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

Publication date: December 2011 Source:Spatial and Spatio-temporal Epidemiology, Volume 2, Issue 4 Author(s): Eustasius Musenge , Penelope Vounatsou , Kathleen Kahn 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 1–5years 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. Highlights ► Problem of Bayesian MCMC inversion of very large data in estimating the spatial random effects known as the “Big N”. ► Use of flexible exponential family link functions to exponential family predictors to avoid identifiability related problems. ► South Africa’s HIV/TB burden in children and efficient modeling thereof. ► Addresses space-time confou...
Source: Spatial and Spatio-temporal Epidemiology - Category: Epidemiology Source Type: research