4 results
Search Results
2. Model-based prediction of CD4 cells counts in HIV-infected adults on antiretroviral therapy in Northwest Ethiopia: A flexible mixed effects approach.
- Author
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Awoke Ayele, Tadesse, Worku, Alemayehu, Kebede, Yigzaw, Zuma, Khangelani, Kasim, Adetayo, and Shkedy, Ziv
- Subjects
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CD4 lymphocyte count , *EFAVIRENZ , *ANTIRETROVIRAL agents , *RANDOM effects model , *HUMAN research subjects , *MEDICAL research ethics , *THERAPEUTICS - Abstract
Background: CD4 cell counts is widely used as a biomarker for treatment progression when studying the efficacy of drugs to treat HIV-infected patients. In the past, it had been also used in determining eligibility to initiate antiretroviral therapy. The main aim of this was to model the evolution of CD4 counts over time and use this model for an early prediction of subject-specific time to cross a pre-specified CD4 threshold. Methods: Hospital based retrospective cohort study of HIV-infected patients was conducted from January 2009 to December 2014 at University of Gondar hospital, Northwest Ethiopia. Fractional polynomial random effect model is used to model the evolution of CD4 counts over time in response to treatment and to estimate the individual probability to be above a pre-selected CD4 threshold. Human subject research approval for this study was received from University of Gondar Research Ethics Committee and the medical director of the hospital. Results: A total of 1347 patients were included in the analysis presented in this paper. The cohort contributed a total of 236.58 per 100 person-years of follow-up. Later the data were divided into two periods: the first is the estimation period in which the parameters of the model are estimated and the second is the prediction period. Based on the parameters from the estimation period, model based prediction for the time to cross a threshold was estimated. The correlations between observed and predicted values of CD4 levels in the estimation period were 0.977 and 0.982 for Neverapine and Efavirenz containing regimens, respectively; while the correlation between the observed and predicted CD4 counts in the prediction period are 0.742 and 0.805 for NVP and EFV, respectively. Conclusions: The model enables us to estimate a subject-specific expected time to cross a CD4 threshold and to estimate a subject-specific probability to have CD4 count above a pre-specified threshold at each time point. By predicting long-term outcomes of CD4 count of the patients one can advise patient about the potential ART benefits that accrue in the long-term. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. Small area estimation of child undernutrition in Ethiopian woredas.
- Author
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Sohnesen, Thomas Pave, Ambel, Alemayehu Azeze, Fisker, Peter, Andrews, Colin, and Khan, Qaiser
- Subjects
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MALNUTRITION in children , *CHILDREN , *SOCIAL policy , *HEALTH surveys , *DATA analysis - Abstract
Reducing child undernutrition is a key social policy objective of the Ethiopian government. Despite substantial reduction over the last decade and a half, child undernutrition is still high; with 48 percent of children either stunted, underweight or wasted, undernutrition remains an important child health challenge. The existing literature highlights that targeting of efforts to reduce undernutrition in Ethiopia is inefficient, in part due to lack of data and updated information. This paper remedies some of this shortfall by estimating levels of stunting and underweight in each woreda for 2014. The estimates are small area estimations based on the 2014 Demographic and Health Survey and the latest population census. It is shown that small area estimations are powerful predictors of undernutrition, even compared to household characteristics, such as wealth and education, and hence a valuable targeting metric. The results show large variations in share of children undernourished within each region, more than between regions. The results also show that the locations with larger challenges depend on the chosen undernutrition statistic, as the share, number and concentration of undernourished children point to vastly different locations. There is also limited correlation between share of children underweight and stunted across woredas, indicating that different locations face different challenges. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
4. Production Efficiency and Market Orientation in Food Crops in North West Ethiopia: Application of Matching Technique for Impact Assessment.
- Author
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Ayenew, Habtamu Yesigat
- Subjects
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FOOD crops , *MARKET orientation , *FOOD production , *AGRICULTURAL technology , *AGRICULTURAL extension work - Abstract
Introduction: Agricultural technologies developed by national and international research institutions were not benefiting the rural population of Ethiopia to the extent desired. As a response, integrated agricultural extension approaches are proposed as a key strategy to transform the smallholder farming sector. Improving Productivity and Market Success (IPMS) of Ethiopian Farmers project is one of the development projects initiated by integrating productivity enhancement technological schemes with market development model. This paper explores the impact of the project intervention in the smallholder farmers’ wellbeing. Methods: To test the research hypothesis of whether the project brought a significant change in the input use, marketed surplus, efficiency and income of farm households, we use a cross-section data from 200 smallholder farmers in Northwest Ethiopia, collected through multi-stage sampling procedure. To control for self-selection from observable characteristics of the farm households, we employ Propensity Score Matching (PSM). We finally use Data Envelopment Analysis (DEA) techniques to estimate technical efficiency of farm households. Results: The outcome of the research is in line with the premises that the participation of the household in the IPMS project improves purchased input use, marketed surplus, efficiency of farms and the overall gain from farming. The participant households on average employ more purchased agricultural inputs and gain higher gross margin from the production activities as compared to the non-participant households. The non-participant households on average supply less output (measured both in monetary terms and proportion of total produce) to the market as compared to their participant counterparts. Except for the technical efficiency of production in potato, project participant households are better-off in production efficiency compared with the non-participant counterparts. Conclusion: We verified the idea that Improving Productivity and Market Success (IPMS) of Ethiopian farmers’ project has contributed for the input and out market integration and/or market oriented agricultural production. Overall, we argue that these can be seen as an experimental model with a promising potential to improve the livelihood of the poor. Furthermore, we suggest that it is worthwhile to employ integrated agricultural extension programs with further targeting in the developing world. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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