Factors associated with performing tuberculosis screening of HIV-positive patients in Ghana: LASSO-based predictor selection in a large public health data set
Identifieur interne : 000203 ( Main/Exploration ); précédent : 000202; suivant : 000204Factors associated with performing tuberculosis screening of HIV-positive patients in Ghana: LASSO-based predictor selection in a large public health data set
Auteurs : Susanne Mueller-Using [Allemagne] ; Torsten Feldt [Allemagne] ; Fred Stephen Sarfo [Ghana] ; Kirsten Alexandra Eberhardt [Allemagne]Source :
- BMC Public Health [ 1471-2458 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Algorithmes, Analyse multivariée, Association triméthoprime-sulfaméthoxazole (usage thérapeutique), Dépistage systématique (), Dépistage systématique (normes), Femelle, Ghana, Humains, Infections à VIH (), Infections à VIH (sang), Infections à VIH (traitement médicamenteux), Lymphocytes T CD4+, Modèles logistiques, Mâle, Santé publique (), Surveillance de la population, Tuberculose (), Tuberculose (diagnostic).
- MESH :
- diagnostic : Tuberculose.
- normes : Dépistage systématique.
- sang : Infections à VIH.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Association triméthoprime-sulfaméthoxazole.
- Adulte, Adulte d'âge moyen, Algorithmes, Analyse multivariée, Dépistage systématique, Femelle, Ghana, Humains, Infections à VIH, Lymphocytes T CD4+, Modèles logistiques, Mâle, Santé publique, Surveillance de la population, Tuberculose.
English descriptors
- KwdEn :
- Adult, Algorithms, CD4-Positive T-Lymphocytes, Female, Ghana, HIV Infections (blood), HIV Infections (complications), HIV Infections (drug therapy), Humans, Logistic Models, Male, Mass Screening (methods), Mass Screening (standards), Mass Screening (statistics & numerical data), Middle Aged, Multivariate Analysis, Population Surveillance, Public Health (statistics & numerical data), Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use), Tuberculosis (diagnosis), Tuberculosis (prevention & control).
- MESH :
- chemical , therapeutic use : Trimethoprim, Sulfamethoxazole Drug Combination.
- blood : HIV Infections.
- complications : HIV Infections.
- diagnosis : Tuberculosis.
- drug therapy : HIV Infections.
- methods : Mass Screening.
- prevention & control : Tuberculosis.
- standards : Mass Screening.
- statistics & numerical data : Mass Screening, Public Health.
- Adult, Algorithms, CD4-Positive T-Lymphocytes, Female, Ghana, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Population Surveillance.
Abstract
The purpose of this study is to propose the Least Absolute Shrinkage and Selection Operators procedure (LASSO) as an alternative to conventional variable selection models, as it allows for easy interpretation and handles multicollinearities. We developed a model on the basis of LASSO-selected parameters in order to link associated demographical, socio-economical, clinical and immunological factors to performing tuberculosis screening in HIV-positive patients in Ghana.
Applying the LASSO method and multivariate logistic regression analysis on a large public health data set, we selected relevant predictors related to tuberculosis screening.
One Thousand Ninety Five patients infected with HIV were enrolled into this study with 691 (63.2 %) of them having tuberculosis screening documented in their patient folders. Predictors found to be significantly associated with performance of tuberculosis screening can be classified into factors related to the clinician’s perception of the clinical state, as well as those related to PLHIV’s awareness. These factors include newly diagnosed HIV infections (
Accelerated TB screening among newly diagnosed HIV-patients indicates that application of the WHO screening form for intensifying tuberculosis case finding among HIV-positive individuals in resource-limited settings is increasingly adopted. However, screening for TB in PLHIV is still impacted by clinician’s perception of patient’s health state and PLHIV’s health awareness. Education of staff, counselling of PLHIV and sufficient financing are needed for further improvement in implementation of TB screening for all PLHIV. The LASSO approach proved a convenient method for automatic variable selection in a large public health data set that requires efficient and fast algorithms.
ClinicalTrials.gov
Url:
DOI: 10.1186/s12889-016-3239-y
PubMed: 27412114
PubMed Central: 4944423
Affiliations:
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Le document en format XML
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Institute for Tropical Medicine, Bernhard Nocht Str. 74, 20359 Hamburg</wicri:regionArea><wicri:noRegion>20359 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Hamburg Institute of International Economics, Heimhuder Str. 71, 20148 Hamburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Hamburg Institute of International Economics, Heimhuder Str. 71, 20148 Hamburg</wicri:regionArea><wicri:noRegion>20148 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Feldt, Torsten" sort="Feldt, Torsten" uniqKey="Feldt T" first="Torsten" last="Feldt">Torsten Feldt</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht Str. 74, 20359 Hamburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht Str. 74, 20359 Hamburg</wicri:regionArea><wicri:noRegion>20359 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff3">Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of the Heinrich Heine University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital of the Heinrich Heine University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Düsseldorf</region><settlement type="city">Düsseldorf</settlement></placeName></affiliation></author><author><name sortKey="Sarfo, Fred Stephen" sort="Sarfo, Fred Stephen" uniqKey="Sarfo F" first="Fred Stephen" last="Sarfo">Fred Stephen Sarfo</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Kwame Nkrumah University of Science and Technology, University Post Office - KNUST, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kwame Nkrumah University of Science and Technology, University Post Office - KNUST, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff5">Komfo Anokye Teaching Hospital, P.O. 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when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Algorithms</term><term>CD4-Positive T-Lymphocytes</term><term>Female</term><term>Ghana</term><term>HIV Infections (blood)</term><term>HIV Infections (complications)</term><term>HIV Infections (drug therapy)</term><term>Humans</term><term>Logistic Models</term><term>Male</term><term>Mass Screening (methods)</term><term>Mass Screening (standards)</term><term>Mass Screening (statistics & numerical data)</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Population Surveillance</term><term>Public Health (statistics & numerical data)</term><term>Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)</term><term>Tuberculosis (diagnosis)</term><term>Tuberculosis (prevention & control)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Algorithmes</term><term>Analyse multivariée</term><term>Association triméthoprime-sulfaméthoxazole (usage thérapeutique)</term><term>Dépistage systématique ()</term><term>Dépistage systématique (normes)</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (sang)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Lymphocytes T CD4+</term><term>Modèles logistiques</term><term>Mâle</term><term>Santé publique ()</term><term>Surveillance de la population</term><term>Tuberculose ()</term><term>Tuberculose (diagnostic)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Trimethoprim, Sulfamethoxazole Drug Combination</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Tuberculosis</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Tuberculose</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mass Screening</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Dépistage systématique</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Tuberculosis</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Mass Screening</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Mass Screening</term><term>Public Health</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Association triméthoprime-sulfaméthoxazole</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Algorithms</term><term>CD4-Positive T-Lymphocytes</term><term>Female</term><term>Ghana</term><term>Humans</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Population Surveillance</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Algorithmes</term><term>Analyse multivariée</term><term>Dépistage systématique</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Infections à VIH</term><term>Lymphocytes T CD4+</term><term>Modèles logistiques</term><term>Mâle</term><term>Santé publique</term><term>Surveillance de la population</term><term>Tuberculose</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The purpose of this study is to propose the Least Absolute Shrinkage and Selection Operators procedure (LASSO) as an alternative to conventional variable selection models, as it allows for easy interpretation and handles multicollinearities. We developed a model on the basis of LASSO-selected parameters in order to link associated demographical, socio-economical, clinical and immunological factors to performing tuberculosis screening in HIV-positive patients in Ghana.</p></sec><sec><title>Methods</title><p>Applying the LASSO method and multivariate logistic regression analysis on a large public health data set, we selected relevant predictors related to tuberculosis screening.</p></sec><sec><title>Results</title><p>One Thousand Ninety Five patients infected with HIV were enrolled into this study with 691 (63.2 %) of them having tuberculosis screening documented in their patient folders. Predictors found to be significantly associated with performance of tuberculosis screening can be classified into factors related to the clinician’s perception of the clinical state, as well as those related to PLHIV’s awareness. These factors include newly diagnosed HIV infections (<italic>n</italic> = 354 (32.42 %), aOR 1.84), current CD4+ T cell count (aOR 0.92), non-availability of HIV type (<italic>n</italic> = 787 (72.07 %), aOR 0.56), chronic cough (<italic>n</italic> = 32 (2.93 %), aOR 5.07), intake of co-trimoxazole (<italic>n</italic> = 271 (24.82 %), aOR 2.31), vitamin supplementation (<italic>n</italic> = 220 (20.15 %), aOR 2.64) as well as the use of mosquito bed nets (<italic>n</italic> = 613 (56.14 %), aOR 1.53).</p></sec><sec><title>Conclusions</title><p>Accelerated TB screening among newly diagnosed HIV-patients indicates that application of the WHO screening form for intensifying tuberculosis case finding among HIV-positive individuals in resource-limited settings is increasingly adopted. However, screening for TB in PLHIV is still impacted by clinician’s perception of patient’s health state and PLHIV’s health awareness. Education of staff, counselling of PLHIV and sufficient financing are needed for further improvement in implementation of TB screening for all PLHIV. The LASSO approach proved a convenient method for automatic variable selection in a large public health data set that requires efficient and fast algorithms.</p></sec><sec><title>Trials registration</title><p>ClinicalTrials.gov <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01897909?term=NCT01897909&rank=1">NCT01897909</ext-link> (July 5, 2013).</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Acharjee, A" uniqKey="Acharjee A">A Acharjee</name></author><author><name sortKey="Finkers, R" uniqKey="Finkers R">R Finkers</name></author><author><name sortKey="Visser, Rg" uniqKey="Visser R">RG Visser</name></author><author><name sortKey="Maliepaard, C" uniqKey="Maliepaard C">C Maliepaard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Derksen, S" uniqKey="Derksen S">S Derksen</name></author><author><name sortKey="Keselman, H" uniqKey="Keselman H">H 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uniqKey="Kimerling M">M Kimerling</name></author><author><name sortKey="Shah, S" uniqKey="Shah S">S Shah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Otwombe, Kn" uniqKey="Otwombe K">KN Otwombe</name></author><author><name sortKey="Variava, E" uniqKey="Variava E">E Variava</name></author><author><name sortKey="Holmes, Cb" uniqKey="Holmes C">CB Holmes</name></author><author><name sortKey="Chaisson, Re" uniqKey="Chaisson R">RE Chaisson</name></author><author><name sortKey="Martinson, N" uniqKey="Martinson N">N Martinson</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Osei, E" uniqKey="Osei E">E Osei</name></author><author><name sortKey="Akweongo, P" uniqKey="Akweongo P">P Akweongo</name></author><author><name sortKey="Binka, F" uniqKey="Binka F">F Binka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ansa, Ga" uniqKey="Ansa G">GA Ansa</name></author><author><name sortKey="Walley, Jd" uniqKey="Walley J">JD Walley</name></author><author><name sortKey="Siddiqi, K" uniqKey="Siddiqi K">K Siddiqi</name></author><author><name sortKey="Wei, X" uniqKey="Wei X">X Wei</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Uwinkindi, F" uniqKey="Uwinkindi F">F Uwinkindi</name></author><author><name sortKey="Nsanzimana, S" uniqKey="Nsanzimana S">S Nsanzimana</name></author><author><name sortKey="Riedel, Dj" uniqKey="Riedel D">DJ Riedel</name></author><author><name sortKey="Muhayimpundu, R" uniqKey="Muhayimpundu R">R Muhayimpundu</name></author><author><name sortKey="Remera, E" uniqKey="Remera E">E Remera</name></author><author><name sortKey="Gasana, M" uniqKey="Gasana M">M Gasana</name></author><author><name sortKey="Mutembayire, G" uniqKey="Mutembayire G">G Mutembayire</name></author><author><name sortKey="Binagwaho, A" uniqKey="Binagwaho A">A Binagwaho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Uyei, J" uniqKey="Uyei J">J Uyei</name></author><author><name sortKey="Coetzee, D" uniqKey="Coetzee D">D Coetzee</name></author><author><name sortKey="Macinko, J" uniqKey="Macinko J">J Macinko</name></author><author><name sortKey="Guttmacher, S" uniqKey="Guttmacher S">S Guttmacher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chehab, Jc" uniqKey="Chehab J">JC Chehab</name></author><author><name sortKey="Vilakazi Nhlapo, Ak" uniqKey="Vilakazi Nhlapo A">AK Vilakazi-Nhlapo</name></author><author><name sortKey="Vranken, P" uniqKey="Vranken P">P Vranken</name></author><author><name sortKey="Peters, A" uniqKey="Peters A">A Peters</name></author><author><name sortKey="Klausner, Jd" uniqKey="Klausner J">JD Klausner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amo Adjei, J" uniqKey="Amo Adjei J">J Amo-Adjei</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kenu, E" uniqKey="Kenu E">E Kenu</name></author><author><name sortKey="K Ser, M" uniqKey="K Ser M">M Käser</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Ghana</li></country><region><li>District de Düsseldorf</li><li>Hambourg</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Düsseldorf</li><li>Hambourg</li></settlement></list><tree><country name="Allemagne"><region name="Hambourg"><name sortKey="Mueller Using, Susanne" sort="Mueller Using, Susanne" uniqKey="Mueller Using S" first="Susanne" last="Mueller-Using">Susanne Mueller-Using</name></region><name sortKey="Eberhardt, Kirsten Alexandra" sort="Eberhardt, Kirsten Alexandra" uniqKey="Eberhardt K" first="Kirsten Alexandra" last="Eberhardt">Kirsten Alexandra Eberhardt</name><name sortKey="Feldt, Torsten" sort="Feldt, Torsten" uniqKey="Feldt T" first="Torsten" last="Feldt">Torsten Feldt</name><name sortKey="Feldt, Torsten" sort="Feldt, Torsten" uniqKey="Feldt T" first="Torsten" last="Feldt">Torsten Feldt</name><name sortKey="Mueller Using, Susanne" sort="Mueller Using, Susanne" uniqKey="Mueller Using S" first="Susanne" last="Mueller-Using">Susanne Mueller-Using</name></country><country name="Ghana"><noRegion><name sortKey="Sarfo, Fred Stephen" sort="Sarfo, Fred Stephen" uniqKey="Sarfo F" first="Fred Stephen" last="Sarfo">Fred Stephen Sarfo</name></noRegion><name sortKey="Sarfo, Fred Stephen" sort="Sarfo, Fred Stephen" uniqKey="Sarfo F" first="Fred Stephen" last="Sarfo">Fred Stephen Sarfo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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