and Health Survey. A variety of count regression models were considered for identifying socio-demographic and environmental factors associated with multiple child loss measured as the number of lifetime under-five child mortality (U5M) experienced per woman. Results Of the total sample, approximately one-fifth (18.9%, n = 3003) of mothers experienced at least one child’s death during their reproductive period. The regression analysis results revealed that women in non-Muslim families, with smaller household sizes, with lower education, who were more advanced in their childbearing years, and from an unhygienic environment were at significantly higher risk of experiencing offspring mortality. This study also identified the J-shaped effect of age at first birth on the risk of U5M. Conclusions This study documented that low education, poor socio-economic status, extremely young or old age at first birth, and an unhygienic environment significantly contributed to U5M per mother. Therefore, improving women’s educational attainment and socio-economic status, prompting appropriate timing of pregnancy during reproductive life span, and increasing access to healthy sanitation are recommended as possible interventions for reducing under-five child mortality from a mother. Our findings point to the need for health policy decision-makers to target interventions for socio-economically vulnerable women in Bangladesh.

scholarly journals Neonatal, Infant and Under-Five Mortality: an Application of Cox Proportional Hazard Model to Bdhs Data

2018 ◽  
Vol 44 (1) ◽  
pp. 7-14
Author(s):  
Shahnaz Nilima ◽  
Rebeka Sultana ◽  
Shahjadi Ireen
Keyword(s):  
Maternal Education ◽  
Hazard Model ◽  
Rank Test ◽  
Bivariate Analysis ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Under Five ◽  
Cox Proportional Hazard ◽  
Size At Birth

This study utilizes data derived from the Bangladesh demographic and health survey (BDHS), 2014 to identify the determinants of neonatal, infant and under-five mortality in Bangladesh. Log-rank test has been used for bivariate analysis. Regression analysis has been performed by applying Cox proportional hazard model to the data. It has been found from the analysis that maternal education, region, exposure to NGO activities are significant determinants of under-five and infant mortality whereas region, gender of child, child’s size at birth play significant role in reducing neonatal mortality in Bangladesh. The findings of the study suggest that policymakers should give priority on maternal education, region, and child’s size at birth as well as exposure to NGO activities to reduce neonatal, infant and under-five mortality in Bangladesh. Asiat. Soc. Bangladesh, Sci. 44(1): 7-14, June 2018

scholarly journals Pigmentary abnormality without significant drusen as a risk factor for late age-related macular degeneration

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Junwon Lee ◽  
Hyun Goo Kang ◽  
Hae Rang Kim ◽  
Christopher Seungkyu Lee ◽  
Min Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Significant Risk ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Hazard Ratios ◽  
Disc Area

AbstractWe investigated the incidence and risk factors of late age-related macular degeneration (AMD) in the fellow eye (FE) without significant drusen of patients with unilateral exudative macular neovascularization (MNV). In this retrospective study, 241 eligible patients who were followed-up for more than 3 years were enrolled. We analyzed the incidence and hazard ratios (HRs) of late AMD in the FE according to demographic and ophthalmologic variables. Hypopigmentation on color fundus photography (CFP) corresponds to shallow irregular RPE elevation (SIRE), so-called “double-layer sign” and/or “attenuation or disruption of RPE and/or ellipsoid zone” on OCT. The 5-year incidence of FE exudative MNV conversion was 8.6%. The 5-year incidence of FE exudative MNV of large hypopigmentation (≥ 0.5 disc area; DA) and small hypopigmentation (< 0.5 DA) on CFP, and SIRE (≥ 1000 µm) and small RPE elevation (< 1000 µm) on OCT were 36.2%, 14.2%, 55.0%, and 15.6%, respectively. The multivariate Cox proportional hazard model revealed that large hypopigmentation, small hypopigmentation, SIRE, and small RPE elevation showed HRs of 23.230, 8.037, 132.589, and 41.823 for FE exudative MNV occurrence, respectively. Hypopigmentation on CFP and SIRE on OCT could represent the same lesion. Even small hypopigmentation and small RPE elevation were significant risk factors for progression to exudative MNV.

scholarly journals Determinants of Under-Five Mortality in Ethiopia: an Application of Cox Proportional Hazard and Frailty Models

2018 ◽  
Vol 10 (2) ◽  
pp. 123-136
Author(s):  
Dereje Tesfaye ZIKE ◽  
Haile Mekonnen FENTA ◽  
Demeke Lakew WORKIE ◽  
Prafulla Kumar SWAIN
Keyword(s):  
Frailty Models ◽  
Proportional Hazard ◽  
Under Five ◽  
Cox Proportional Hazard
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