Evidence map›Paper›PMID 34358233›Full record

ArticlePloS one2021

Model-based small area estimation methods and precise district-level HIV prevalence estimates in Uganda.

Joseph Ouma, Caroline Jeffery, Colletar Anna Awor, Allan Muruta, Joshua Musinguzi, Rhoda K Wanyenze, Sam Biraro, Jonathan Levin, Joseph J Valadez

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Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Joseph OumaDivision of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.ORCID 0000-0001-5249-7440
Caroline JefferyMETRe Group, Department of International Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Colletar Anna AworData Science and Informatics Branch, Centers for Disease Control and Prevention, Uganda.
Allan MurutaAIDS Control Program, Ministry of Health, Uganda.
Joshua MusinguziAIDS Control Program, Ministry of Health, Uganda.
Rhoda K WanyenzeDepartment of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
Sam BiraroICAP at Columbia University, Nakasero, Kampala, Uganda.
Jonathan LevinDivision of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
Joseph J ValadezMETRe Group, Department of International Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Funding

CGH CDC HHS U2G GH001226PEPFARWellcome TrustWellcome Trust 107754/Z/15/Z
6 · The paper itself

Abstract

backgroundModel-based small area estimation methods can help generate parameter estimates at the district level, where planned population survey sample sizes are not large enough to support direct estimates of HIV prevalence with adequate precision. We computed district-level HIV prevalence estimates and their 95% confidence intervals for districts in Uganda.

methodsOur analysis used direct survey and model-based estimation methods, including Fay-Herriot (area-level) and Battese-Harter-Fuller (unit-level) small area models. We used regression analysis to assess for consistency in estimating HIV prevalence. We use a ratio analysis of the mean square error and the coefficient of variation of the estimates to evaluate precision. The models were applied to Uganda Population-Based HIV Impact Assessment 2016/2017 data with auxiliary information from the 2016 Lot Quality Assurance Sampling survey and antenatal care data from district health information system datasets for unit-level and area-level models, respectively.

resultsEstimates from the model-based and the direct survey methods were similar. However, direct survey estimates were unstable compared with the model-based estimates. Area-level model estimates were more stable than unit-level model estimates. The correlation between unit-level and direct survey estimates was (β1 = 0.66, r2 = 0.862), and correlation between area-level model and direct survey estimates was (β1 = 0.44, r2 = 0.698). The error associated with the estimates decreased by 37.5% and 33.1% for the unit-level and area-level models, respectively, compared to the direct survey estimates.

conclusionsAlthough the unit-level model estimates were less precise than the area-level model estimates, they were highly correlated with the direct survey estimates and had less standard error associated with estimates than the area-level model. Unit-level models provide more accurate and reliable data to support local decision-making when unit-level auxiliary information is available.

Indexed as

AdolescentAdultAlgorithmsFemaleHIV InfectionsHumansLot Quality Assurance SamplingMaleMiddle AgedPregnancyPrenatal CarePrevalenceUgandaYoung Adult

Identifiers

PMID34358233
PMCPMC8345831

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