期刊论文详细信息
Nutrition Journal
Application of ordinal logistic regression analysis in determining risk factors of child malnutrition in Bangladesh
Rajwanur M Rahman1  Sumonkanti Das2 
[1] Shafi Consultancy Bangladesh, Sylhet, Bangladesh;Department of Statistics, Shahjalal University of Science & Technology, Bangladesh
关键词: Child malnutrition;    Anthropometric index;    Binary logistic regression model;    Partial proportional odds model;    Proportional odds model;    Ordinal logistic regression model;   
Others  :  828456
DOI  :  10.1186/1475-2891-10-124
 received in 2011-01-23, accepted in 2011-11-14,  发布年份 2011
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【 摘 要 】

Background

The study attempts to develop an ordinal logistic regression (OLR) model to identify the determinants of child malnutrition instead of developing traditional binary logistic regression (BLR) model using the data of Bangladesh Demographic and Health Survey 2004.

Methods

Based on weight-for-age anthropometric index (Z-score) child nutrition status is categorized into three groups-severely undernourished (< -3.0), moderately undernourished (-3.0 to -2.01) and nourished (≥-2.0). Since nutrition status is ordinal, an OLR model-proportional odds model (POM) can be developed instead of two separate BLR models to find predictors of both malnutrition and severe malnutrition if the proportional odds assumption satisfies. The assumption is satisfied with low p-value (0.144) due to violation of the assumption for one co-variate. So partial proportional odds model (PPOM) and two BLR models have also been developed to check the applicability of the OLR model. Graphical test has also been adopted for checking the proportional odds assumption.

Results

All the models determine that age of child, birth interval, mothers' education, maternal nutrition, household wealth status, child feeding index, and incidence of fever, ARI & diarrhoea were the significant predictors of child malnutrition; however, results of PPOM were more precise than those of other models.

Conclusion

These findings clearly justify that OLR models (POM and PPOM) are appropriate to find predictors of malnutrition instead of BLR models.

【 授权许可】

   
2011 Das and Rahman; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]de Onis M, Frongillo EA, Blossner M: Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980. Bull Pan Am Health Organ 2000, 78:1222-1233.
  • [2]ACC/SCN: Nutrition throughout the life cycle. In Fourth report on the world nutrition situation. ACC/SCN in collaboration with IFPRI, Geneva, Switzerland; 2000.
  • [3]Pelletier DL, Frongillo EA, Schroeder DG, Habicht JP: The effects of malnutrition on child mortality in developing countries. Bul World Health Org 1995, 73:443-448.
  • [4]National Institute of Population Research and Training (NIPORT, Bangladesh), Mitra and Associates, ORC Macro: Bangladesh Demographic and Health Survey 2007. Dhaka, Bangladesh, and Calverton, Maryland USA; 2009.
  • [5]World Health Organization: Physical status: The use and interpretation of anthropometry. WHO technical report series 854, World Health Organization, Geneva, Switzerland; 1995.
  • [6]Das S, Hossain MZ, Nesa MK: Levels and trends in child malnutrition in Bangladesh. Asia Pacific Population Journal 2009, 24(2):51-78.
  • [7]Rajaretnam T, Hallad JS: Determinants of nutritional status of young children in India: Analysis of 1992-93 NFHS data. Demography India 2000, 29(2):179-200.
  • [8]Rayhan MI, Khan MSH: Factors causing malnutrition among under five children in Bangladesh. Pakistan Journal of Nutrition 2006, 5(6):558-562.
  • [9]Das S, Hossain MZ: Levels and determinants of child undernutrition in Bangladesh. Pakistan Journal of Statistics 2008, 24(4):301-323.
  • [10]Das S, Hossain MZ, Islam MA: Predictors of child chronic malnutrition in Bangladesh. Proceedings of Pakistan Academy of Science 2008, 45(3):137-155.
  • [11]Tharakan CT, Suchindran CM: Determinants of child malnutrition: an intervention model for Botswana. Nutr Res 1999, 19(6):843-860.
  • [12]Armstrong BG, Sloan M: Ordinal regression models for epidemiologic data. Am J Epidemiol 1989, 129:191-204.
  • [13]Harrell FE Jr, Margolis PA, Gove S, Mason KE, Mulholland EK, Lehmann D, et al.: Tutorial in biostatistics: Development of a clinical prediction model for an ordinal outcome: The World Health Organization ARI Multicentre Study of clinical signs and etiological agents of pneumonia, sepsis, and meningitis in young infants. Stat Med 1998, 17:909-944.
  • [14]Adeleke KA, Adepoju AA: Ordinal logistic regression model: An application to pregnancy outcomes. J Math & Stat 2010, 6(3):279-285.
  • [15]Abreu MNS, Siqueira AL, Cardoso CS, Caiaffa WT: Ordinal logistic regression models: application in quality of life studies. Cad Saúde Pública, Rio de Janeiro 2008, 24(4):S581-S591.
  • [16]Haojie Li M, Huiman XB, Aryeh DS, Reynaldo M: Effects of early childhood supplementation on the educational achievement of women. Pediatrics 2003, 112(5):1156-1162.
  • [17]Gemeroff MJ: Using the proportional odds model for health-related outcomes: Why, when, and how with various SAS® procedures. Proceedings of the Thirtieth Annual SAS Users Group International Conference: April 10-13, 2005 2005. Paper # 205-30.
  • [18]McCullagh P: Regression models for ordinal data. J R Stat Soc B 1980, 42:109-142.
  • [19]Anderson JA: Regression and ordered categorical variables. J R Stat Soc B 1984, 46:1-30.
  • [20]Agresti A: Tutorial on modeling ordered categorical response data. Psych Bull 1989, 105:290-301.
  • [21]Greenland S: Alternative models for ordinal logistic regression. Stat Med 1994, 13:1665-1677.
  • [22]Cox C: Location-scale cumulative odds models for ordinal data: A generalized non-linear model approach. Stat Med 1995, 14:1191-1203.
  • [23]Cox C: Multinomial regression models based upon continuation ratios. Stat Med 1997, 16:435-441.
  • [24]Scott SC, Goldberg MS, Mayo NE: Statistical assessment of ordinal outcomes in comparative studies. J Clin Epidemiol 1997, 50:45-55.
  • [25]McCullagh P, Nelder JA: Generalized Linear Models. New York: Chapman and Hall; 1989.
  • [26]Brant R: Assessing proportionality in the proportional odds model for ordinal logistic regression. Biometrics 1990, 46:1171-8.
  • [27]Lee J: Cumulative logit modeling for ordinal response variables: Application in biochemical research. Compt Appl Biosci 1992, 8:555-562.
  • [28]Ananth CV, Kleinbaum DG: Regression models for ordinal responses: A review of methods and applications. Int J Epidemiol 1997, 26:1323-33.
  • [29]Bender R, Grouven U: Ordinal logistic regression in medical research. J R Coll Physicians Lond 1997, 31:546-51.
  • [30]Hendrickx J: Special restrictions in multinomial logistic regression. Stata Technical Bulletin 2000, 56:18-26.
  • [31]Walters SJ, Campbell MJ, Lall R: Design and analysis of trials with quality of life as an outcome: A practical guide. J Biopharm Stat 2001, 11:155-76.
  • [32]Lall R, Campbell MJ, Walters SJ, Morgan K: A review of ordinal regression models applied on health-related quality of life assessments. Stat Methods Med Res 2002, 11:49-67.
  • [33]Hosmer DW, Lemeshow S: Applied Logistic Regression. 2nd edition. New York: John Wiley and Sons; 2000.
  • [34]Agresti A: An Introduction to Categorical Analysis. New York: John Wiley and Sons Inc; 1996.
  • [35]Pongsapukdee V, Sukgumphaphan S: Goodness of fit of cumulative logit models for ordinal response categories and nominal explanatory variables with two-factor interaction. Silpakorn U Science & Tech J 2007, 1(2):29-38.
  • [36]Peterson B, Harrell FE Jr: Partial proportional odds models for ordinal response variables. Appl Stat 1990, 39:205-217.
  • [37]Bender R, Grouven U: Using binary logistic regression models for ordinal data with non-proportional odds. J Clin Epidemiol 1998, 51(10):809-816.
  • [38]National Institute of Population Research and Training (NIPORT, Bangladesh), Mitra and Associates, and ORC Macro: Bangladesh Demographic and Health Survey 2004. Dhaka, Bangladesh, and Calverton, Maryland USA; 2005.
  • [39]Bairagi R, Chowdhury MK: Socio-economic and anthropometric status and mortality of young children in rural Bangladesh. Int J Epid 1994, 23:1197-1281.
  • [40]Ramachandran L: The effect of antenatal and natal services on pregnancy outcome and heath of the mother and child. The Journal of Family Welfare 1989, 35(5):34-46.
  • [41]Frongillo EA Jr, de Onis M, Hanson KMP: Socioeconomic and demographic factors are associated with worldwide patterns of stunting and wasting of children. J Nutr 1997, 127:2302-9.
  • [42]Dinesh K, Goel NK, Mittal P, Misra P: Influence of infant feeding practices on nutritional status of under-five children. Ind J Pediatrics 2006, 73(5):417-421.
  • [43]Ruel MT, Menon P: Child feeding practices are associated with child nutritional status in Latin America: Innovative uses of the Demographic and Health Surveys. J Nutr 2002, 132:1180-1187.
  • [44]Hosmer DW, Lemeshow S: Goodness-of-fit tests for the multiple logistic regression model. Comm Stat A 1980, 9:1043-1069.
  • [45]Hosmer DW, Hosmer T, le Cessie S, Lemeshow S: A comparison of goodness-of-fit tests for the logistic regression modle. Stat Med 1997, 16:965-980.
  • [46]Liu X: Fitting Proportional Odds Models to Educational Data in Ordinal Logistic Regression Using Stata, SAS and SPSS. In Proceedings of Annual Conference of the American Educational Research Association (AERA): April, 2007; Chicago, IL. 2008;
  • [47]Williams R: Generalized ordered logit/partial proportional odds models for ordinal dependent variables. The Stata Journal 2006, 6(1):58-82.
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