The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.

<h4>Introduction</h4>This study used Targeted Maximum Likelihood Estimation (TMLE) as a double robust method to estimate the causal effect of previous tuberculosis treatment history on the occurrence of multidrug-resistant tuberculosis (MDR-TB). TMLE is a method to estimate the marginal...

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Main Authors: Adel Hussein Elduma, Kourosh Holakouie-Naieni, Amir Almasi-Hashiani, Abbas Rahimi Foroushani, Hamdan Mustafa Hamdan Ali, Muatsim Ahmed Mohammed Adam, Asma Elsony, Mohammad Ali Mansournia
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0279976&type=printable
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author Adel Hussein Elduma
Kourosh Holakouie-Naieni
Amir Almasi-Hashiani
Abbas Rahimi Foroushani
Hamdan Mustafa Hamdan Ali
Muatsim Ahmed Mohammed Adam
Asma Elsony
Mohammad Ali Mansournia
author_facet Adel Hussein Elduma
Kourosh Holakouie-Naieni
Amir Almasi-Hashiani
Abbas Rahimi Foroushani
Hamdan Mustafa Hamdan Ali
Muatsim Ahmed Mohammed Adam
Asma Elsony
Mohammad Ali Mansournia
author_sort Adel Hussein Elduma
collection DOAJ
description <h4>Introduction</h4>This study used Targeted Maximum Likelihood Estimation (TMLE) as a double robust method to estimate the causal effect of previous tuberculosis treatment history on the occurrence of multidrug-resistant tuberculosis (MDR-TB). TMLE is a method to estimate the marginal statistical parameters in case-control study design. The aim of this study was to estimate the causal effect of the previous tuberculosis treatment on the occurrence of MDR-TB using TMLE in Sudan.<h4>Method</h4>A case-control study design combined with TMLE was used to estimate parameters. Cases were MDR-TB patients and controls were and patients who cured from tuberculosis. The history of previous TB treatment was considered the main exposure, and MDR-TB as an outcome. A designed questionnaire was used to collect a set of covariates including age, time to reach a health facility, number of times stopping treatment, gender, education level, and contact with MDR-TB cases. TMLE method was used to estimate the causal association of parameters. Statistical analysis was carried out with ltmle package in R-software. Result presented in graph and tables.<h4>Results</h4>A total number of 430 cases and 860 controls were included in this study. The estimated risk difference of the previous tuberculosis treatment was (0.189, 95% CI; 0.161, 0.218) with SE 0.014, and p-value (<0.001). In addition, the estimated risk ratio was (16.1, 95% CI; 12.932, 20.001) with SE = 0.014 and p-value (<0.001).<h4>Conclusion</h4>Our findings indicated that previous tuberculosis treatment history was determine as a risk factor for MDR-TB in Sudan. Also, TMLE method can be used to estimate the risk difference and the risk ratio in a case-control study design.
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spelling doaj-art-a1c8e501d1dd4722940c5e1f1d882d452025-08-20T03:13:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e027997610.1371/journal.pone.0279976The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.Adel Hussein EldumaKourosh Holakouie-NaieniAmir Almasi-HashianiAbbas Rahimi ForoushaniHamdan Mustafa Hamdan AliMuatsim Ahmed Mohammed AdamAsma ElsonyMohammad Ali Mansournia<h4>Introduction</h4>This study used Targeted Maximum Likelihood Estimation (TMLE) as a double robust method to estimate the causal effect of previous tuberculosis treatment history on the occurrence of multidrug-resistant tuberculosis (MDR-TB). TMLE is a method to estimate the marginal statistical parameters in case-control study design. The aim of this study was to estimate the causal effect of the previous tuberculosis treatment on the occurrence of MDR-TB using TMLE in Sudan.<h4>Method</h4>A case-control study design combined with TMLE was used to estimate parameters. Cases were MDR-TB patients and controls were and patients who cured from tuberculosis. The history of previous TB treatment was considered the main exposure, and MDR-TB as an outcome. A designed questionnaire was used to collect a set of covariates including age, time to reach a health facility, number of times stopping treatment, gender, education level, and contact with MDR-TB cases. TMLE method was used to estimate the causal association of parameters. Statistical analysis was carried out with ltmle package in R-software. Result presented in graph and tables.<h4>Results</h4>A total number of 430 cases and 860 controls were included in this study. The estimated risk difference of the previous tuberculosis treatment was (0.189, 95% CI; 0.161, 0.218) with SE 0.014, and p-value (<0.001). In addition, the estimated risk ratio was (16.1, 95% CI; 12.932, 20.001) with SE = 0.014 and p-value (<0.001).<h4>Conclusion</h4>Our findings indicated that previous tuberculosis treatment history was determine as a risk factor for MDR-TB in Sudan. Also, TMLE method can be used to estimate the risk difference and the risk ratio in a case-control study design.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0279976&type=printable
spellingShingle Adel Hussein Elduma
Kourosh Holakouie-Naieni
Amir Almasi-Hashiani
Abbas Rahimi Foroushani
Hamdan Mustafa Hamdan Ali
Muatsim Ahmed Mohammed Adam
Asma Elsony
Mohammad Ali Mansournia
The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
PLoS ONE
title The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
title_full The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
title_fullStr The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
title_full_unstemmed The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
title_short The Targeted Maximum Likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in Multidrug-resistant tuberculosis in Sudan.
title_sort targeted maximum likelihood estimation to estimate the causal effects of the previous tuberculosis treatment in multidrug resistant tuberculosis in sudan
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0279976&type=printable
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