Modelling Factors that Predict Differences in Childhood Mortality in Lagos Communities Using Prognostic Logistic and Poisson Regression Models

W. Akanji, R. Kareem, J. A. Akinyemi, M. Ekum
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Abstract

Lagos State is a city with one of the largest concentration of people in the world with heterogenous behaviour and cultural beliefs. There are different prognostic models in the medical sciences, yet their real life application, especially to childhood mortality is limited. There are variations in childhood mortality rate across different communities in Lagos State. Childhood mortality is a subject of interest to World Health Organization (WHO) and one of the major Millennium Development Goals. In 2014, the Special Adviser to the Lagos State Governor on Public Health, Dr. Yewande Adeshina said that under-5 and infant mortality rates in Lagos state have reduced due to various health interventions being implemented in the State. However, the truth of the matter is that childhood mortality is still high and this is an indication that we still have lots of work to do in this regard. In this paper, prognostic models were used in modelling factors that predict the differences in childhood mortality in Lagos communities. Six models, two each from logistic regression, linear regression and Poisson regression models were used. Primary data were collected from mothers that fall in the age bracket (15-49), who reside in any of the 5 divisions of Lagos State, namely Ikorodu, Badagry, Lagos Mainland/Ikeja, Lagos Island and Epe. Five variables were identified as covariates. The prognostic multi-variable models were employed. The binary logistic regression model with 5 covariates was selected as the best model for the binary response variable, while the Poisson regression model with 4 covariates was selected as the best model for the count response variable. At the end of the research, Ikorodu, Badagry and Epe communities have higher than expected childhood mortality rates. Also, we estimated childhood mortality rate in Lagos State and measured the variations in childhood mortality across Lagos communities. The factors that predict these variations were detected and control measures were recommended to reduce the difference in childhood mortality rate in Lagos State.
利用预测性 Logistic 和泊松回归模型对拉各斯社区儿童死亡率差异的预测因素进行建模
拉各斯州是世界上人口最集中的城市之一,人们的行为和文化信仰各不相同。医学界有各种不同的预后模型,但它们在现实生活中的应用,尤其是在儿童死亡率方面的应用却很有限。拉各斯州不同社区的儿童死亡率存在差异。儿童死亡率是世界卫生组织(WHO)关注的问题,也是主要的千年发展目标之一。2014 年,拉各斯州州长公共卫生特别顾问 Yewande Adeshina 博士表示,由于拉各斯州实施了各种卫生干预措施,该州 5 岁以下儿童和婴儿死亡率有所下降。然而,事实是儿童死亡率仍然很高,这表明我们在这方面还有很多工作要做。本文使用预后模型来模拟预测拉各斯社区儿童死亡率差异的因素。本文使用了六个模型,其中逻辑回归模型、线性回归模型和泊松回归模型各两个。本文从居住在拉各斯州五个分区(即伊科罗杜、巴达格里、拉各斯大陆/伊克贾、拉各斯岛和埃佩)中任何一个分区的 15-49 岁年龄段的母亲那里收集了原始数据。五个变量被确定为协变量。采用了预后多变量模型。对于二元响应变量,有 5 个协变量的二元逻辑回归模型被选为最佳模型,而对于计数响应变量,有 4 个协变量的泊松回归模型被选为最佳模型。研究结束时,伊科罗杜、巴达格里和埃佩社区的儿童死亡率高于预期。此外,我们还估算了拉各斯州的儿童死亡率,并测量了拉各斯各社区儿童死亡率的差异。我们发现了预测这些差异的因素,并建议采取控制措施来减少拉各斯州儿童死亡率的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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