Ordinal Regression Modeling of Mother to Infant HIV Transmission in Nyeri County, Kenya
International Journal of Data Science and Analysis
Volume 6, Issue 5, October 2020, Pages: 145-152
Received: Sep. 30, 2020;
Accepted: Oct. 20, 2020;
Published: Oct. 23, 2020
Views 180 Downloads 67
Agnes Njoki, Department of Statistics and Actuarial Science, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
Anthony Wanjoya, Department of Statistics and Actuarial Science, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
Antony Waititu, Department of Statistics and Actuarial Science, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
The transmission rates of HIV from a HIV-positive mother to her child during pregnancy, delivery or breastfeeding remains of much concern. Various governments and non-governmental organizations have aimed at coming up with policies aimed at minimizing the transmissions. For this to be achievable, there is a need for sound statistical procedures in the analysis of the mother to infant HIV transmission data. The study gives an application of the ordinal regression to the modeling of such data, a case of Nyeri County-Kenya. The logistic regression has been described as the best methodology for modeling binary response variables. However it does not provide a best fit for an ordered categorical variable with more than two categories. This calls for the extensions of the logistic regression which can be used when modeling such kind of variables, such an extension is the ordinal regression methodology. This study proposes the use of the ordinal regression methodology with probit and logit link functions to model infant feeding, arv regimen, maternal cell count and maternal viral load effect on mother to infant HIV transmission in Nyeri county, Kenya a case of Karatina sub-county referral hospital. An aspect of the ordinal link models, which can be useful for this implementation is particularly emphasized as it is in their interpretation that the classes of the dependent variable can be considered from the partition of the variation interval of an underlying continuous random variable. Data to be used shall be secondary data collected from Karatina sub-county referral hospital. Inference on parameters and model diagnostics is also provided.
Ordinal Regression Modeling of Mother to Infant HIV Transmission in Nyeri County, Kenya, International Journal of Data Science and Analysis.
Vol. 6, No. 5,
2020, pp. 145-152.
Kahungu, M. M., Kiwanuka, J., Kaharuza, F. & Wanyenze, R. K. (2018). Factors associated with HIV positive sero-status among exposed infants attending care at health facilities: A cross sectional study in rural Uganda. BMC Public Health; 18 (139). doi: 10.1186/s12889-018-5024-6.
Adler, C., Haelterman, E., Barlow, P., Marchant, A., Levy, J. & Goetghebuer, T. (2015). Severe Infections in HIV-Exposed Uninfected Infants Born in a European Country. PLoS ONE; 10 (8). doi: 10.1371/journal.pone.0135375.
Fondoh, V. N. & Mom, N. A. (2017) Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at the Bamenda Regional Hospital, Cameroon. Africa. Afr J Lab Med; 6 (1). doi: 10.4102/ajlm.v6i1.589.
Rutagwera, David & Molès, jean-pierre & Kankasa, Chipepo & Mwiya, Mwiya & Tuaillon, Edouard & Peries, Marianne & Nagot, Nicolas & Van de Perre, Philippe & Tylleskär& Thorkild. (2019). Prevalence and determinants of HIV shedding in breast milk during continued breastfeeding among Zambian mothers not on antiretroviral treatment (ART): A cross-sectional study. Medicine; 98 (44). doi: 10.1097/MD.0000000000017383.
Manji, Karim & Duggan, Christopher & Liu, Enju & Bosch, Ronald & Kisenge, Rodrick & Aboud, Said & Kupka, Ronald & Fawzi & Wafaie. (2016). Exclusive Breast-feeding Protects against Mother-to-Child Transmission of HIV-1 through 12 Months of Age in Tanzania. Journal of Tropical Pediatrics; 62 (4). doi: 10.1093/tropej/fmw012.
Potty, Rajaram & Sinha, Anju & Sethumadhavan, Rajeev & Isac, Shajy & Washington, Reynold. (2019). Incidence, prevalence and associated factors of mother-to-child transmission of HIV, among children exposed to maternal HIV, in Belgaum district, Karnataka, India. BMC Public Health; 19 (386). doi: 10.1186/s12889-019-6707-3.
Lumbanraja, S. N. & Sanusi, S. R. (2016) Triple antiretroviral therapy effectively eliminates HIV transmission from mother to child. International Journal of Pharm Tech Research; 9 (11), 68-71.
Obsa, Siyum & Dabsu, Regea & Ejeta & Eyasu (2018). Rate of mother to child transmission of HIV and factors associated among HIV exposed infants in OromiaRegional State, Ethiopia: Retrospective study. Egyptian Pediatric Association Gazette; 66 (3), 61-65. doi: 10.1016/j.epag.2018.07.002.
Mugwaneza, P., Lyambabaje, A., Umubyeyi, A., Humuza, J., Tsague, L., Mwanyumba, F., Mutabazi, V., Nsanzimana, S., Ribakare, M., Irakoze, A. A., Mutaganzwa, E., Lombard, C., & Jackson, D. (2018). Impact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwanda. BMC Public Health; 18 (1248).
Thomas, T. K., Masaba, R., Borkowf, C. B., Ndivo, R., Zeh, C., Misore, A., Otieno, J., Jamieson, D., Thigpen, M. C., Bulterys, M., Slutsker, L., De Cock, K. M., Amornkul, P. N., Greenberg, A. E., Fowler, M. G. & KIBS Study Team (2011). PLoS Med; 8 (3). doi: 10.1371/journal.pmed.1001015.
Lang’at, Purity & Ogada, Irene & Steenbeek, Audrey & Macdonald, Noni & Ochola, Sophie & Bor, Wesley & Odinga, Godfrey. (2018). Infant feeding practices among HIV-exposed infants less than 6 months of age in Bomet County, Kenya: An in-depth qualitative study of feeding choices. Archives of Disease in Childhood; 103 (5). doi: 10.1136/archdischild-2017-314521.
Nyamagoudar, A., Mruthyunjaya, S., Murugesh, P. & Banapurmath, C. R. (2016). Study on impact of maternal CD4 count on birth outcomes and mother to child transmission of HIV infection. IJCMPH; 3 (8), 2083-2087.
Izudi, J., Apangu, P., Bajunirwe, F., Mulogo, E. & Batwala, V. (2018). High Baseline CD4 Count and Exclusive Breastfeeding Are Associated with Lower Rates of Mother to Child HIV Transmission in Northwestern Uganda: A Two-Year Retrospective Cohort Study. Advances in Public Health; 2018 (4140254).
Railer, H., Kurt, H. & Laura, V. (2019). Multivariate Ordinal Regression Models: An analysis of Corporate Credit Ratings. Statistical Methods and Applications, 2019 (28), 507-539. doi: 10.1007/s10260-018-00437-7.
Liang, J., Bi, G. & Zhan, C. (2020). Multinomial and Ordinal Logistic Regression analyses with Multi-Categorical Variables using R. Ann Transl Med; 8 (16), 982. doi: 10.21037/atm-2020-57.
Blais, P., Sirivar, S. & Seto, S. (2019). Supporting implementation research to improve coverage and uptake of HIV related interventions. Journal of Acquired Immune Deficiency Syndromes Supplement, 75; 109-110. doi: 10.1097/QAI.0000000000001365.
Alison, L. D., Kerry, A. T., Caitlin, Q., Morkor, N. O., Nuwagira, I. B., Chitembo, L., Shaffiq, E., Baggaley, R. & Cheryl, C. J. (2019). Retest and treat: a review of national HIV testing guidelines to inform elimination of mother-to-child HIV transmission (EMTCT) efforts. Journal of International AIDS Society, 2019 (22). Doi: 10.1002/jia2.25271.
Kenya Population-based HIV Impact Assessment (2018). National AIDS and STI Control Programme (NASCOP), Ministry of Health, Kenya. Http://www.nascop.or.ke.