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Nevin Manimala Statistics

Risky sexual practice and associated factors among people living with HIV/AIDS receiving antiretroviral therapy in Ethiopia: Systematic review and meta-analysis

PLoS One. 2022 Apr 14;17(4):e0266884. doi: 10.1371/journal.pone.0266884. eCollection 2022.

ABSTRACT

BACKGROUND: The risky sexual behavior of people living with HIV/AIDS (PLWHA) may impose a risk of transmitting the disease to their partners and increase Human Immunodeficiency Virus (HIV) co-infection. This systematic review and meta-analysis aimed to determine the pooled prevalence of risky sexual behavior and associated factors among PLWHA receiving [Antiretroviral Therapy (ART)] in Ethiopia.

METHODS: To identify both published and unpublished research articles, systematic searches were performed in PubMed, HINARI, Medline, Science Direct, and Google Scholar databases. The review was carried out following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. Cross-sectional studies reporting the prevalence of risky sexual practice and its associated factors among PLWHA receiving ART in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format prepared in Microsoft Excel and exported to STATA version 14 statistical software for further analyses. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Since the included studies exhibited considerable heterogeneity, the random-effects meta-analysis model was computed to estimate the pooled prevalence of risky sexual practice which was determined by dividing the total number of PLWHA with risky sexual practice practices by the total number of PLWHA on ART in the study and multiplied by 100. Furthermore, pooled odds ratio (OR) with 95% confidence interval (CI) was determined for the association between determinant factors and risky sexual practice.

RESULT: In this study, 2351 articles were identified from different databases, and fifteen articles were selected for final systematic review and meta-analysis. In Ethiopia, the pooled prevalence of risky sexual practices was 43.56% (95% confidence interval (CI):35.51, 51.62). Discussion about safe sex with sexual partner/s [AOR = 0.26, 95% CI: 0.08, 0.92] and having multiple sexual partners [AOR = 1.90, 95% CI: 0.53, 6.84] were factors significantly associated with risky sexual practice in Ethiopia.

CONCLUSION: A significant proportion of respondents engaged in risky sexual practices. Multiple sexual partners and a lack of discussion about safe sex are linked to a higher prevalence of the risky sexual practice in Ethiopia. It is critical to raise awareness about safe sexual practices during health education and counselling services and to encourage clients to freely discuss safer sex practices with their sexual partner/s at their antiretroviral therapy (ART) appointments as part of their follow-up care.

PROTOCOL REGISTRATION: The protocol for this systematic review and meta-analysis was registered at PROSPERO (record ID = CRD42021274600, 25 September 2021).

PMID:35421163 | DOI:10.1371/journal.pone.0266884

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Nevin Manimala Statistics

Bayesian interval estimations for the mean of delta-three parameter lognormal distribution with application to heavy rainfall data

PLoS One. 2022 Apr 14;17(4):e0266455. doi: 10.1371/journal.pone.0266455. eCollection 2022.

ABSTRACT

Flash flooding is caused by heavy rainfall that frequently occurs during a tropical storm, and the Thai population has been subjected to this problem for a long time. The key to solving this problem by planning and taking action to protect the population and infrastructure is the motivation behind this study. The average weekly rainfall in northern Thailand during Tropical Storm Wipha are approximated using interval estimations for the mean of a delta-three parameter lognormal distribution. Our proposed methods are Bayesian confidence intervals-based noninformative (NI) priors (equal-tailed and highest posterior density (HPD) intervals based on NI1 and NI2 priors). Our numerical evaluation shows that the HPD-NI1 prior was closer to the nominal confidence level and possessed the narrowest expected length when the variance was small-to-medium for a large threshold. The efficacy of the methods was illustrated by applying them to weekly natural rainfall data in northern Thailand to examine their abilities to indicate flooding occurrence.

PMID:35421161 | DOI:10.1371/journal.pone.0266455

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Obesity among type 2 diabetes mellitus at Sidama Region, Southern Ethiopia

PLoS One. 2022 Apr 14;17(4):e0266716. doi: 10.1371/journal.pone.0266716. eCollection 2022.

ABSTRACT

BACKGROUND: Type 2 diabetes is becoming highly prevalent worldwide and it is one of the leading causes of mortality. The cause of mortality among these patients is mostly related to the dominant presence of modifiable cardiovascular risk factors such as obesity. The aim of the current study is therefore to determine the prevalence of obesity and its associated factors among patients with type 2 diabetes mellitus at Sidama region, Ethiopia.

METHOD: Institution-based cross-sectional study design was implemented to determine the prevalence of obesity and its associated factor among patients with type two diabetes at Hawassa University Comprehensive Specialized Hospital and Yirgalem General Hospital from October 16 2018 to December 21, 2018. A simple random sampling technique was implemented to select 314 study participants. After obtaining consent, different patients’ related data were collected using a questionnaire. Patients’ records were also reviewed. 4ml of the blood sample was collected from each study participant and analyzed for lipid profile test. Blood glucose level was done using COBAS INTEGRA 6000. A binary logistic regression was used to assess factors that have an association with obesity. A P-value of <0.05 was considered statistically significant.

RESULT: The majority of the study participants (67.2%) were male and 61.8% of the study participants were aged >45years. The overall prevalence of overweight and obesity among the study participants was 36.3% and 18.8% respectively. About 41% of the study participants have a normal BMI. Females were more obese (28.2% Vs 14.2%) than males and BMI stratification by sex was statistically significant (P = 0.02). Sex (AOR = 3.0, CI = 1.6-5.7, P-Value = 0.001) and TG (AOR = 3.6, CI = 1.6-8.3, P-Value = 0.003) are factors that were independently associated with obesity among type 2 DM patients.

CONCLUSION: Overweight and obesity among type two diabetic patients were prevalent. In addition, obesity and overweight disorder are common among T2DM and gender and triglycerides levels were associated with obesity.

PMID:35421153 | DOI:10.1371/journal.pone.0266716

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Nevin Manimala Statistics

Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis

PLoS One. 2022 Apr 14;17(4):e0264559. doi: 10.1371/journal.pone.0264559. eCollection 2022.

ABSTRACT

BACKGROUND: Worldwide, diarrhea is the second most common cause of death and morbidity among under -five years’ children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years’ children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea.

METHODS: This study utilized secondary data from 12 East African countries’ most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors.

RESULTS: The pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15-24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25-34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7-12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12-24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25-59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases.

CONCLUSION: The pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child’s age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.

PMID:35421129 | DOI:10.1371/journal.pone.0264559

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Health economic evaluation of noninvasive prenatal testing and serum screening for down syndrome

PLoS One. 2022 Apr 14;17(4):e0266718. doi: 10.1371/journal.pone.0266718. eCollection 2022.

ABSTRACT

BACKGROUND: Down syndrome (DS), also known as trisomy 21 (T21), is the most common genetic disorder associated with intellectual disability. There are two methods commonly used for prenatal testing of DS: serum screening (SS) for biomarkers in maternal serum and noninvasive prenatal testing (NIPT) for aneuploidy by cell-free DNA (cfDNA) in maternal plasma. However, cost-effectiveness analyses of these two methods are mostly based on data derived from simulations with various models, with theoretical values calculated. In this study, we statistically analyzed clinical DS screening data and pregnancy outcomes during the follow-up of pregnant women in Zhuhai City, China. The economics of the two mainstream prenatal DS screening methods was evaluated from a public health perspective.

METHODS: A retrospective analysis was performed on the data of 17,363 pregnant women who received SS and NIPT during gestation in Zhuhai from 2018 to 2019, and a cost-effectiveness analysis was performed with four screening strategies. In strategy I, all pregnant women received SS, and those with T21 risk ≥1/270 had invasive prenatal diagnosis (IPD). In strategy II, all pregnant women received SS, those with T21 risk ≥ 1/270 had IPD, and those with 1/270 > T21 risk ≥ 1/1,000 had NIPT; then, women at high risk based on NIPT also had IPD. In strategy III, all pregnant women received SS, and those with T21 risk ≥1,000 had NIPT; then, women at high risk based on NIPT results had IPD. In strategy IV, all pregnant women received NIPT and those at high risk based on NIPT results had IPD. Finally, to assess the cost and effectiveness of DS screening, the total costs were calculated as the sum of screening and diagnosis as well as the direct and indirect economic burden during the average life cycle of DS patients.

RESULTS: A total of 22 of the 17,363 (1/789) pregnant women had DS, of which only one woman was over 35 years of age. SS detected 1,024 cases at high risk of T21 (≥1/270), 8 cases were true positive, with a positive predictive value of 0.78% and a detection rate of 36.4%. NIPT detected 27 cases at high risk of T21 (Z ≥ 3) and 22 cases of DS, with a positive predictive value of 81.5% and a detection rate of 100%. Strategy I had the largest total cost of 65.54 million CNY, strategy II and III had similar total costs of 40 million CNY, and strategy IV had the lowest total cost of 14.91 million CNY. By comparison, the screening strategy with NIPT alone had the highest health economic value for DS.

CONCLUSIONS: SS was greatly affected by nuchal translucency and the accuracy of gestational age measured by ultrasonography. Unstandardized ultrasonography was an important reason for the low DS detection rate with SS. The influence of interfering factors on NIPT was much lower than in SS. NIPT can be used as an alternative to SS and as a primary screening strategy of prenatal DS screening for secondary prevention and control of birth defects. NIPT greatly decreased the frequency of IPD and the miscarriages associated with IPD, saved the limited medical and health resources, and greatly increased DS detection rate. Therefore, NIPT has great social and economic benefits.

PMID:35421148 | DOI:10.1371/journal.pone.0266718

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Nevin Manimala Statistics

Performance of COVID-19 case-based surveillance system in FCT, Nigeria, March 2020 -January 2021

PLoS One. 2022 Apr 14;17(4):e0264839. doi: 10.1371/journal.pone.0264839. eCollection 2022.

ABSTRACT

INTRODUCTION: The emergence of novel SARS-CoV-2 has caused a pandemic of Coronavirus Disease 19 (COVID-19) which has spread exponentially worldwide. A robust surveillance system is essential for correct estimation of the disease burden and containment of the pandemic. We evaluated the performance of COVID-19 case-based surveillance system in FCT, Nigeria and assessed its key attributes.

METHODS: We used a cross-sectional study design, comprising a survey, key informant interview, record review and secondary data analysis. A self-administered, semi-structured questionnaire was administered to key stakeholders to assess the attributes and process of operation of the surveillance system using CDC’s Updated Guidelines for Evaluation of Public Health Surveillance System 2001. Data collected alongside surveillance data from March 2020 to January 2021 were analyzed and summarized using descriptive statistics.

RESULTS: Out of 69,338 suspected cases, 12,595 tested positive with RT-PCR with a positive predictive value (PPV) of 18%. Healthcare workers were identified as high-risk group with a prevalence of 23.5%. About 82% respondents perceived the system to be simple, 85.5% posited that the system was flexible and easily accommodates changes, 71.4% reported that the system was acceptable and expressed willingness to continue participation. Representativeness of the system was 93%, stability 40%, data quality 56.2% and timeliness 45.5%, estimated result turnaround time (TAT) was suboptimal.

CONCLUSION: The system was found to be useful, simple, flexible, sensitive, acceptable, with good representativeness but the stability, data quality and timeliness was poor. The system meets initial surveillance objectives but rapid expansion of sample collection and testing sites, improvement of TAT, sustainable funding, improvement of electronic database, continuous provision of logistics, supplies and additional trainings are needed to address identified weaknesses, optimize the system performance and meet increasing need of case detection in the wake of rapidly spreading pandemic. More risk-group persons should be tested to improve surveillance effectiveness.

PMID:35421123 | DOI:10.1371/journal.pone.0264839

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Isolation and optimization of extracellular PHB depolymerase producer Aeromonas caviae Kuk1-(34) for sustainable solid waste management of biodegradable polymers

PLoS One. 2022 Apr 14;17(4):e0264207. doi: 10.1371/journal.pone.0264207. eCollection 2022.

ABSTRACT

Bioplastics, synthesized by several microbes, accumulates inside cells under stress conditions as a storage material. Several microbial enzymes play a crucial role in their degradation. This research was carried to test the biodegradability of poly-β-hydroxybutyrate (PHB) utilizing PHB depolymerase, produced by bacteria isolated from sewage waste soil samples. Potent PHB degrader was screened based on the highest zone of hydrolysis followed by PHB depolymerase activity. Soil burial method was employed to check their degradation ability at different incubation periods of 15, 30, and 45 days at 37±2°C, pH 7.0 at 60% moisture with 1% microbial inoculum of Aeromonas caviae Kuk1-(34) (MN414252). Without optimized conditions, 85.76% of the total weight of the PHB film was degraded after 45 days. This degradation was confirmed with Fourier-transform infrared spectroscopy (FTIR) and Scanning electron microscope (SEM) analysis. The presence of bacterial colonies on the surface of the degraded film, along with crest, holes, surface erosion, and roughness, were visible. Media optimization was carried out in statistical mode using Plackett Burman (PB) and Central Composite Design (CCD) of Response Surface Methodology (RSM) by considering ten different factors. Analysis of Variance (ANOVA), Pareto chart, response surface plots, and F-value of 3.82 implies that the above statistical model was significant. The best production of PHB depolymerase enzyme (14.98 U/mL) was observed when strain Kuk1-(34) was grown in a media containing 0.1% PHB, K2HPO4 (1.6 gm/L) at 27 ℃ for seven days. Exploiting these statistically optimized conditions, the culture was found to be a suitable candidate for the management of solid waste, where 94.4% of the total weight of the PHB film was degraded after 45 days of incubation.

PMID:35421107 | DOI:10.1371/journal.pone.0264207

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Dissecting recurrent waves of pertussis across the boroughs of London

PLoS Comput Biol. 2022 Apr 14;18(4):e1009898. doi: 10.1371/journal.pcbi.1009898. Online ahead of print.

ABSTRACT

Pertussis has resurfaced in the UK, with incidence levels not seen since the 1980s. While the fundamental causes of this resurgence remain the subject of much conjecture, the study of historical patterns of pathogen diffusion can be illuminating. Here, we examined time series of pertussis incidence in the boroughs of Greater London from 1982 to 2013 to document the spatial epidemiology of this bacterial infection and to identify the potential drivers of its percolation. The incidence of pertussis over this period is characterized by 3 distinct stages: a period exhibiting declining trends with 4-year inter-epidemic cycles from 1982 to 1994, followed by a deep trough until 2006 and the subsequent resurgence. We observed systematic temporal trends in the age distribution of cases and the fade-out profile of pertussis coincident with increasing national vaccine coverage from 1982 to 1990. To quantify the hierarchy of epidemic phases across the boroughs of London, we used the Hilbert transform. We report a consistent pattern of spatial organization from 1982 to the early 1990s, with some boroughs consistently leading epidemic waves and others routinely lagging. To determine the potential drivers of these geographic patterns, a comprehensive parallel database of borough-specific features was compiled, comprising of demographic, movement and socio-economic factors that were used in statistical analyses to predict epidemic phase relationships among boroughs. Specifically, we used a combination of a feed-forward neural network (FFNN), and SHapley Additive exPlanations (SHAP) values to quantify the contribution of each covariate to model predictions. Our analyses identified a number of predictors of a borough’s historical epidemic phase, specifically the age composition of households, the number of agricultural and skilled manual workers, latitude, the population of public transport commuters and high-occupancy households. Univariate regression analysis of the 2012 epidemic identified the ratio of cumulative unvaccinated children to the total population and population of Pakistan-born population to have moderate positive and negative association, respectively, with the timing of epidemic. In addition to providing a comprehensive overview of contemporary pertussis transmission in a large metropolitan population, this study has identified the characteristics that determine the spatial spread of this bacterium across the boroughs of London.

PMID:35421101 | DOI:10.1371/journal.pcbi.1009898

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Biosecurity in an age of open science

PLoS Biol. 2022 Apr 14;20(4):e3001600. doi: 10.1371/journal.pbio.3001600. eCollection 2022 Apr.

ABSTRACT

The risk of accidental or deliberate misuse of biological research is increasing as biotechnology advances. As open science becomes widespread, we must consider its impact on those risks and develop solutions that ensure security while facilitating scientific progress. Here, we examine the interaction between open science practices and biosecurity and biosafety to identify risks and opportunities for risk mitigation. Increasing the availability of computational tools, datasets, and protocols could increase risks from research with misuse potential. For instance, in the context of viral engineering, open code, data, and materials may increase the risk of release of enhanced pathogens. For this dangerous subset of research, both open science and biosecurity goals may be achieved by using access-controlled repositories or application programming interfaces. While preprints accelerate dissemination of findings, their increased use could challenge strategies for risk mitigation at the publication stage. This highlights the importance of oversight earlier in the research lifecycle. Preregistration of research, a practice promoted by the open science community, provides an opportunity for achieving biosecurity risk assessment at the conception of research. Open science and biosecurity experts have an important role to play in enabling responsible research with maximal societal benefit.

PMID:35421093 | DOI:10.1371/journal.pbio.3001600

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Bidirectional flow of MHD nanofluid with Hall current and Cattaneo-Christove heat flux toward the stretching surface

PLoS One. 2022 Apr 14;17(4):e0264208. doi: 10.1371/journal.pone.0264208. eCollection 2022.

ABSTRACT

Vacuum pump oil (VPO) is used as a lubricant in pumps of different machines. The rate of heat transport is a fundamental requirement of all phenomena. To enhance the rate of heat transmission and reduce the amount of energy consumed as a result of high temperatures. For this reason, the vacuum pump oil (VPO) is taken as a base fluid and Fe3O4 is the nanoparticles suspended in VPO. That’s why, the present study inspected the consequence of Hall current, Joule heating effect and variable thickness on these three-dimensional magnetohydrodynamics bidirectional flow of nanoliquid past on a stretchable sheet. Further, the Cattaneo-Christove heat flux and radiation impacts are also considered. The VPO-Fe3O4 nanofluid model is composed of momentum equations in x-direction, y-direction and temperature equations. The leading higher-order non-linear PDEs of the current study have been changed into non-linear ODEs with the implementation of appropriate similarity transformations. The procedure of the homotopy analysis method is hired on the resulting higher-order non-linear ODEs along with boundary conditions for the analytical solution. The significance of distinct flow parameters on the velocities in x-direction, y-direction and temperature profiles of the nanofluid have been encountered and briefly explained in a graphical form. Some important findings of the present modelling are that with the increment of nanoparticles volume fraction the nanofluid velocities in x-direction and y-direction are increased. It is also detected that higher estimations of magnetic field parameter, Prandtl number and thermal relaxation time parameter declined the nanofluid temperature. During this examination of the model, it is found that the Fe3O4-Vacuum pump oil (VPO) nanofluid enhanced the rate of heat transfer. Also, the vacuum pump oil (VPO) has many industrial and engineering applications. The current study will help to improve the rate of heat transmission by taking this into account due to which working machines will do better performance and the loss of useful energy will be decayed. Lastly, the skin friction coefficient and Nusselt number are also illustrated in a tabular form. Some major findings according to the numerical computation of the problem are that the enhancing estimations of magnetic parameter, nanoparticles volume fraction and wall thickness parameter augmented the skin friction coefficient in x-direction and Nusselt number. The reduction in skin friction coefficient of the nanofluid in y-direction is examined for Hall current and shape parameter.

PMID:35421096 | DOI:10.1371/journal.pone.0264208