Suchergebnisse

Child mortality is high in Sub-Saharan Africa compared to other regions in the world. In Kenya, the risk of mortality is assumed to vary from county to county due to diversity in socio-economic and even climatic factors. Recently, the country was split into 47 different administrative regions called counties, and health care was delegated to those county governments, further aggravating the spatial differences in health care from county to county. The goal of this study is to evaluate the effects of spatial variation in under-five mortality in Kenya. Data from the Kenya Demographic Health Survey (KDHS-2014) consisting the newly introduced counties was used to analyze this risk. Using a spatial Cox Proportional Hazard model, an Intrinsic Conditional Autoregressive Model (ICAR) was fitted to account for the spatial variation among the counties in the country while the Cox model was used to model the risk factors associated with the time to death of a child. Inference regarding the risk factors and the spatial variation was made in a Bayesian setup based on the Markov Chain Monte Carlo (MCMC) technique to provide posterior estimates. The paper indicate the spatial disparities that exist in the country regarding child mortality in Kenya. The specific counties have mortality rates that are county-specific, although neighboring counties have similar hazards for death of a child. Counties in the central Kenya region were shown to have the highest hazard of death, while those from the western region had the lowest hazard of death. Demographic factors such as the sex of the child and sex of the household head, as well as social economic factors, such as the level of education, accounted for the most variation when spatial differences were factored in. The spatial Cox proportional hazard frailty model performed better compared to the non-spatial non-frailty model. These findings can help the country to plan health care interventions at a subnational level and guide social and health policies by ensuring that counties with ...

Background: Prior reviews argue that unsafe sexual behaviors and poor HIV knowledge significantly increase the probability of acquiring HIV infections among adolescents. This study assessed the predictors of HIV prevention knowledge and sexual behaviors among Makerere university students in Uganda. Methods: We performed a cross-sectional survey. We performed a normality test using Shapiro Wilk test on knowledge score. Results revealed that knowledge score was not normally distributed. The study used two sample Wilcoxon Rank Sum and Kruskal Wallis Rank tests to assess the effect of HIV knowledge on demographic characteristics and sexual behaviors. Post-hoc tests were conducted using Bonferroni correction. Spearman rank correlation test was used for continuous variables while Chi-square and Fisher's tests were used for categorical variables to assess the relationship between demographic characteristics and sexual behaviors. Results: We report results for 1337 students. The mean age was 21.2SD (1.6) and more than half 700(52.4%) were male students. The median HIV prevention knowledge score of students was 13 IQR (11-15) in the range of 0 to 18. Males significantly scored higher than females (13.0 IQR (12-15) vs. 12.0 IQR (10-14) p=0.000), an increase in age was associated with higher knowledge scores (Rho = 0.101, p = 0.000). Students in the third year of study significantly scored higher than those in the first year, and government-sponsored students scored higher than the privately sponsored students. HIV knowledge was also significantly associated with sexual experience, and condom use at univariate level but insignificant at multiple level analysis. Males were more likely to have ever had sex (31.7% vs. 12.7%) and ever used a condom (63% vs. 55%) than females respectively Conclusion: Our findings suggest that Makerere University students possessed good knowledge on HIV. There is evidence of an association between student's knowledge, and demographic characteristics and a few sexual behaviors. Future behavioral and educational programs that target both sexually and non-sexually experienced students should address the gender differences.