Skewed logit model for analyzing correlated infant morbidity data.

<h4>Background</h4>Infant morbidity is a topic of interest because it is used globally as an indicator of the status of health care in a country. A large body of evidence supports an association between bacterial vaginosis (BV) and infant morbidity. When estimating the relationship betwe...

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Main Authors: Ngugi Mwenda, Ruth Nduati, Mathew Kosgei, Gregory Kerich
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0246269
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author Ngugi Mwenda
Ruth Nduati
Mathew Kosgei
Gregory Kerich
author_facet Ngugi Mwenda
Ruth Nduati
Mathew Kosgei
Gregory Kerich
author_sort Ngugi Mwenda
collection DOAJ
description <h4>Background</h4>Infant morbidity is a topic of interest because it is used globally as an indicator of the status of health care in a country. A large body of evidence supports an association between bacterial vaginosis (BV) and infant morbidity. When estimating the relationship between the predictors and the estimated variable of morbidity severity, the latter exhibits imbalanced data, which means that violation of symmetry is expected. Two competing methods of analysis, that is, (1) probit and (2) logit techniques, can be considered in this context and have been applied to model such outcomes. However, these models may yield inconsistent results. While non-normal modeling approaches have been embraced in the recent past, the skewed logit model has been given little attention. In this study, we exemplify its usefulness in analyzing imbalanced longitudinal responses data.<h4>Methodology</h4>While numerous non-normal methods for modeling binomial responses are well established, there is a need for comparison studies to assess their usefulness in different scenarios, especially under a longitudinal setting. This is addressed in this study. We use a dataset from Kenya about infants born to human immunodeficiency virus (HIV) positive mothers, who are also screened for BV. We aimed to investigate the effect of BV on infant morbidity across time. We derived a score for morbidity incidences depending on illnesses reported during the month of reference. By adjusting for the mother's BV status, the child's HIV status, sex, feeding status, and weight for age, we estimated the standard binary logit and skewed logit models, both using Generalized Estimating Equations.<h4>Results</h4>Results show that accounting for skewness in imbalanced binary data can show associations between variables in line with expectations documented by the literature. In addition, an in-depth analysis accounting for skewness has shown that, over time, maternal BV is associated with multiple health conditions in infants.<h4>Interpretation</h4>Maternal BV status was positively associated with infant morbidity incidences, which highlights the need for early intervention in cases of HIV-infected pregnant women.
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spelling doaj.art-b9852b9685c54e45af35d7b7f89010282022-12-21T19:15:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01162e024626910.1371/journal.pone.0246269Skewed logit model for analyzing correlated infant morbidity data.Ngugi MwendaRuth NduatiMathew KosgeiGregory Kerich<h4>Background</h4>Infant morbidity is a topic of interest because it is used globally as an indicator of the status of health care in a country. A large body of evidence supports an association between bacterial vaginosis (BV) and infant morbidity. When estimating the relationship between the predictors and the estimated variable of morbidity severity, the latter exhibits imbalanced data, which means that violation of symmetry is expected. Two competing methods of analysis, that is, (1) probit and (2) logit techniques, can be considered in this context and have been applied to model such outcomes. However, these models may yield inconsistent results. While non-normal modeling approaches have been embraced in the recent past, the skewed logit model has been given little attention. In this study, we exemplify its usefulness in analyzing imbalanced longitudinal responses data.<h4>Methodology</h4>While numerous non-normal methods for modeling binomial responses are well established, there is a need for comparison studies to assess their usefulness in different scenarios, especially under a longitudinal setting. This is addressed in this study. We use a dataset from Kenya about infants born to human immunodeficiency virus (HIV) positive mothers, who are also screened for BV. We aimed to investigate the effect of BV on infant morbidity across time. We derived a score for morbidity incidences depending on illnesses reported during the month of reference. By adjusting for the mother's BV status, the child's HIV status, sex, feeding status, and weight for age, we estimated the standard binary logit and skewed logit models, both using Generalized Estimating Equations.<h4>Results</h4>Results show that accounting for skewness in imbalanced binary data can show associations between variables in line with expectations documented by the literature. In addition, an in-depth analysis accounting for skewness has shown that, over time, maternal BV is associated with multiple health conditions in infants.<h4>Interpretation</h4>Maternal BV status was positively associated with infant morbidity incidences, which highlights the need for early intervention in cases of HIV-infected pregnant women.https://doi.org/10.1371/journal.pone.0246269
spellingShingle Ngugi Mwenda
Ruth Nduati
Mathew Kosgei
Gregory Kerich
Skewed logit model for analyzing correlated infant morbidity data.
PLoS ONE
title Skewed logit model for analyzing correlated infant morbidity data.
title_full Skewed logit model for analyzing correlated infant morbidity data.
title_fullStr Skewed logit model for analyzing correlated infant morbidity data.
title_full_unstemmed Skewed logit model for analyzing correlated infant morbidity data.
title_short Skewed logit model for analyzing correlated infant morbidity data.
title_sort skewed logit model for analyzing correlated infant morbidity data
url https://doi.org/10.1371/journal.pone.0246269
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