title: Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa.
abstract: 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.
authors: MRC/Wits Rural Public Health & 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. Eustasius.Musenge@wits.ac.za
authors: Eustasius
authors: E
authors: Musenge
authors: Penelope
authors: P
authors: Vounatsou
authors: Kathleen
authors: K
authors: Kahn
mesh_terms: D001499:Bayes Theorem; D046688:Child Mortality; D054540:Child, Orphaned; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003906:Developing Countries; D015658:HIV Infections / Q000150:complications / Q000401:mortality*; D006679:HIV Seropositivity / Q000401:mortality; D006801:Humans; D016867:Immunocompromised Host; D053208:Kaplan-Meier Estimate; D008432:Mathematical Computing; D011203:Poverty; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D013029:Space-Time Clustering; D062211:Spatio-Temporal Analysis; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000401:mortality*