Survival Analysis of Twin Under Five Mortality in Ethiopia: Using Gamma Frailty Modelling Approach

Abstract

Twins are relatively rare events, but several studies confirm that they contribute substantially to mortality in both neonatal and post-neonatal periods. The excess infant and child mortality rates among twins calls for a need to identify the main causes behind it. In studies involving multiple individuals from the same family, the independence assumption is not plausible unless all important familial factors were measured and controlled for in the model. Hence, it is important to include random effect or frailty in the model to account for the existence of correlation or unmeasured covariates. This study, therefore, employed survival analysis using gamma frailty models. Information on twin under-five mortality was found from the birth history of women who were included in the 2016 Ethiopia Demographic and Health survey. The results of the study show that sex of child, between twins birth order, preceding birth interval, and succeeding birth interval are significantly associated with under-five twin mortality. In addition, the result of the study confirmed the significance of shared /family random effect.

Keywords: word; under-five twin mortality; frailty; random effect; gamma

DOI: 10.7176/JBAH/9-15-05

Publication date: August 31^st 2019