Spat Spatiotemporal Epidemiol - Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa.

Tópicos

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Resumo

South Africa is experiencing a major burden of HIV/TB. We used longitudinal data from the Agincourt sub-district in rural northeast South Africa over the years 2000 to 2005. A total of 187 HIV/TB deaths were observed among 16,844 children aged 1-5 years coming from 8,863 households. In this paper we used Bayesian models to assess risk factors for child HIV/TB mortality taking into account the presence of spatial correlation. Bayesian zero inflated spatiotemporal models were able to detect hidden patterns within the data. Our main finding was that maternal orphans experienced a threefold greater risk of HIV/TB death compared to those with living mothers (AHR=2.93, 95% CI[1.29;6.93]). Risk factor analyses which adjust for person, place and time provide evidence for policy makers that includes a spatial distribution of risk. Child survival is dependent on the mother's survival; hence programs that promote maternal survival are critical.

Resumo Limpo

south africa experienc major burden hivtb use longitudin data agincourt subdistrict rural northeast south africa year total hivtb death observ among children age year come household paper use bayesian model assess risk factor child hivtb mortal take account presenc spatial correl bayesian zero inflat spatiotempor model abl detect hidden pattern within data main find matern orphan experienc threefold greater risk hivtb death compar live mother ahr ci risk factor analys adjust person place time provid evid polici maker includ spatial distribut risk child surviv depend mother surviv henc program promot matern surviv critic

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