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Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa
MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 7 York Road, Parktown 2193, Johannesburg, South Africa; Biostatistics and Epidemiology Division, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 7 York Road, Parktown 2193, Johannesburg, South Africa.
Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 7 York Road, Parktown 2193, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
2011 (English)In: Spatial and Spatio-temporal Epidemiology, ISSN 1877-5845, E-ISSN 1877-5853, Vol. 2, no 4, p. 205-217Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2011. Vol. 2, no 4, p. 205-217
Keywords [en]
Agincourt rural South Africa, HIV/TB, Over-dispersed, Spatiotemporal confounding, Zero inflated
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:umu:diva-215796DOI: 10.1016/j.sste.2011.07.001ISI: 000438424200001PubMedID: 22748220Scopus ID: 2-s2.0-82455168025OAI: oai:DiVA.org:umu-215796DiVA, id: diva2:1808114
Funder
Wellcome trustAvailable from: 2023-10-30 Created: 2023-10-30 Last updated: 2025-02-20Bibliographically approved

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Kahn, Kathleen

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