318 research outputs found
APPLICATION OF KALMAN FILTER TO ARTIFICIAL NEURAL NETWORKS PREDICTION FOR FOREIGN EXCHANGE RATES
In recent years, artificial neural networks have received increasing attention as a decision making tool when prediction of financial time series is concerned. Modeling issues associated with artificial neural network model like the size of sample data and the general architecture of the model affect the performance of the model. For this reason, artificial neural networks outputs are prone to over-fitting or under-learning resulting to large mean squared errors which affect the accuracy of the prediction. In this paper, we investigate if the application Kalman filter algorithm to artificial neural networks model output can improve the model accuracy through the reduction of the mean squared error. Performance measures for prediction accuracy were used to compare the two models over the datasets for dollar, Euro and Pound exchange rates in Kenya Shilling for a period of five years. In the entire cases artificial neural networks model performed better than artificial neural networks with Kalman filter model. Keywords: Artificial Neural Networks, Currency, Exchange Rates, Kalman Filter, Multi-Layer Perceptro
Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya
BACKGROUND: In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. METHODS: A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. RESULTS: 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. CONCLUSION: The proposed spatial modelling framework presents a rationale for equitable allocation of routine LLINs and could be used for quantification of other maternal and child health commodities applicable in different settings. Western Kenya region received adequate LLINs for routine distribution in line with government of Kenya targets, however, the model shows important inefficiencies in the allocation of the LLINs at clinic level
Paraoxonase1 Genetic Polymorphisms in a Mixed Ancestry African Population
Paraoxonase 1 (PON1) activity is markedly influenced by coding polymorphisms, Q/R at position 192 and M/L at position 55 of the PON1 gene. We investigated the frequencies of these polymorphisms and their effects on PON1 and antioxidant activities in 844 South African mixed ancestry individuals. Genotyping was done using allele-specific TaqMan technology, PON1 activities were measured using paraoxon and phenylacetate, oxidative status was determined by measuring the antioxidant activities of ferric reducing antioxidant power and trolox equivalent antioxidant capacity, and lipid peroxidation markers included malondialdehyde and oxidized LDL. The frequencies of Q192R and L55M were 47.6% and 28.8%, respectively, and the most common corresponding alleles were 192R (60.4%) and 55M (82.6%). The Q192 was significantly associated with 5.8 units’ increase in PON1 concentration and 15.4 units’ decrease in PONase activity after adjustment for age, sex, BMI, and diabetes, with suggestion of differential effects by diabetes status. The PON1 L55 variant was associated with none of the measured indices. In conclusion, we have shown that the Q192R polymorphism is a determinant of both PON1 concentration and activity and this association appeared to be enhanced in subjects with diabetes
Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital
OBJECTIVE: To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies. DESIGN: Retrospective medical record review of hospital admissions during 2005 in eight countries. SETTING: Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety. PARTICIPANTS: Convenience sample of 26 hospitals from which 15,548 patient records were randomly sampled. MAIN OUTCOME MEASURES: Two stage screening. Initial screening based on 18 explicit criteria. Records that screened positive were then reviewed by a senior physician for determination of adverse event, its preventability, and the resulting disability. RESULTS: Of the 15,548 records reviewed, 8.2% showed at least one adverse event, with a range of 2.5% to 18.4% per country. Of these events, 83% were judged to be preventable, while about 30% were associated with death of the patient. About 34% adverse events were from therapeutic errors in relatively non-complex clinical situations. Inadequate training and supervision of clinical staff or the failure to follow policies or protocols contributed to most events. CONCLUSIONS: Unsafe patient care represents a serious and considerable danger to patients in the hospitals that were studied, and hence should be a high priority public health problem. Many other developing and transitional economies will probably share similar rates of harm and similar contributory factors. The convenience sampling of hospitals might limit the interpretation of results, but the identified adverse event rates show an estimate that should stimulate and facilitate the urgent institution of appropriate remedial action and also to trigger more research. Prevention of these adverse events will be complex and involves improving basic clinical processes and does not simply depend on the provision of more resources
Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting
Background. Information on adverse events (AEs) in hospitalised patients in developing countries is scanty.Objective. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting.Methods. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression.Results. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02).Conclusions. Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting
Perceived risks of infection, hospitalization, and death from COVID-19 at the Equator: Ecuador and Kenya
Objectives: This study''s goal was to determine the perceived risks of infection as well as the perceived risks of hospitalization and death from COVID-19 in Ecuador and Kenya. It also assessed the factors associated with the risk-related perceptions. Methods: Cross-sectional studies with samples from the adult populations in both countries were conducted to assess the perceived risks of contracting COVID-19. Data were collected online using the Qualtrics platform from samples of 1, 050 heads of households ages 18 years or older in each country. Three statistical analyses were conducted: summary statistics, correlation, and linear regression. Results: The average perceived risks of COVID-19 infection, hospitalization, and death in the Kenyan sample were 27.1%, 43.2%, and 17.2%, respectively, and the values for the Ecuadorian sample were 34%, 32.8%, and 23.3%, respectively. The Pearson''s correlation coefficients between the risk measures in each country were less than 0.38. Risk measures were associated with several sociodemographic variables (e.g., income, gender, location) but not age. Conclusions: The perceived risks of COVID-19 infection, hospitalization, and death in Kenya and Ecuador were significantly higher relative to the statistics reported; however, no strong association existed between perceived risk and age, which is a key factor in adverse health outcomes, including death, among COVID-19 infected individuals
Mangroves in peril: unprecedented degradation rates of peri-urban mangroves in Kenya
Marine ecosystems are experiencing unprecedented degradation rates higher
than any other ecosystem on the planet, which in some instances are up to
4 times those of rainforests. Mangrove ecosystems have especially been
impacted by compounded anthropogenic pressures leading to significant cover
reductions of between 35 and 50% (equivalent to 1–2% loss pa) for
the last half century. The main objective of this study was to test the
hypothesis that peri-urban mangroves suffering from compounded and intense
pressures may be experiencing higher degradation rates than the global mean
(and/or national mean for Kenya) using Mombasa mangroves (comprising Tudor
and Mwache creeks) as a case study. Stratified sampling was used to sample
along 22 and 10 belt transects in Mwache and Tudor respectively, set to
capture stand heterogeneity in terms of species composition and structure in
addition to perceived human pressure gradients using proximity to human
habitations as a proxy. We acquired SPOT (HRV/ HRVIR/ HRS) images of April
1994, May 2000 and January 2009 and a vector mangrove map of 1992 at a scale
of 1:50 000 for cover change and species composition analysis. Results
from image classification of the 2009 image had 80.23% overall accuracy
and Cohen's kappa of 0.77, thus proving satisfactory for use in this context.
Structural data indicate that complexity index (CI) which captures stand
structural development was higher in Mwache at 1.80 compared to Tudor at
1.71. From cover change data, Tudor lost 86.9% of the forest between
1992 and 2009, compared to Mwache at 45.4%, representing very high
hitherto undocumented degradation rates of 5.1 and 2.7% pa,
respectively. These unprecedentedly high degradation rates, which far exceed
not only the national mean (for Kenya of 0.7% pa) but the global mean
as well, strongly suggest that these mangroves are highly threatened due to
compounded pressures. Strengthening of governance regimes through enforcement
and compliance to halt illegal wood extraction, improvement of land-use
practices upstream to reduce soil erosion, restoration in areas where natural
regeneration has been impaired, provision of alternative energy
sources/building materials and a complete moratorium on wood extraction
especially in Tudor Creek to allow recovery are some of the suggested
management interventions
A rapid and reproducible picture of open access health facility data in Africa to support the COVID-19 response
Background: Open data on the locations and services provided by health facilities in some countries have allowed the development of software tools contributing to COVID-19 response. The UN and WHO encourage countries to make health facility location data open, to encourage use and improvement. We provide a summary of open access health facility location data in Africa using re-useable code. We aim to support data analysts developing software tools to address COVID-19 response in individual countries. In Africa there are currently three main sources of such data; 1) direct from national ministries of health, 2) a database for sub-Saharan Africa collated and published by a team from KEMRI-Wellcome Trust Research Programme and now hosted by WHO, and 3) The Global Healthsites Mapping Project in collaboration with OpenStreetMap.
Methods: We searched for and documented official national facility location data that were openly available. We developed re-useable open-source R code to summarise and visualise facility location data by country from the three sources. This re-useable code is used to provide a web user interface allowing data exploration through maps and plots of facility type.
Results: Out of 53 African countries, seven provide an official open facility list that can be downloaded and analysed reproducibly. Considering all three sources, there are over 185,000 health facility locations available for Africa. However, there are differences and overlaps between sources and a lack of data on capacities and service provision.
Conclusions: We suggest that these summaries and tools will encourage greater use of existing health facility location data, incentivise further improvements in the provision of those data by national suppliers, and encourage collaboration within wider data communities. The tools are a part of the afrimapr project, actively developing R building blocks to facilitate the use of health data in Africa
The indirect health effects of malaria estimated from health advantages of the sickle cell trait
Most estimates of the burden of malaria are based on its direct impacts; however, its true burden is likely to be greater because of its wider effects on overall health. Here we estimate the indirect impact of malaria on children’s health in a case-control study, using the sickle cell trait (HbAS), a condition associated with a high degree of specific malaria resistance, as a proxy indicator for an effective intervention. We estimate the odds ratios for HbAS among cases (all children admitted to Kilifi County Hospital during 2000–2004) versus community controls. As expected, HbAS protects strongly against malaria admissions (aOR 0.26; 95%CI 0.22–0.31), but it also protects against other syndromes, including neonatal conditions (aOR 0.79; 0.67–0.93), bacteraemia (aOR 0.69; 0.54–0.88) and severe malnutrition (aOR 0.67; 0.55–0.83). The wider health impacts of malaria should be considered when estimating the potential added benefits of effective malaria interventions
Biology of barley shoot fly Delia flavibasis Stein (Diptera: Anthomyiidae) on resistant and susceptible barley cultivars
The biology of barley shoot fly Delia flavibasis was studied using resistant (Dinsho and Harbu) and susceptible (Holker) barley cultivars at Sinana Agricultural Research Center, Ethiopia. A higher number of eggs was laid on Holker (17 eggs/female) than on Dinsho (11 eggs/female) or Harbu (12 eggs/female). However, there were no differences between cultivars in preoviposition and total reproductive periods. The shortest time required to complete larval, pupal and total developmental stages from egg to adult emergence occurred when the insect was reared on the cultivar Holker. Pupal weight, adult emergence and adult longevity did not differ between cultivars. The female to male sex ratio was 1:1. This study enabled us to understand the duration of each of the life stages of D.flavibasis, which will undoubtedly aid researchers and growers to design a sustainable management strategy against barley shoot fly
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