Metta Kuning

Inadequacy of nutrients intake among pregnant women in the Deep South of Thailand

BackgroundThe deep south of Thailand is an area which has been affected by violence since 2004, yet the concurrent coverage of antenatal care has remained at over 90%. Our study aimed to describe the prevalence of nutrient inadequacy among pregnant women who attended antenatal care clinics in hospitals in the study area and assess factors associated with nutrient inadequacy.MethodsPregnant women from four participating hospitals located in lower southern Thailand were surveyed during January-December 2008. Nutrient intake was estimated based on information provided by the women on the amount, type and frequency of various foods eaten. Logistic regression was used to assess individual and community factors associated with inadequate nutrient intake, defined as less than two thirds of the recommended dietary allowance (RDA).ResultsThe prevalence of carbohydrate, protein, fat, calories, calcium, phosphorus, iron, thiamine, riboflavin, retinol, niacin, vitamin C, folic acid and iodine inadequacy was 86.8%, 59.2%, 78.0%, 83.5%, 55.0%, 29.5%, 45.2%, 85.0%, 19.2%, 3.8%, 43.2%, 0.8%, 0.0% and 0.8%, respectively. Maternal age, education level, gestational age at enrolment and pre-pregnancy body mass index and level of violence in the district were significantly associated with inadequacy of carbohydrate, protein, phosphorus, iron, thiamine and niacin intake.ConclusionsNutrient intake inadequacy among pregnant women was common in this area. Increasing levels of violence was associated with nutrient inadequacy in addition to individual factors.

Factors associated with low birth weight in Nepal using multiple imputation

BackgroundSurvey data from low income countries on birth weight usually pose a persistent problem. The studies conducted on birth weight have acknowledged missing data on birth weight, but they are not included in the analysis. Furthermore, other missing data presented on determinants of birth weight are not addressed. Thus, this study tries to identify determinants that are associated with low birth weight (LBW) using multiple imputation to handle missing data on birth weight and its determinants.MethodsThe child dataset from Nepal Demographic and Health Survey (NDHS), 2011 was utilized in this study. A total of 5,240 children were born between 2006 and 2011, out of which 87% had at least one measured variable missing and 21% had no recorded birth weight. All the analyses were carried out in R version 3.1.3. Transform-then impute method was applied to check for interaction between explanatory variables and imputed missing data. Survey package was applied to each imputed dataset to account for survey design and sampling method. Survey logistic regression was applied to identify the determinants associated with LBW.ResultsThe prevalence of LBW was 15.4% after imputation. Women with the highest autonomy on their own health compared to those with health decisions involving husband or others (adjusted odds ratio (OR) 1.87, 95% confidence interval (95% CI) = 1.31, 2.67), and husband and women together (adjusted OR 1.57, 95% CI = 1.05, 2.35) were less likely to give birth to LBW infants. Mothers using highly polluting cooking fuels (adjusted OR 1.49, 95% CI = 1.03, 2.22) were more likely to give birth to LBW infants than mothers using non-polluting cooking fuels.ConclusionThe findings of this study suggested that obtaining the prevalence of LBW from only the sample of measured birth weight and ignoring missing data results in underestimation.

Graphing Incidence Rates over Regions using R and Google Earth

A method for modeling and graphically comparing incidence rates of adverse events that vary over geographical regions is shown and discussed. To achieve our goal, we used a statistical model to compare incidence rates and showed how informative three-dimensional graphs of such incidence rates can be created dynamically using R and interactively controlled using Google Earth with Keyhole Markup Language (KML). These methods are applied to the terrorism events in regions of Southern Thailand that occurred from 2004 to 2009.