Survival data analysis results are usually communicated through the overall survival probability. Alternative measures provide additional insights and may help in communicating the results to a wider audience. We describe these alternative measures in two data settings, the overall survival setting and the relative survival setting, the latter corresponding to the particular competing risk setting in which the cause of death is unavailable or unreliable. In the overall survival setting, we describe the overall survival probability, the conditional survival probability and the restricted mean survival time (restricted to a prespecified time window). In the relative survival setting, we describe the net survival probability, the conditional net survival probability, the restricted mean net survival time, the crude probability of death due to each cause and the number of life years lost due to each cause over a prespecified time window. These measures describe survival data either on a probability scale or on a timescale. The clinical or population health purpose of each measure is detailed, and their advantages and drawbacks are discussed. We then illustrate their use analyzing England population-based registry data of men 15–80 years old diagnosed with colon cancer in 2001–2003, aiming to describe the deprivation disparities in survival. We believe that both the provision of a detailed example of the interpretation of each measure and the software implementation will help in generalizing their use.
With expanded HIV treatment and prevention programmes, most infants born to HIV-positive women are uninfected, but the patterns and determinants of their growth are not well described. This study aimed to assess growth patterns in a cohort of HIV-exposed uninfected (HEU) infants who participated in an experimental HIV vaccine trial and to test for associations with maternal and infant factors, including in-utero exposure to antiretroviral therapy (ART), mode of delivery, exclusive breastfeeding, mother's education and receipt of the vaccine. Infants in the trial were seen at regular clinic visits from birth to 48 weeks of age. From the anthropometric measurements at these visits, weight-forage z-scores (WAZ), weight-for-length zscores (WLZ) and length-forage z-scores (LAZ) were computed using World Health Organization (WHO) software and reference tables. Growth patterns were investigated with respect to maternal and infant factors, using linear mixed regression models. From 94 infants included at birth, growth data were available for 75.5% at 48 weeks. The determinants of infant growth in this population are multifactorial: infant LAZ during the first year was significantly lower among infants delivered by caesarean section (p = 0.043); both WAZ and LAZ were depressed among infants with longer exposure to maternal ART (WAZ: p = 0.015; LAZ: p < 0.0001) and among infants of mothers with lower educational level (WAZ: p = 0.038; LAZ: p < 0.0001); the effect of maternal education was modified by breastfeeding practice, with no differences seen in exclusively breastfed infants. These findings inform intervention strategies to preserve growth in this vulnerable infant population.
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Background Malnutrition is a public health concern in low- and middle-income countries. In Senegal, 35% of adolescent girls are undernourished and 56% are anemic. Methods This study assessed the dietary intake of 14–18-year-old adolescent girls in Dakar, Senegal. Specifically, the study 1) assessed their intake in energy, fibre, macro- and micronutrients, 2) described the types and the quality of the foods they consume, and 3) assessed some of their eating behaviours. Dietary intake was measured using three non-consecutive 24-h recalls from 136 adolescent girls attending two colleges. Energy and nutrient intakes were measured and compared to recommendations. Foods were classified by food group and by whether they were healthy or unhealthy. Adolescents’ daily intake (g) of fruits and vegetables, as well as the proportion of girls who ate breakfast and who consumed three meals a day were calculated. Results Sodium intake was high, while fibre intake was low. On average, 40% of the adolescents’ total energy intake came from fats. Mean intakes of zinc and calcium were higher on the weekend than on weekdays, while the opposite was observed for sodium. Eighty-three percent of adolescents had an inadequate intake of iron and 99% were at risk of calcium deficiency. Approximately 60% of the foods consumed were classified as healthy, however, the majority came from grains. Conclusions Adolescent nutrition deserves attention given the poor quality of their dietary intake which may put them at risk of malnutrition and chronic diseases. These findings may be used to help improve programs targeting Senegalese adolescent girls’ nutrition.
Intake of iron-rich foods was investigated in Senegalese adolescent girls. A cross-sectional survey was conducted among 136 girls aged 13 to 18, attending two colleges in Dakar. Data on the consumption of iron-rich foods over the previous week were collected through a food frequency questionnaire. Results show that 12% of the girls had consumed dishes made with iron-rich foods 3 times or less in the past seven days, 34%, 4 to 6 times, and 54%, 7 times and above. However, 83% of the girls had anntake of iron-rich foods below the 84 g per day recommended for animal protein sources by the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. The diet of Senegalese adolescent girls seems conducive to iron deficiency. To define effective interventions to improve the situation, investigating underlying factors to the low consumption of iron-rich foods is warranted.
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