The Cox Proportional Hazard Regression Model Vis-à-Vis ITN-Factor Impact on Mortality Due to Malaria

Abstract

This study has provided a starting point for defining and working with Cox models in respect of multivariate modeling. In medical researches, there may be situations, where several risk factors potentially affect patient prognosis, howbeit, only one or two might predict patient’s predicament. In seeking to find out which of the risk factors contribute the most to the survival times of patients, there was the need for researchers to adjust the covariates to realize their impact on survival times of patients. Aside the multivariate nature of the covariates, some covariates might be categorical while others might be quantitative. Again, there might be cases where researchers need a model that has the capability of extending survival analysis methods to assessing simulta neously the effect of several risk factors on survival times. This study unveiled the Cox model as a robust technique which could accomplish the aforementioned cases. An investigation meant to evaluate the ITN-factor vis-à-vis its contribution towards death due to Malaria was exemplified with the Cox model. Data were taken from hospitals in Ghana. In doing so, we assessed hospital in-patients who reported cases of malaria (origin state) to time until death or censoring (destination stage) as a result of predictive factors (exposure to the malaria parasites) and some socioeconomic variables. We purposefully used Cox models to quantify the effect of the ITN-factor in the presence of other risk factors to obtain some measures of effect that could describe the rela tionship between the exposure variable and time until death adjusting for other variables. PH assumption holds for all three covariates. Sex of patient was insignificant to deaths due to malaria. Age of patient and user status were both significant. The magnitude of the coefficient (0.384) of ITN user status depicts its high contribution to the variation in the dependent variable.