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1.
Malar J ; 17(1): 65, 2018 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-29402268

RESUMO

BACKGROUND: Malaria is one of the major causes of childhood death in sub-Saharan countries. A reliable estimation of malaria prevalence is important to guide and monitor progress toward control and elimination. The aim of the study was to estimate the true prevalence of malaria in children under five in the Democratic Republic of the Congo, Uganda and Kenya, using a Bayesian modelling framework that combined in a novel way malaria data from national household surveys with external information about the sensitivity and specificity of the malaria diagnostic methods used in those surveys-i.e., rapid diagnostic tests and light microscopy. METHODS: Data were used from the Demographic and Health Surveys (DHS) and Malaria Indicator Surveys (MIS) conducted in the Democratic Republic of the Congo (DHS 2013-2014), Uganda (MIS 2014-2015) and Kenya (MIS 2015), where information on infection status using rapid diagnostic tests and/or light microscopy was available for 13,573 children. True prevalence was estimated using a Bayesian model that accounted for the conditional dependence between the two diagnostic methods, and the uncertainty of their sensitivities and specificities obtained from expert opinion. RESULTS: The estimated true malaria prevalence was 20% (95% uncertainty interval [UI] 17%-23%) in the Democratic Republic of the Congo, 22% (95% UI 9-32%) in Uganda and 1% (95% UI 0-3%) in Kenya. According to the model estimations, rapid diagnostic tests had a satisfactory sensitivity and specificity, and light microscopy had a variable sensitivity, but a satisfactory specificity. Adding reported history of fever in the previous 14 days as a third diagnostic method to the model did not affect model estimates, highlighting the poor performance of this indicator as a malaria diagnostic. CONCLUSIONS: In the absence of a gold standard test, Bayesian models can assist in the optimal estimation of the malaria burden, using individual results from several tests and expert opinion about the performance of those tests.


Assuntos
Malária/epidemiologia , África Subsaariana/epidemiologia , Teorema de Bayes , Pré-Escolar , Humanos , Lactente , Prevalência , Estudos Retrospectivos
2.
Euro Surveill ; 22(38)2017 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-28935025

RESUMO

Salmonellosis, campylobacteriosis and listeriosis are food-borne diseases. We estimated and forecasted the number of cases of these three diseases in Belgium from 2012 to 2020, and calculated the corresponding number of disability-adjusted life years (DALYs). The salmonellosis time series was fitted with a Bai and Perron two-breakpoint model, while a dynamic linear model was used for campylobacteriosis and a Poisson autoregressive model for listeriosis. The average monthly number of cases of salmonellosis was 264 (standard deviation (SD): 86) in 2012 and predicted to be 212 (SD: 87) in 2020; campylobacteriosis case numbers were 633 (SD: 81) and 1,081 (SD: 311); listeriosis case numbers were 5 (SD: 2) in 2012 and 6 (SD: 3) in 2014. After applying correction factors, the estimated DALYs for salmonellosis were 102 (95% uncertainty interval (UI): 8-376) in 2012 and predicted to be 82 (95% UI: 6-310) in 2020; campylobacteriosis DALYs were 1,019 (95% UI: 137-3,181) and 1,736 (95% UI: 178-5,874); listeriosis DALYs were 208 (95% UI: 192-226) in 2012 and 252 (95% UI: 200-307) in 2014. New actions are needed to reduce the risk of food-borne infection with Campylobacter spp. because campylobacteriosis incidence may almost double through 2020.


Assuntos
Infecções por Campylobacter/epidemiologia , Efeitos Psicossociais da Doença , Listeriose/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Infecções por Salmonella/epidemiologia , Bélgica/epidemiologia , Infecções por Campylobacter/economia , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/microbiologia , Saúde Global , Humanos , Incidência , Listeriose/economia , Modelos Econômicos , Infecções por Salmonella/economia , Fatores de Tempo
3.
PLoS One ; 10(9): e0138143, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26398193

RESUMO

Executions in Texas from 1994-2005 do not deter homicides, contrary to the results of Land et al. (2009). We find that using different models--based on pre-tests for unit roots that correct for earlier model misspecifications--one cannot reject the null hypothesis that executions do not lead to a change in homicides in Texas over this period. Using additional control variables, we show that variables such as the number of prisoners in Texas may drive the main drop in homicides over this period. Such conclusions however are highly sensitive to model specification decisions, calling into question the assumptions about fixed parameters and constant structural relationships. This means that using dynamic regressions to account for policy changes that may affect homicides need to be done with significant care and attention.


Assuntos
Pena de Morte/estatística & dados numéricos , Homicídio/psicologia , Homicídio/estatística & dados numéricos , Humanos , Modelos Teóricos , Estações do Ano , Texas , Fatores de Tempo
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