Modeling the E ects of Nutritional Withdrawal on CD4 Cell Count Among HIV/AIDS Patients Using Generalized Estimating Equations (GEE).

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September 08, 2015
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Abstract
Malnutrition is one of the major complications of HIV/AIDS (Lui et al., 2011). Nutritional intervention programs for People Living with HIV/AIDS (PLWHA) were withdrawn in Kumasi. The aim of this study is to examine the withdrawal e ects of the nutritional intervention on CD4+ cell counts and model the CD4+ cell counts before, during and after the initiation of the intervention, given BMI, HB levels and other characteristics of PLWHA. The study was carried out using data from a retrospective cohort study of 501 PLWHA who started ART from 2007 to 2011. Generalized Estimation Equations (GEE) was used to model the CD4+ cell counts before, during and after the initiation of the intervention, given BMI, HB levels and other characteristics of PLWHA. Age, the linear interaction between HB and time, the linear interaction between BMI and time, Group 1 (No Intervention) and Group 2 (Intervention) were all statistically signi cant predictors of CD4+ cell count at the level of 0.05. The nutritional interven- tion positively a ected the health outcomes of PLWHA during the nutritional intervention. After the intervention however, there was a signi cant reduction in the average CD4 cell count of respondents. BMI predicts a positive gain in CD4+ cell count of respondent and there was a positive correlation between the blood haemoglobin levels of the HIV/AIDS patients and their CD4 cell counts. There was an inverse relationship between age and CD4 cell counts of HIV/AIDS patients; which is consistent with other works.
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A thesis submitted to the Department of Mathematics, Kwame Nkrumah University of Science and Technology In partial fulfillment of the requirement for the Degree of M.Phil Mathematical Statistics.
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