[Show abstract][Hide abstract] ABSTRACT: Orphanhood is a vast problem in the world with impacts on the social and public health sectors. Evidence-based information on the geographic distribution of orphans is an important information gap in Nepal. The present study aimed to identify the proportion of children who are orphans and their geographic distribution in Nepal. This study used the population subset of 0-17 year olds from the nationally representative Demographic and Health Survey (DHS) 2011, Nepal. The Generalized Estimating Equations (GEE) method was used while fitting a logistic regression model to adjust for the correlation among children in the same household. The result was adjusted for age and sex of a child and wealth index of the household. The analysis was further stratified by age groups. Of the total 21,484 children, 1,142 (5.3%) were orphaned. Among the 13 sub-regions, Western Mountain and Eastern Terai had higher and Central Hill had lower proportions of orphan children than the overall mean. However, the results differed in age-stratified analysis. The study also explored possible factors related to orphanhood: poverty and famine, conflict and displacement, a high adult mortality related to HIV/AIDS and maternal causes. In conclusion, the distribution of orphan children in households was found to vary by sub-regions. Therefore, orphan welfare programmes should be focused on those regions with higher proportions of orphans.
Pertanika Journal of Social Science and Humanities 08/2015; 23(3):711-724.
[Show abstract][Hide abstract] ABSTRACT: Children’s living arrangement plays a crucial role on their physical, emotional as well as social development. This study aimed to examine the living arrangement of children (both orphan & non-orphan) based on a nationally representative Nepal Demographic and Health Survey (NDHS) 2006 and 2011. This study used total sample of 0-17 years children consist of 19 935 and 20 808 respectively in 2006 and 2011 survey. The survey package in statistical software R was used to analyze the data. Chi-square test and logistic regression model were employed as statistical tools. Of the total children, 5% (95% CI, 4.7-6.0) in 2006 and 5.3% (95% CI, 4.5-5.5) in 2011were orphans. The number of paternal orphans almost doubled the number of maternal orphans in both surveys. Furthermore, approximately 7% (95% CI, 6.2-8.1) of the children lived apart from their biological parents in both surveys. This study also found that about one quarter of the children, representing 23.5% (95% CI, 21.4-25.7) in 2006 and 28.7% (95% CI, 26.8-30.6) in 2011 were living only with their biological mother. The multivariate analysis found that orphans were more likely to reside in poorest households, in households having no or unrelated adult, in female headed and more than50 year age group headed households. In conclusion, the proportion of children living with both parents had slightly decreased, whereas those living with mother had slightly increased over the time. The living arrangement in relation to household level characteristics between orphans and non-orphans was significantly varied.
Asian Social Science 04/2015; 11(12). DOI:10.5539/ass.v11n12p84
[Show abstract][Hide abstract] ABSTRACT: Tuberculosis (TB) is an important public health problem in Nepal. The aim of this study was to investigate the spatial and temporal variations in TB incidence in Nepal. Data regarding TB cases were obtained from the Nepal National Tuberculosis Center (NTC) for 2003-2010 and analyzed. Models were developed for TB incidence by gender, year and location using linear regression of log-transformed incidence rates. Apart from a relatively small number of outliers, these models provided a good fit, as indicated by residual plots and the r-squared statistic (0.94). The overall incidence of TB was 1.31 cases per 1,000 population with a male to female incidence rate ratio of 1.83. There were trends of increasing incidence in TB for recent years among both sexes. There were marked variations by location with higher rates occurring in the Terai region and relatively moderate and low rates of TB in the Hill and Mountain regions, respectively. TB incidence was also higher in the capital city Kathmandu and other metropolitan cities. A log-linear regression model can be used as a simple method to model TB incidence rates that vary by location and year. These findings provide information for health authorities to help establish effective prevention programs in specific areas where the disease burden is relatively high.
The Southeast Asian journal of tropical medicine and public health 06/2014; 45(1):95-102. · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to examine factors associated with treatment outcome of multidrug-resistant tuberculosis (MDR-TB) cases in Nepal. A retrospective analysis of MDR-TB cases by demographic determinants and treatment was conducted. A total of 494 MDR-TB cases were registered from 2005 to 2008, with data obtained from the National Tuberculosis Center. Chi-squared tests were used to assess statistically the association between smear and culture conversion and treatment outcome. Determinants were analyzed with the use of Kaplan-Meier curves and Cox proportional hazards models to generate estimates of the associations with the time to treatment outcome. Sputum conversion status and culture conversion status were positively associated with treatment outcome for MDR-TB. In a multiple Cox proportional hazards regression model, no determinants were found to be associated with time to cure.
Asia-Pacific Journal of Public Health 05/2012; 24(4):631-40. DOI:10.1177/1010539511408067 · 1.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Monthly catch weights in Songkhla Lake were collected over the period from January 2003 to December 2006, for a total of 126 species. Catch weights were first aggregated by species and combination of bi-monthly season of year and catching gear (set bag net, trap, or gill net) and were log-transformed to remove skewness. A regression model containing
three species-season/gear components was then used to predict these outcomes. The first component was represented by the most species of estuarine and marine vertebrates as well as some invertebrates and reflected the fact that set bag net was the gear that resulted in the highest catches. The second component mainly represented freshwater fish and some marine invertebrates, and reflected the fact that most of these species were caught by gill nets. The third component focused on the seasonal fluctuations in catch weight. Such models can provide further tools in understanding of fish community structure clustering in fishery landings.
Turkish Journal of Fisheries and Aquatic Sciences 06/2011; DOI:10.4194/trjfas.2011.0201 · 0.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this study, we examined age-specific death rates among men and women from various districts in Thailand using mortality data from 1999 to 2001. A Poisson generalized linear model was used for analysis. To adjust for large variations in resident populations among districts, the 926 districts in Thailand were reduced to 235 "superdistricts" based on a minimum population of 200,000. The Poisson model incorporating additive factors for age-group and superdistrict generally provided a good fit for these data. The fitted mortality rates among the 235 superdistricts were compared with the overall means for each gender (637 per 100,000 for males and 415 per 100,000 for females). Thematic maps were created with three different colors signifying each superdistrict's mortality rate compared to the mean. Northeastern Thailand had higher than average mortality for both males and females. Lower than average death rates were found in southern Thailand with the exception of Phuket and Narathiwat, and in Bangkok, except for females in the superdistrict containing Nong Chok and Lat Krabang Districts. This modeling and mapping approach is a useful preliminary tool enabling public health planners to determine statistically valid geographical variations in mortality and to develop effective interventions.
The Southeast Asian journal of tropical medicine and public health 09/2010; 41(5):1209-19. · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine the trend, seasonal and geographic effects on tuberculosis (TB) incidence in the fourteen southern provinces of Thailand from 1999 to 2004. Data were obtained from the National Notifiable Disease Surveillance Report (506), Ministry of Public Health. The joint effects of gender, age, quarterly season and location on the TB incidence rates were modeled using both negative binomial distribution for the number of cases and log-linear distribution for the incidence rate; then these models were compared. The linear regression models provided a good fit, as indicated by residual plots and the R2 (0.64). The model showed that males and females aged less than 25 years had similar risks for TB in the study area. Both sexes had their risk increased with age but to a much greater extent for men than women, with the highest rate noted in males aged 65 years and over. There was no evidence of a trend in the annual incidence of TB during 1999-2004, but the incidence has a significant season variation with peaks in the first quarter over the six year period. There were also differences in the incidence rate of TB both within and between provinces. The high risk areas were in upper western and lower southern parts of the region. The log-linear regression model could be used as a simple method for modeling TB incidence rates. These findings highlight the importance of selectively monitoring geographic location when studying TB incidence patterns.
The Southeast Asian journal of tropical medicine and public health 05/2010; 41(3):574-82. · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Diarrhea is a major health problem in Thailand, but reported data of disease incidence are known or suspected to be under-reported. This study aimed to develop a statistical model for estimating the annual incidence of hospital diarrhea cases among children under five years. Data regarding diarrhea patients 0-4 years old were collected for the National Notifiable Disease Surveillance (Report 506) about Thai provinces bordering Cambodia during 1999-2004 by the Ministry of Public Health. A log-linear regression model based on the prevailing seasonal-trend pattern was used for diarrhea incidence as a function of quarter, year and district, after imputing rates where under-reporting was evident, using populations obtained from the 2000 population census. The model also takes any spatial correlation between districts into account, using the generalized estimating equation (GEE) method. Diarrhea incidence had seasonal peaks in the first quarter (January to March) and the trend steadily increased from 1999 to 2004. Results from such studies can help health authorities develop prevention policies.
The Southeast Asian journal of tropical medicine and public health 01/2010; 41(1):203-14. · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In statistical studies, generalized linear models (GLMs) are usually preferred for modeling incidence rates, often with extensions to zero-inflated GLMs when the proportion of zero counts is large. However Warton has shown that for many ecological studies, simple linear models fitted to log-transformed counts do surprisingly well. In this study, we used data comprising a sizable set of pneumonia incidence rates. We compared the negative binomial GLM with a log transformed linear model, and found further support for this simpler alternative method.
Chiang Mai Journal of Science 01/2010; 37(37):29-38. · 0.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigated regional and temporal patterns of death reported from infectious diseases (including HIV/AIDS) in 14 provinces of southern Thailand over the period 1999-2004, using data obtained from the Thailand Bureau of Policy and Strategy, Ministry of Public Health. Causes of deaths were identified using the International Classification of Diseases 10th revision (ICD-10), and mortality incidence rates were then calculated using populations obtained from the 2000 population census. Poisson and negative binomial lagged observation-driven regression models for mortality incidence were fitted to the data separately for HIV/ AIDS and other infectious diseases. Overall, the hospital mortality rates started to increase sharply in 2003 - 2004. The in-hospital mortality for HIV/AIDS showed peaks in urban districts and decreased from north to south with mortality for males approximately double that of females. For other infectious diseases, an upward trend in hospital mortality age 40 and over started in 2003-2004, particularly among persons reported as dying from septicemia, while showing a slightly increasing trend for other infectious diseases. Identifying the real cause of hospital deaths recorded as septicemia would substantially improve hospital mortality data quality.
The Southeast Asian journal of tropical medicine and public health 12/2007; 38(6):1029-40. · 0.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Songkhla Lake has not been adequately managed and catches are in decline. This study aims to develop statistical models for forecasting the quantity of fish catch and evaluation of fish damage caused by fishing gears in the Songkhla Lake Basin, Thailand. Data comprise total monthly (t) fish catch (yt) in tones from January 1997 to December 2006. We fitted an observation-driven model to ln(yt) containing seasonal effects and lagged terms for the preceding two months, obtaining an r-squared of 51% with both the seasonal and lagged coefficients statistically significant. Although the catch has decreased substantially in the last ten years no long-term trend is evident. This model can be used for short-term fish catch forecasting. The possible annual quantities of fish stock damage caused by destructive fishing practices approximate 32.71 tones and its cost around 40,605 USD. The catch in the Lake may have exceeded the sustainable capacity due to over-exploitation, non-target bycatch and illegal fishing. Therefore, strengthening the political will to develop enforceable sustainable fishing practices is desirable.
[Show abstract][Hide abstract] ABSTRACT: Objectives: (i) To investigate the demographic, temporal, and spatial variation of Liver cancer mortality in the upper north-eastern region of Thailand (Public Health Area 6). (ii) To develop a visualization tool for displaying the statistical analysis of liver cancer mortality. Methodology: All registered home deaths aged 30 years and over due to liver cancer in the upper north-eastern region of Thailand during 1996-2006 were analyzed using a Poisson regression model. The statistical model and statistical graphs were developed using R commands. In addition, KML source code for displaying the analysis results in Google Earth was created using R commands. Results: The Poisson model with gender, age group, year and super-district (a collection of neighboring districts in the same province with population approximately 200,000) as the factors provided a good fit to liver cancer mortality in the study region. All super-districts in Sakon-Nakhon province have higher than average liver cancer mortality, while all super-districts in Khon-Kaen and Loei provinces have lower mortality. Finally, a mortality map displayed on Google Earth gives insight into district-level variation of liver cancer mortality across the study region. Conclusions: There were differences in liver cancer mortality across 25 super-districts in the upper north-eastern region of Thailand. The combination of Google Earth and open statistical package such as R provide an inexpensive functional tool for analysis and visualization for public health research.