PUBH2203 Foundations of Epidemiology and Biostatistics

Question:

Risk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Uganda.

1)  What was the primary research question being investigated by this study?

2) Provide one additional piece of information about the epidemiology of leishmaniasis that was not given or extends the information in the background section of this article.

3)  This article is an example of a case-control study. Give one advantage and one disadvantage of doing a cohort study to answer the same research question.

4)  a) What was the case definition of visceral leishmaniasis used in this study?

b) Identify and explain one advantage and one disadvantage of this case definition?

5)  Identify and explain two potential strengths and two potential weaknesses of the selection of controls.

6)  a) A number of exposures were of interest in this study. What were the broad categories of exposures in this study?   

b) Identify and explain one strength and one limitation of the methods for exposure assessment.

7)  In the multivariate analysis, the authors adjusted for age group and sex. Why might sex be a confounder for the relationship between ‘Sleeps with animals’ and VL?

8)  Table 2, on p349, provides the results of the multivariable logistic regression. Interpret the odds ratio for the variable ‘Has a mosquito net’

9)  Briefly discuss the four Bradford-Hill criteria for causality, listed below, for the finding that SES is associated with visceral leishmaniasis

(i) Strength;

(ii) Dose Response;

(iii) Consistency with other study findings; and

(iv) Temporality.

10)       Discuss the external validity of this study

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