Bayesian statistical inference of loglogistic model with interval-censored lifetime data

The properties of Palm Oil (PO) and Coconut Oil (CO) offer the potential for transformers Interval-censored data arise when a failure time say, T cannot be observed directly but can only be determined to lie in an interval obtained from a series of inspection times. The frequentist approach for analysing interval-censored data has been developed for some time now. It is very common due to unavailability of software in the field of biological, medical and reliability studies to simplify the interval censoring structure of the data into that of a more standard right censoring situation by imputing the midpoints of the censoring intervals. In this research paper, we apply the Bayesian approach by employing Lindley's 1980, and Tierney and Kadane 1986 numerical approximation procedures when the survival data under consideration are interval-censored. The Bayesian approach to interval-censored data has barely been discussed in literature. The essence of this study is to explore and promote the Bayesian methods when the survival data been analysed are is interval-censored. We have considered only a parametric approach by assuming that the survival data follow a loglogistic distribution model. We illustrate the proposed methods with two real data sets. A simulation study is also carried out to compare the performances of the methods

Knowledge and use of information and communication technology by health sciences students of the University of Ghana

Background: Studies have shown that ICT adoption contributes to productivity and economic growth. It is therefore important that health workers have knowledge in ICT to ensure adoption and uptake of ICT tools to enable efficient health delivery.Objective: To determine the knowledge and use of ICT among students of the College of Health Sciences at the University of Ghana.Methods: This was a cross-sectional study conducted among students in all the five Schools of the College of Health Sciences at the University of Ghana. A total of 773 students were sampled from the Schools. Sampling proportionate to size was then used to determine the sample sizes required for each school, academic programme and level of programme. Simple random sampling was subsequently used to select students from each stratum.Results: Computer knowledge was high among students at almost 99%. About 83% owned computers (p < 0.001) and self-rated computer knowledge was also 87 % (p <0.001). Usage was mostly for studying at 93% (p< 0.001). Conclusions: This study shows students have adequate knowledge and use of computers. It brings about an opportunity to introduce ICT in healthcare delivery to them. This will ensure their adequate preparedness to embrace new ways of delivering care to improve service delivery.Funding: Africa Build Project, Grant Number: FP7-266474Keywords: ICT, health professionals, knowledge, student

Assessing the impact of differences in malaria transmission intensity on clinical and haematological indices in children with malaria.

BACKGROUND: Malaria control interventions have led to a decline in transmission intensity in many endemic areas, and resulted in elimination in some areas. This decline, however, will lead to delayed acquisition of protective immunity and thus impact disease manifestation and outcomes. Therefore, the variation in clinical and haematological parameters in children with malaria was assessed across three areas in Ghana with varying transmission intensities. METHODS: A total of 568 children between the ages of 2 and 14 years with confirmed malaria were recruited in hospitals in three areas with varying transmission intensities (Kintampo > Navrongo > Accra) and a comprehensive analysis of parasitological, clinical, haematological and socio-economic parameters was performed. RESULTS: Areas of lower malaria transmission tended to have lower disease severity in children with malaria, characterized by lower parasitaemias and higher haemoglobin levels. In addition, total white cell counts and percent lymphocytes decreased with decreasing transmission intensity. The heterozygous sickle haemoglobin genotype was protective against disease severity in Kintampo (P = 0.016), although this was not significant in Accra and Navrongo. Parasitaemia levels were not a significant predictor of haemoglobin level after controlling for age and gender. However, higher haemoglobin levels in children were associated with certain socioeconomic factors, such as having fathers who had any type of employment (P < 0.05) and mothers who were teachers (P < 0.05). CONCLUSIONS: The findings demonstrate significant differences in the haematological presentation and severity of malaria among areas with different transmission intensity in Ghana, indicating that these factors need to be considered in planning the management of the disease as the endemicity is expected to decline after control interventions

Do dietary practices and household environmental quality mediate socioeconomic inequalities in child undernutrition risk in West Africa?

We investigated the relationship between socioeconomic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as Minimum Dietary Diversity [MDD], Minimum Meal Frequency [MMF], and Minimum acceptable diet [MAD]) and household environmental quality (HEQ) in the observed relationship. Thirteen countries were included in the study. We leveraged the most recent Demographic and Health Surveys datasets ranging from 2010 to 2019. Poisson regression model with robust standard errors was used to estimate prevalence ratios and their corresponding 95% CIs. Structural Equation Modelling was used to conduct the mediation analysis. West Africa. 132,448 under-five children born within five years preceding the survey were included. Overall, 32.5%, 8.2%, 20.1% and 71.7% of WA children were stunted, wasted, underweight and anaemic, respectively. Prevalence of undernutrition decreased with increasing maternal education and household wealth (Trend p-values < 0.001). Secondary or higher maternal education and residence in rich households were associated with statistically significant decrease in the prevalence of stunting, wasting, underweight and anaemia among children in WA. MAD was found to mediate the association of low maternal education and poor household wealth with childhood stunting and underweight by 35.9% to 44.5%. MDD, MMF and HEQ did not mediate the observed relationship. The study findings enables an evaluation and improvement of existing intervention strategies through a socioeconomic lens to help address the high burden of child undernutrition in WA and other developing regions

Secular trends in low birth weight and child undernutrition in West Africa : evidence from complex nationwide surveys, 1985–2019

Objective: We present prevalence estimates and secular trends of stunting, wasting, underweight, and anaemia among children under 5 years of age and low birth weight (LBW) over the period 1985–2019 in West Africa (WA). Design: Analysis of Demographic and Health Survey (DHS) and World Bank data. DerSimonian–Laird random effect model with the Knapp–Hartung adjustment to the standard error was used to derive overall prevalence estimates. We used fixed effect ordinary least square regression models with cluster robust standard error to conduct time trends analyses. Setting: West Africa. Participants: Children aged 0 to 59 months. Results: Three distinct periods (1986–1990, 1993–1996 and 1997–2000) of sharp increases in prevalence of all outcomes was observed. After the year 2000, prevalence of all outcomes except LBW started to decline with some fluctuations. LBW prevalence showed a steady increase after 2000. We observed a decline in prevalence of stunting (β = –0·20 %; 95 % CI –0·43 %, 0·03 %), log-wasting (β = –0·02 %; 95 % CI –0·02 %, –0·01 %), log-underweight (β = –0·02 %; 95 % CI –0·03 %, –0·01 %) anaemia (β = –0·44; 95 % CI –0·55 %, –0·34 %), and an increase in LBW (β = 0·06 %; 95 % CI –0·10 %, 0·22 %) in WA over the period. Pooled prevalence of stunting, wasting, underweight, anaemia and LBW in WA for the period 1985–2019 was 26·1 %, 16·4 %, 22·7 %, 76·2 % and 11·3 %, respectively. Conclusions: Child undernutrition prevalence varied greatly between countries and the year cohorts. We observed marginal reductions in prevalence of all outcomes except anaemia where the reductions were quite striking and LBW where an increase was noted. There is the need for more rigorous and sustained targeted interventions in WA

Is The Mobile Phone Technology Feasible For Effective Monitoring Of Defecation Practices In Ghana? The Case Of A Peri-Urban District In Ghana

Abstract: Background: The world leaders have decided to increase the sanitation coverage in areas of with poor access and monitor the progress. However, data collection via existing paper-based monitoring and evaluation (M &amp; E) survey tools has limitations, including the approach used in Ghana. Therefore, there is the need to test new innovative M &amp; E tools for monitoring sanitation practices. Objective: To compare a mobile phone short messaging service (SMS) M &amp; E survey tool with a paper based format in a rapidly expanding peri-urban setting of Prampram, Ghana. Methods: Four hundred and fifty-eight adults with access to a mobile phone were purposely selected. Next, they were randomly assigned to the group using SMS or the group reporting on sanitation practices through a paper-based survey method. Respondents were asked to answer 5 questions on sanitation practices once every quarter over a one-year period. Non-responders were interviewed to ascertain reasons for non-response. A subset of 227 respondents were interviewed to obtain information on acceptability, ease of use and level of privacy of the two M &amp; E survey tools. Results: Respondents from this study, found the mobile phone SMS M &amp; E survey tool to be feasible although the tool was unacceptable, not user friendly and offered a low level of privacy as compared to the paper tool. Conclusions: The mobile phone SMS M &amp; E tool cannot replace paper-based tool for sanitation M &amp; E in Ghana. Further studies could examine alternative mobile phone applications, for example the use of pictorial mobile phone technology for data collection among lowliteracy populations

The President's Malaria Initiative contributed to reducing malaria burden in sub-Saharan Africa between 2004 and 2014: Evidence from generalized estimating equation analysis.

The President's Malaria Initiative (PMI) launched in 2005 as a key player in malaria prevention and treatment in sub-Saharan Africa (SSA). Several country-specific evaluations have demonstrated great progress in reducing under-five mortality associated with scaling up malaria interventions in PMI priority countries. Documentation of PMI's specific contributions was limited, until the publication of Jakubowski, et al., which used difference-in-difference analysis to show a higher reduction of under-five mortality in PMI-supported countries than in others. To generate more evidence, this study used rigorous statistical analyses to assess the reduction in mortality attributable to PMI support. The study used generalized estimating equations and a series of matching procedures to evaluate the impact of PMI on under-five mortality and on population coverage of insecticide-treated nets (ITNs), indoor residual spraying (IRS), and artemisinin-based combination therapy (ACT) in SSA. The analyses used country-level secondary data and controlled for several country-level characteristics assumed to influence outcome measures of interest, PMI program participation, or both. The Mahalanobis distance metric, with 1:1 nearest neighbor matching adjusting for bias in population size in the particular country, showed a reduction in under-five mortality by approximately 12 per 1,000 live births (95% Confidence Interval [CI]: 20.6-3.1; p = 0.012). There were statistically significant increases in the population coverage of ITNs, IRS, and ACTs in PMI countries over the implementation period. ITN use in the population was 0.23% higher (95% CI average treatment effect on the treated: 0.17-0.30; p<0.001) in PMI-recipient countries than in non-PMI countries. The findings show that PMI contributed significantly to increasing the coverage of malaria control interventions and reducing under-five mortality in SSA

Healthcare utilization in Ghana: Insights from the 2017 Ghana Living Standard Survey.

IntroductionThe persistence of healthcare utilization disparities in Ghana despite several policy efforts highlights the urgency of understanding its determinants to enhance equitable health access. We sought to examine the determinants of healthcare utilization in Ghana.MethodsWe used the 2017 Ghana Living Standard Survey (GLSS) data. This was a cross-sectional design, which employed a stratified two-stage random sampling technique. We analyzed data involving 8,298 respondents with information on visits to healthcare facilities for services on account of illness or injury two weeks prior to the survey. Pearson's chi-squared test was used to assess the distribution of healthcare utilization across background characteristics. Further, we used multivariable Poisson regression model with robust standard error to identify factors independently associated with healthcare utilization.ResultsAmong the 8,298, the median age was 24 years (interquartile range = 7-47), 45% were males, and 45% had no education. About 42% of respondents utilized health services during an episode of illness or injury. Age, sex, educational level, marital status, wealth quintile, health insurance and severity of illness/injury were independently associated with healthcare utilization. Healthcare utilization increased significantly with wealth quintiles-those in the highest wealth quintiles had about 22% increased utilization compared to those in the lowest wealth quintiles (aPR = 1.22; 95%CI = 1.13-1.32) while it was about 77% higher among those who had valid health insurance compared to those without (aPR = 1.77; 95% CI = 1.68-1.86). Regarding severity of illness or injury, those with severe conditions were about 65% more likely to utilize healthcare services compared to those with acute conditions (aPR = 1.65; 95% CI = 1.53-1.78).ConclusionOur study underscores the importance of socio-economic factors and health insurance in healthcare utilization in Ghana. Addressing these can pave the way for more equitable access to healthcare services across all segments of the population