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Your search keyword '"Stanley M. Kamande"' showing total 2 results
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2 results on '"Stanley M. Kamande"'

1. Small area estimation of under-5 mortality in Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia using spatially misaligned data

Author

Laura Dwyer-Lindgren, Ellen R. Squires, Stephanie Teeple, Gloria Ikilezi, D. Allen Roberts, Danny V. Colombara, Sarah Katherine Allen, Stanley M. Kamande, Nicholas Graetz, Abraham D. Flaxman, Charbel El Bcheraoui, Kristjana Asbjornsdottir, Gilbert Asiimwe, Ângelo Augusto, Orvalho Augusto, Baltazar Chilundo, Caroline De Schacht, Sarah Gimbel, Carol Kamya, Faith Namugaya, Felix Masiye, Cremildo Mauieia, Yodé Miangotar, Honoré Mimche, Acácio Sabonete, Haribondhu Sarma, Kenneth Sherr, Moses Simuyemba, Aaron Chisha Sinyangwe, Jasim Uddin, Bradley H. Wagenaar, and Stephen S. Lim

Subjects
U5MR, Small area estimation, Subnational, Geographic disparities, Inequalities, Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

Abstract Background The under-5 mortality rate (U5MR) is an important metric of child health and survival. Country-level estimates of U5MR are readily available, but efforts to estimate U5MR subnationally have been limited, in part, due to spatial misalignment of available data sources (e.g., use of different administrative levels, or as a result of historical boundary changes). Methods We analyzed all available complete and summary birth history data in surveys and censuses in six countries (Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia) at the finest geographic level available in each data source. We then developed small area estimation models capable of incorporating spatially misaligned data. These small area estimation models were applied to the birth history data in order to estimate trends in U5MR from 1980 to 2015 at the second administrative level in Cameroon, Chad, Mozambique, Uganda, and Zambia and at the third administrative level in Bangladesh. Results We found substantial variation in U5MR in all six countries: there was more than a two-fold difference in U5MR between the area with the highest rate and the area with the lowest rate in every country. All areas in all countries experienced declines in U5MR between 1980 and 2015, but the degree varied both within and between countries. In Cameroon, Chad, Mozambique, and Zambia we found areas with U5MRs in 2015 that were higher than in other parts of the same country in 1980. Comparing subnational U5MR to country-level targets for the Millennium Development Goals (MDG), we find that 12.8% of areas in Bangladesh did not meet the country-level target, although the country as whole did. A minority of areas in Chad, Mozambique, Uganda, and Zambia met the country-level MDG targets while these countries as a whole did not. Conclusions Subnational estimates of U5MR reveal significant within-country variation. These estimates could be used for identifying high-need areas and positive deviants, tracking trends in geographic inequalities, and evaluating progress towards international development targets such as the Sustainable Development Goals.

Published
2018
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2. Treadmill exercise testing improves diagnostic accuracy in children with concealed congenital long QT syndrome

Author

Trisha M Patel, Jeffrey P. Moak, Sridhar Hanumanthaiah, Charles I. Berul, Stanley M Kamande, Elizabeth Jarosz, James E. Bost, and Elizabeth D. Sherwin

Subjects
Male, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Supine position, Adolescent, Long QT syndrome, Stress testing, Treadmill exercise, 030204 cardiovascular system & hematology, Sitting, QT interval, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Bruce protocol, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, cardiovascular diseases, 030212 general & internal medicine, Treadmill, Child, business.industry, General Medicine, medicine.disease, Long QT Syndrome, Exercise Test, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, circulatory and respiratory physiology
Abstract

Background Resting electrocardiogram (ECG) identification of long QT syndrome (LQTS) has limitations. Uncertainty exists on how to classify patients with borderline prolonged QT intervals. We tested if exercise testing could help serve to guide which children with borderline prolonged QT intervals may be gene positive for LQTS. Methods Pediatric patients (n = 139) were divided into three groups: Controls (n = 76), gene positive LQTS with borderline QTc (n = 21), and gene negative patients with borderline QTc (n = 42). Borderline QTc was defined between 440-470 (male) and 440-480 (female) ms. ECGs were recorded supine, sitting, and standing. Patients then underwent treadmill stress testing with Bruce protocol followed by a 9-minute recovery phase. Results Supine resting QTc, age, and Schwartz score for the three groups were: (a) gene positive: 446 ± 23 ms, 12.4 ± 3.4 years old, 3.2 ± 1.8; (b) gene negative: 445 ± 20 ms, 12.1 ± 2 years old, 2.0 ± 1.2; and (c) control: 400 ± 24 ms, 15.0 ± 3 years old. The three groups could be differentiated by their QTc response at two time points: standing and recovery phase at 6 minutes. Standing QTc ≥460 ms differentiated borderline prolonged QTc patients (gene positive and gene negative) from controls. Late recovery QTc ≥480 ms distinguished gene positive from gene negative patients. Conclusion Exercise stress testing can be useful to identify children who are gene positive borderline LQTS from a normal population and gene negative borderline QTc children, allowing for selective gene testing in a higher risk group of patients with borderline QTc intervals and intermediate Schwartz scores.

Published
2020
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