Analyzing Child Mortality in Nigeria with Geoadditive Survival Models

Child mortality reflects a country's level of socio-economic development and quality of life. In developing countries, mortality rates are not only influenced by socio-economic, demographic and health variables but they also vary considerably across regions and districts. In this paper, we analyze child mortality in Nigeria with flexible geoadditive survival models. This class of models allows to measure small-area district-specific spatial effects simultaneously with possibly nonlinear or time-varying effects of other factors. Inference is fully Bayesian and uses recent Markov chain Monte Carlo (MCMC) simulation. The application is based on the 1999 Nigeria Demographic and Health Survey. Our method assesses effects at a high level of temporal and spatial resolution not available with traditional parametric models

Geoadditive Latent Variable Modelling of Count Data on Multiple Sexual Partnering in Nigeria

The 2005 National HIV/AIDS and Reproductive Health Survey in Nigeria provides evidence that multiple sexual partnering increases the risk of contracting HIV and other sexually transmitted diseases. Therefore, partner reduction is one of the prevention strategies to accomplish the Millenium development goal of halting and reversing the spread of HIV/AIDS. In order to explore possible association between sexual partnering and some risk factors, this paper utilizes a novel Bayesian geoadditive latent variable model for count outcomes. This allows us to simultaneously analyze linear and nonlinear effects of covariates as well as spatial variations of one or more latent variables, such as attitude towards multiple partnering, which in turn directly influences the multivariate observable outcomes or indicators. Influence of demographic factors such as age, gender, locality, state of residence, educational attainment, etc., and knowledge about HIV/AIDS on attitude towards multiple partnering is also investigated. Results can provide insights to policy makers with the aim of reducing the spread of HIV and AIDS among the Nigerian populace through partner reduction

Geoadditive latent variable modelling of count data on multiple sexual partnering in Nigeria

The 2005 National HIV/AIDS and Reproductive Health Survey in Nigeria provides evidence that multiple sexual partnering increases the risk of contracting HIV and other sexually transmitted diseases. Therefore, partner reduction is one of the prevention strategies to accomplish the Millenium development goal of halting and reversing the spread of HIV/AIDS. In order to explore possible association between sexual partnering and some risk factors, this paper utilizes a novel Bayesian geoadditive latent variable model for count outcomes. This allows us to simultaneously analyze linear and nonlinear effects of covariates as well as spatial variations of one or more latent variables, such as attitude towards multiple partnering, which in turn directly influences the multivariate observable outcomes or indicators. Influence of demographic factors such as age, gender, locality, state of residence, educational attainment, etc., and knowledge about HIV/AIDS on attitude towards multiple partnering is also investigated. Results can provide insights to policy makers with the aim of reducing the spread of HIV and AIDS among the Nigerian populace through partner reduction.factor loading; geographical variations; latent variable model; MCMC; Nigeria; semiparametric Poisson model

Bayesian Geoadditive Seemingly Unrelated Regression

Parametric seemingly unrelated regression (SUR) models are a common tool for multivariate regression analysis when error variables are reasonably correlated, so that separate univariate analysis may result in inefficient estimates of covariate effects. A weakness of parametric models is that they require strong assumptions on the functional form of possibly nonlinear effects of metrical covariates. In this paper, we develop a Bayesian semiparametric SUR model, where the usual linear predictors are replaced by more flexible additive predictors allowing for simultaneous nonparametric estimation of such covariate effects and of spatial effects. The approach is based on appropriate smoothness priors which allow different forms and degrees of smoothness in a general framework. Inference is fully Bayesian and uses recent Markov chain Monte Carlo techniques

Relationship between care-givers' misconceptions and non-use of ITNs by under-five Nigerian children

<p>Abstract</p> <p>Background</p> <p>Malaria has been a major public health problem in Nigeria and many other sub-Saharan African countries. Insecticide-treated nets have shown to be cost-effective in the prevention of malaria, but the number of people that actually use these nets has remained generally low. Studies that explore the determinants of use of ITN are desirable.</p> <p>Methods</p> <p>Structured questionnaires based on thematic areas were administered by trained interviewers to 7,223 care-givers of under-five children selected from all the six geo-political zones of Nigeria. Bivariate analysis and multinomial logit model were used to identify possible determinants of use of ITN.</p> <p>Results</p> <p>Bivariate analysis showed that under-five children whose care-givers had some misconceptions about causes and prevention of malaria were significantly less likely to use ITN even though the household may own a net (p < 0.0001). Education and correct knowledge about modes of prevention of malaria, knowing that malaria is dangerous and malaria can kill were also significantly associated with use of ITN (p < 0.0001). Knowledge of symptoms of malaria did not influence use of ITN. Association of non-use of ITN with misconceptions about prevention of malaria persisted with logistic regression (Odds ratio 0.847; 95% CI 0.747 to 0.960).</p> <p>Conclusions</p> <p>Misconceptions about causes and prevention of malaria by caregivers adversely influence the use ITN by under-five children. Appropriate communication strategies should correct these misconceptions.</p

Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria

<p>Abstract</p> <p>Background</p> <p>Malaria during pregnancy is a major public health problem in Nigeria leading to increase in the risk of maternal mortality, low birth weight and infant mortality. This paper is aimed at highlighting key predictors of the ownership of insecticide treated nets (ITNs) and its use among pregnant women in Nigeria.</p> <p>Methods</p> <p>A total of 2348 pregnant women were selected by a multi-stage probability sampling technique. Structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behaviour and practices. Logistic regression was used to detect predictors of two indicators: ITN ownership, and ITN use in pregnancy among those who owned ITNs.</p> <p>Results</p> <p>ITN ownership was low; only 28.8% owned ITNs. Key predictors of ITN ownership included women who knew that ITNs prevent malaria (OR = 3.85; <it>p </it>< 0001); and registration at antenatal clinics (OR = 1.34; <it>p </it>= 0.003). The use of ITNs was equally low with only 7.5% of all pregnant women, and 25.7% of all pregnant women who owned ITNs sleeping under a net. The predictors of ITN use in pregnancy among women who owned ITNs (N = 677) identified by logistic regression were: urban residence (OR = 1.87; <it>p </it>= 0.001); knowledge that ITNs prevent malaria (OR = 2.93; <it>p </it>< 0001) and not holding misconceptions about malaria prevention (OR = 1.56; <it>p </it>= 0.036). Educational level was not significantly related to any of the two outcome variables. Although registration at ANC is significantly associated with ownership of a bednet (perhaps through free ITN distribution) this does not translate to significant use of ITNs.</p> <p>Conclusions</p> <p>ITN use lagged well behind ITN ownership. This seems to suggest that the current mass distribution of ITNs at antenatal facilities and community levels may not necessarily lead to use unless it is accompanied by behaviour change interventions that address the community level perceptions, misconceptions and positively position ITN as an effective prevention device to prevent malaria</p

Next Generation Nanochitosan Applications in Animal Husbandry, Aquaculture and Food Conservation

Studies have identified the properties of enzymes, functionalized molecules, and compounds in food industry applications as edible coatings and encapsulations, that assure prolonged food quality and standards. These molecules present benefits of longer shelf-life by delayed deterioration and inhibition of the proliferation of spoilage and mycotoxigenic microorganisms. However, challenges of reduced nutrient levels, miniaturized size, and low chemical stability remain concerning. Chitosan polymers naturally formed from the deacetylation of shellfish shells and exoskeletons of aquatic arthropods and crustaceans offer improved benefits when functionalized into nanoparticles as nanochitosans. These polysaccharides produced by the alkalescent deacetylation of chitin, comprise a series of 2-deoxy-2 (acetylamino) glucose linked by ß-(1- 4) glycosidic linkages. This chapter considers the health impacts and microbiological health hazards associated with animal feeds quality and the enzyme immobilization potentials of nanochitosans in animalbased food and feed packages. Thereafter, nanochitosan properties and benefits are compared against traditional preservatives from microbes and plants; with highlights on current challenges in the application of nanochitosan for enzyme immobilization

Chapter 21 - Utilization of nanochitosan in the sterilization of ponds and water treatment for aquaculture

Water pollution constitutes the leading cause of infant mortality, neonatal deformities, and shrinkage of man’s average life expectancy. Pollutants come from point and nonpoint sources; and water pollution arises from the discharge of wastewater containing undesirable impurities used for domestic, agricultural, and industrial purposes. More so, high nutrient and wastewater runoffs from fish production systems contribute to the fouling and eutrophication of recipient water bodies. Hence, aquaculture which is inextricably linked to the natural environment is challenged by the dearth of appropriate water quantity and quality, militating against fish, and fishery production. Nanochitosans as polysaccharides produced by the alkalescent deacetylation of chitin, comprise a series of 2-deoxy-2 (acetylamino) glucose linked by ß-(1-4) glycosidic linkages. They are naturally formed from the deacetylation of shellfish shells and exoskeletons of aquatic arthropods and crustaceans. The unique attributes of chitin confer a wide range of biotechnological applications on the polymer, observed in flocculation as a wastewater treatment and purification route initiated by chitosan. This chapter highlights nanochitosan properties of aquaculture relevance; and elucidates the purification potentials of nanochitosan, compared to inorganic coagulants and organic polymeric flocculants. Effects of chitosan on contaminants and microorganisms, as well as applications in fish pathogens detection, fish disease diagnosis, and control are discussed

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49\ub74% (95% uncertainty interval [UI] 46\ub74–52\ub70). The TFR decreased from 4\ub77 livebirths (4\ub75–4\ub79) to 2\ub74 livebirths (2\ub72–2\ub75), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83\ub78 million people per year since 1985. The global population increased by 197\ub72% (193\ub73–200\ub78) since 1950, from 2\ub76 billion (2\ub75–2\ub76) to 7\ub76 billion (7\ub74–7\ub79) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2\ub70%; this rate then remained nearly constant until 1970 and then decreased to 1\ub71% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2\ub75% in 1963 to 0\ub77% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2\ub77%. The global average age increased from 26\ub76 years in 1950 to 32\ub71 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59\ub79% to 65\ub73%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1\ub70 livebirths (95% UI 0\ub79–1\ub72) in Cyprus to a high of 7\ub71 livebirths (6\ub78–7\ub74) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0\ub708 livebirths (0\ub707–0\ub709) in South Korea to 2\ub74 livebirths (2\ub72–2\ub76) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0\ub73 livebirths (0\ub73–0\ub74) in Puerto Rico to a high of 3\ub71 livebirths (3\ub70–3\ub72) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2\ub70% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill &amp; Melinda Gates Foundation

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress