Mortality estimation

  • 文章类型: Journal Article
    背景:也门正在进行的战争造成了严重而持久的危机,使近四分之三的人口需要紧急的人道主义援助。尽管经历了八年的冲突,但关于冲突(以及冲突与新冠肺炎大流行)如何影响也门死亡率的可靠估计很少。由于安全局势限制了受影响人口的机会,我们设计了一种替代当地死亡率调查的新方法。
    方法:我们使用了基于Web的,受访者驱动的抽样方法,在全球也门侨民中传播死亡率调查。我们使用Cox比例风险生存模型来估计暴露之间的关联(即冲突前,冲突,和冲突/大流行时期)和死亡风险,调整性别和出生队列。
    结果:89名符合条件的受访者完成了调查。受访者提供了1704人的状况数据,其中85人(5%)死亡;据报道,这65人(3.8%)在也门死亡。对受访者父母在50岁生日后的生存率进行的分析(根据性别和出生队列进行了调整)提供了微弱的证据,表明与战前相比,战争和大流行时期与更高的死亡率相关。对也门死亡人数的分析也表明,但在战争/大流行期间死亡的危险不显著:当考虑到整个队列中不同程度的也门外迁移时,这种关联趋于显著.也门受访者的兄弟姐妹和五岁以下儿童死亡人数太低,无法进行有意义的分析。
    结论:我们的数据表明,在战争/大流行期间死亡率增加,与战前时期相比,在也门成年人中。然而,我们的发现需要仔细解释,因为我们的研究设计无法确定因果关系,由于我们的小样本和无代表性样本似乎偏向高收入,城市社区。对散居人口的调查提供了一种描述受危机影响人口死亡模式的有希望的手段;但是,可能需要大量的受访者来实现准确的死亡率估计并调整选择偏差.
    BACKGROUND: The ongoing war in Yemen has created a severe and protracted crisis that has left nearly three-quarters of the population in need of urgent humanitarian assistance. Despite eight years of conflict there exist few robust estimates of how the conflict (and the conflict combined with the COVID-19 pandemic) have affected mortality in Yemen. As the security situation has limited access to affected populations we have designed a novel alternative to local mortality surveys.
    METHODS: We used a web-based, respondent-driven sampling method to disseminate a mortality survey amongst the global Yemeni diaspora. We used Cox proportional hazards survival models to estimate the association between the exposure (i.e. between the pre-conflict, conflict, and conflict/pandemic periods) and mortality risk, adjusted for gender and birth cohort.
    RESULTS: Eighty-nine eligible respondents completed the survey. Respondents provided data on the status of 1704 individuals of whom 85 (5%) had died; of these 65 (3.8%) were reported to have died in Yemen. An analysis of survivorship of respondents\' parents after their 50th birthday (adjusted for gender and birth cohort) provided weak evidence that the war and pandemic periods were associated with higher mortality when compared to the pre-war period. Analysis of the subset of individuals who died in Yemen also suggested an increased, but non-significant hazard of dying during the war/pandemic period: this association tended towards significance when allowing for varying degrees of out-migration from Yemen across the cohort. The number of deaths amongst respondents\' siblings and children under five in Yemen were too low to allow meaningful analysis.
    CONCLUSIONS: Our data suggest increased mortality during the war/pandemic period, compared to the pre-war period, among older Yemeni adults. However, our findings require careful interpretation as our study design cannot establish causation, and as our small and non-representative sample appeared skewed towards higher-income, urban communities. Surveys of diaspora populations offer a promising means of describing mortality patterns in crisis-affected populations; though, large numbers of respondents are likely required to achieve accurate mortality estimates and to adjust for selection bias.
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  • 文章类型: Journal Article
    背景:受访者驱动抽样(RDS)既指链式推荐抽样方法,也指用于分析抽样数据的分析模型。基于网络的受访者驱动抽样(webRDS)使用基于互联网的招聘以及电子调查来进行RDS研究;目前还没有商业上可用的webRDS解决方案。我们设计并开发了一个webRDS解决方案,以支持一项旨在估计也门冲突归因死亡率的研究。我们的webRDS解决方案由现有的调查平台(即ODK)和定制的RDS系统组成。RDS系统旨在管理和管理RDS调查级联,包括:(1)应用程序编程接口,(2)研究参与者客户,和(3)管理员界面。我们在这里报告webRDS解决方案的设计及其实现。
    结果:在整个解决方案的开发过程中,我们咨询了也门侨民的成员。技术障碍主要是由于:WhatsApp关于批量消息传递和自动消息传递行为的政策,短信的固有约束,和SMS过滤行为。语言支持是直接但耗时的。调查吸收低于预期。可能影响摄取的因素包括:我们使用消耗品调查链接,侨民的兴趣低,缺乏物质激励,以及调查本身的长度和主题。SMS/WhatsApp消息集成相对复杂,并且限制了我们可以向潜在参与者发送的信息。
    结论:尽管调查结果低于预期,我们相信我们的webRDS解决方案提供了有效和灵活的方法来调查全球不同的人群。
    Respondent-driven sampling (RDS) refers both to a chain-referral sampling method and an analytical model for analysing sampled data. Web-based respondent-driven sampling (webRDS) uses internet-based recruitment coupled with an electronic survey to carry out RDS studies; there is currently no commercially available webRDS solution. We designed and developed a webRDS solution to support a research study aimed at estimating conflict-attributable mortality in Yemen. Our webRDS solution is composed of an existing survey platform (i.e. ODK) and a bespoke RDS system. The RDS system is designed to administer and manage an RDS survey cascade and includes: (1) an application programming interface, (2) a study participant client, and (3) an administrator interface. We report here on the design of the webRDS solution and its implementation.
    We consulted members of the Yemeni diaspora throughout the development of the solution. Technical obstacles were largely the result of: WhatsApp\'s policies on bulk messaging and automated messaging behaviour, the inherent constraints of SMS messaging, and SMS filtering behaviour. Language support was straight-forward yet time consuming. Survey uptake was lower than expected. Factors which may have impacted uptake include: our use of consumable survey links, low interest amongst the diaspora population, lack of material incentives, and the length and subject matter of the survey itself. The SMS/WhatsApp messaging integration was relatively complex and limited the information we could send potential participants.
    Despite lower-than expected survey uptake we believe our webRDS solution provides efficient and flexible means to survey a globally diverse population.
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  • 文章类型: Journal Article
    Sibling survival histories are a major source of adult mortality estimates in countries with incomplete death registration. We evaluate age and date reporting errors in sibling histories collected during a validation study in the Niakhar Health and Demographic Surveillance System (Senegal). Participants were randomly assigned to either the Demographic and Health Survey questionnaire or a questionnaire incorporating an event history calendar, recall cues, and increased probing strategies. We linked 60-62 per cent of survey reports of siblings to the reference database using manual and probabilistic approaches. Both questionnaires showed high sensitivity (>96 per cent) and specificity (>97 per cent) in recording siblings\' vital status. Respondents underestimated the age of living siblings, and age at and time since death of deceased siblings. These reporting errors introduced downward biases in mortality estimates. The revised questionnaire improved reporting of age of living siblings but not of age at or timing of deaths.
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  • 文章类型: Journal Article
    背景:允许分析不同人口变化的适当的死亡率预测模型是人口转型国家感兴趣的话题。死亡率降低等现象,老化,预期寿命的增加对规划旨在促进各国经济和社会发展的公共政策非常有用。据我们所知,本文是最早评估应用于简化寿命表的死亡率预测模型的性能的论文之一。
    目标:选择一个死亡率模型,该模型可以最好地描述和预测哥伦比亚的死亡率特征,而只有简化的生命表。
    方法:我们使用了1973-2005年期间哥伦比亚的简略生命表和来自拉丁美洲人类死亡率数据库的数据。本研究提出了不同的死亡率模型来处理死亡概率的建模和预测。对于死亡率模型的比较,分析了两个标准:图形残差分析和保持方法来评估模型的预测性能,应用不同的拟合优度度量。
    结果:只有三个模型没有收敛问题:Lee-Carter(LC),李-卡特有两个条款(LC2),和年龄-周期-队列(APC)模型。所有型号都更适合女性,LC上LC2的改善主要适用于男性的中心年龄,和APC模型的拟合比其他两个差。对标准化偏差残差的分析使我们能够推断出合理拟合哥伦比亚死亡率数据的模型是LC和LC2。主要残差对应于儿童的年龄和更晚的年龄。
    结论:LC和LC2模型具有更好的拟合效果,确定哥伦比亚死亡率的主要特征。根据按性别划分的简化生命表进行的死亡率预测对于研究发展中国家之间的差异和人口变化的趋同/分歧具有明显的附加值。
    BACKGROUND: An adequate forecasting model of mortality that allows an analysis of different population changes is a topic of interest for countries in demographic transition. Phenomena such as the reduction of mortality, ageing, and the increase in life expectancy are extremely useful in the planning of public policies that seek to promote the economic and social development of countries. To our knowledge, this paper is one of the first to evaluate the performance of mortality forecasting models applied to abridged life tables.
    OBJECTIVE: Select a mortality model that best describes and forecasts the characteristics of mortality in Colombia when only abridged life tables are available.
    METHODS: We used Colombian abridged life tables for the period 1973-2005 with data from the Latin American Human Mortality Database. Different mortality models to deal with modeling and forecasting probability of death are presented in this study. For the comparison of mortality models, two criteria were analyzed: graphical residuals analysis and the hold-out method to evaluate the predictive performance of the models, applying different goodness of fit measures.
    RESULTS: Only three models did not have convergence problems: Lee-Carter (LC), Lee-Carter with two terms (LC2), and Age-Period-Cohort (APC) models. All models fit better for women, the improvement of LC2 on LC is mostly for central ages for men, and the APC model\'s fit is worse than the other two. The analysis of the standardized deviance residuals allows us to deduce that the models that reasonably fit the Colombian mortality data are LC and LC2. The major residuals correspond to children\'s ages and later ages for both sexes.
    CONCLUSIONS: The LC and LC2 models present better goodness of fit, identifying the principal characteristics of mortality for Colombia.Mortality forecasting from abridged life tables by sex has clear added value for studying differences between developing countries and convergence/divergence of demographic changes.
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  • 文章类型: Comparative Study
    This paper provides an overview of trends in mortality in children aged under 5 and adults between the ages of 15 and 60 in sub-Saharan Africa, using data on the survival of the children and siblings collected in Demographic and Health Surveys. If conspicuous stalls in the 1990s are disregarded, child mortality levels have generally declined and converged over the last 30-40 years. In contrast, adult mortality in many East and Southern African countries has increased markedly, echoing earlier increases in the incidence of HIV. In recent years, adult mortality levels have begun to decline once again in East Africa, in some instances before the large-scale expansion of antiretroviral therapy programmes. More surprising is the lack of sustained improvements in adult survival in some countries that have not experienced severe HIV epidemics. Because trends in child and adult mortality do not always evolve in tandem, we argue that model-based estimates, inferred by matching indices of child survival onto standard mortality schedules, can be very misleading.
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