Journal of Biostatistics and Epidemiology

ESTIMATION OF HIV PREVALENCE AMONG WOMEN IN KENYA IN THE PRESENCE OF MEDIATION USING LATENT TRAIT ANALYSIS

DRINOLD ALUDA MBETE — 2025-08-20

Estimating prevalence in cause-effect relationships where the mediator variables are assumed to be latent is not usually easy. However, the use of proper indicators and statistical model can make the measurement and use of such constructs easy.
Methods: Structural Equation Modeling makes it possible to analyze simultaneously both the relationship between the latent variable and the links between the latent variable and their indicators. The 2018 Kenya AIDS Indicator Survey data was used to validate the model developed. The maximum likelihood was used to estimate the model parameters. The findings of the study were, there is a relationship between education attainment and knowledge /awareness of HIV/AIDS.
Results: The results further shows that education levels are not associated with HIV prevalence after controlling for a number of socio-demographic characteristics and behavioral factors.
Conclusion: These findings can inform policy makers in formulation of appropriate HIV/AIDS management (policies) and intervention strategies aimed at reducing HIV/AIDS prevalence that has remained a challenge in many developing countries.

A Multifunctional Approach to Feature Extraction from fMRI Images in Alzheimer's disease

Shahriar Mohammadi — 2025-06-15

Introduction: The use of fMRI imaging in medical science has led to the diagnosis of diseases at the very first stages before the disease get advancedwhich plays a significant role in some diseases such as Alzheimer's. Extracting useful information from these images is the first step in the initial diagnosis of the disease that the accuracy in extracting as much of this information as possible contributes significantly to the initial diagnosis. Increases the speed of processing and estimation accuracy which was done in the present study using a multi-purpose method. While in recent studies, simpler methods with a limited number of features were used.

Methods: The information of 140 patients with Alzheimer's disease was obtained, and the stable multipurpose feature extraction method was used to extract the information. In this way, two-level wavelet, modeling of wavelet coefficients, normalization method and feature selection are applied.

Results: The results obtained from the examination of 285 features in five categories showed that some of the information contained in the features overlapped and lacked useful information. In addition, dimensionality and noise reduction using the PCA algorithm showed that about 41% of the relevant features are outliers or missing information.

Cunclusion:In general, increasing the speed of processing and estimation accuracy which was done in the present study using a multi-purpose method. While in recent studies, simpler methods with a limited number of features were used.

Optimizing Maternal Health in Refugee Settings: Perspectives on the WHO's Enhanced Antenatal Care Schedule: A Mixed-Methods Study in Zarqa, Jordan

Zachrieh Alhaj — 2025-06-15

Background: Antenatal care (ANC) is essential for improving maternal and newborn health by enabling early detection and treatment of potential complications. In 2016, the World Health Organization (WHO) increased the recommended number of ANC visits from four to eight, aiming to enhance maternal health outcomes. This study explores the experiences of pregnant women in Jordanian refugee camps and examines the perceived impact of the revised WHO ANC schedule.

Methods: A mixed-methods study was conducted at Zarqa health centers in Jordan from May 28, 2023, to July 26, 2023. Data were collected through structured interviews with 46 female patients (pregnant, postpartum, or trying to conceive), focus group discussions (FGDs) with six participants, and semi-structured interviews with six healthcare providers. Quantitative data were gathered using structured questionnaires, while qualitative data were obtained through FGDs and provider interviews.

Results: Participants unanimously agreed that eight ANC visits are essential for optimal maternal and fetal health. Approximately 90% expressed a need for clearer communication from healthcare providers during appointments. Despite demonstrating strong self-awareness about when to seek medical attention, participants highlighted key barriers to ANC access, including transportation challenges, childcare responsibilities, and long waiting times. Healthcare providers acknowledged these barriers and emphasized the need for improved patient communication and resource allocation. Overall, participants reported general satisfaction with the services provided at refugee health clinics.

Discussion: While refugee women in Jordan recognize the importance of the WHO-recommended ANC schedule, barriers such as inadequate communication, transportation difficulties, and childcare responsibilities persist. Addressing these barriers through targeted interventions, such as enhanced provider training, better scheduling, and community outreach, could significantly improve maternal and newborn healthcare outcomes in refugee settings.

Conclusion: Optimizing ANC access in refugee settings requires a multifaceted approach that addresses communication gaps, logistical challenges, and systemic healthcare barriers to ensure equitable maternal health outcomes.

Characterization and Determinants of the Utilization of Family Planning Services

Zachrieh Alhaj — 2025-06-15

Background: Family planning is a vital aspect of reproductive health, encompassing contraceptive use, pregnancy, and STI prevention. Among Palestinian refugees in Jordan, particularly those utilizing UNRWA services, maternal mortality rates and contraceptive utilization highlight the urgent need to address gaps in family planning access. Sociocultural factors and service barriers remain determinants of contraceptive use and family planning outcomes in this population.

Methods: A mixed-methods study was conducted from June 5–7, 2023, at the Marka health center in Jordan. The study involved structured interviews with 57 female patients, focus group discussions (FGDs), and semi-structured interviews with healthcare providers. Data collection explored sociodemographic factors, perceptions of family planning services, and sociocultural determinants influencing contraceptive use. Quantitative and qualitative data were analyzed to identify themes related to family planning knowledge, access, and utilization.

Results: Three major themes were determined: (1) Knowledge and access to family planning methods varied, with 59.6% of participants reporting contraceptive use. The most common methods included condoms (37.8%) and birth control pills (29.7%). (2) Sociocultural factors significantly shaped decisions, with 37.8% citing spousal preferences and 10.5% reporting pressure from extended family. (3) Perceptions of UNRWA’s services were largely positive, with 63% rating them adequate, although logistical challenges like long wait times hindered utilization. Younger women aged 18–29 formed most participants, highlighting the need for targeted interventions. Most participants were housewives, with limited employment and varying educational levels.

Conclusions: While UNRWA’s family planning services are well-regarded, persistent barriers such as sociocultural constraints, limited knowledge, and service accessibility require targeted interventions. Addressing misconceptions, fostering supportive sociocultural environments, and improving logistical factors like wait times can enhance service uptake. Future research should explore long-term impacts of family planning initiatives and expand the scope to include other refugee populations to inform inclusive, effective health policies.

Integration of time into a 2-dimensional geography to visualize spatio-temporal clusters of dog rabies in Thailand

Thanidtha Te-Chaniyom — 2025-06-15

Background: Space-time scanning analysis to detect cylindrical spatio-temporal clusters of diseases is available. Yet, there is no satisfactory way to visualize the data. Our aim is to visualize spatio-temporal cylindrical clusters of dog rabies in Thailand from 2005 to 2021.

Methods: We obtained dog rabies data from 2005 to 2021 from the World Animal Health Information System under the World Organisation for Animal Health (WOAH). The rsatscan package in R was applied to identify spatio-temporal clusters of dog rabies using the discrete Poisson model and Monte Carlo simulation. Using a user-defined function developed by our research team, cylindrical shapes were created based on the provincial administration maps to demonstrate significant clusters over space and time.

Results: The average incidence of dog rabies was 0.5 events per 100,000 human-years, and seven clusters were found during the study period in all five national regions, based on 15% of the population being at risk.

Conclusion: Seven dog rabies clusters were detected throughout Thailand. We recommend intensive control measures to alleviate dog rabies. Our method to generate multi-dimensional graphics can comprehensibly visualize cylinder-shaped outcomes from spatio-temporal data.