Thesis Hiv Aids

Thesis Hiv Aids-81
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Results confirmed significant spatial effects and some ecological factors were significant in explaining the variation.

Also, variation due to various levels of aggregation was prominent.

A Correction factor for underreporting was ascertained by studying attendance at the laboratory facility over two time periods defined by the cost of HIV screening.

Estimates of HIV prevalence obtained from corrected data using the modified nonparametric back-calculation are comparable with UN estimates obtained by a different method.

The existence of spatial clusters was investigated using cluster analysis and some measure of spatial autocorrelation (Moran I and Geary c coefficients, semivariogram and kriging) applied to the National HIV/AIDS Surveillance data.

Results revealed the existence of spatial clusters with significant positive spatial autocorrelation coefficients that tended to get stronger as the epidemic developed through time.The bulk of infection was found in patients aged 15-49 years, about 86 percent of infected females and 78 percent of males were in this age group.Attendance at the laboratory and the proportion of HIV positive tests witnessed a remarkable increase when screening became free of charge.This thesis has two broad aims: the first is to develop statistical models which adequately describe the spatial distribution of the Nigerian HIV/AIDS epidemic and its associated ecological risk factors; the second, to develop models that could reconstruct the HIV incidence curve, obtain an estimate of the hidden HIV/AIDS population and a short term projection for AIDS incidence and a measure of precision of the estimates.To achieve these objectives, we first examined data from various sources and selected three sets of data based on national coverage and minimal reporting delay.Parameter estimates obtained using 3-step and 4-step models were similar but the standard errors of these parameters were higher in the 4-step model.Estimates obtained using linear, quadratic, cubic and natural splines differed and also depended on the number and positions of the knots.The constant hazard of routine testing and the proportionality coefficient of symptom-related tests were estimated from the data and incorporated into the HIV induction distribution function.Estimates of HIV prevalence differ widely (about three times higher) from those obtained using parametric and ordinary nonparametric back-calculation methods.The data sets are the outcome of the National HIV/AIDS Sentinel Surveillance Survey conducted in 1999, 2001, 20 by the Federal Ministry of Health; the outcome of the survey of 1057 health and laboratory facilities conducted by the Nigerian Institute of Medical Research in 2000; and case by case HIV screening data collected from an HIV/AIDS centre of excellence.A thorough review of methods used by WHO/UNAIDS to produce estimates of the Nigerian HIV/AIDS scenario was carried out.


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