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|Title: ||Factors associated with performing tuberculosis screening of HIV-positive patients in Ghana: LASSO-based predictor selection in a large public health data set|
|Authors: ||Mueller-Using, Susanne|
Sarfo, Fred Stephen
Eberhardt, Kirsten Alexandra
|Issue Date: ||2016|
|Publisher: ||BMC Public Health|
|Citation: ||BMC Public Health (2016) 16:563 ;DOI 10.1186/s12889-016-3239-y|
|Abstract: ||Background: 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.
Methods: Applying the LASSO method and multivariate logistic regression analysis on a large public health data
set, we selected relevant predictors related to tuberculosis screening.
Results: 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 (n = 354 (32.
42 %), aOR 1.84), current CD4+ T cell count (aOR 0.92), non-availability of HIV type (n = 787 (72.07 %), aOR 0.56), chronic
cough (n = 32 (2.93 %), aOR 5.07), intake of co-trimoxazole (n = 271 (24.82 %), aOR 2.31), vitamin supplementation (n =220
(20.15 %), aOR 2.64) as well as the use of mosquito bed nets (n = 613 (56.14 %), aOR 1.53).
Conclusions: 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.|
|Description: ||An article published in BMC Public Health (2016) 16:563 ;DOI 10.1186/s12889-016-3239-y|
|Appears in Collections:||College of Health Sciences|
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