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Misreporting Month of Birth: Diagnosis and Implications for Research on Nutrition and Early Childhood in Developing Countries.

ABSTRACT: A large literature has used children's birthdays to identify exposure to shocks and estimate their impacts on later outcomes. Using height-for-age z scores (HAZ) for more than 990,000 children in 62 countries from 163 Demographic and Health Surveys (DHS), we show how random errors in birth dates create artifacts in HAZ that can be used to diagnose the extent of age misreporting. The most important artifact is an upward gradient in HAZ by recorded month of birth (MOB) from start to end of calendar years, resulting in a large HAZ differential between December- and January-born children of -0.32 HAZ points. We observe a second artifact associated with round ages, with a downward gradient in HAZ by recorded age in months, and then an upward step after reaching ages 2, 3, and 4. These artifacts have previously been interpreted as actual health shocks. We show that they are not related to agroclimatic conditions but are instead linked to the type of calendar used and arise mainly when enumerators do not see the child's birth registration cards. We explain the size of the December-January gap through simulation in which 11 % of children have their birth date replaced by a random month. We find a minor impact on the average stunting rate but a larger impact in specific error-prone surveys. We further show how misreporting MOB causes attenuation bias when MOB is used for identification of shock exposure as well as systematic bias in the impact on HAZ of events that occur early or late in each calendar year.

SUBMITTER: Larsen AF

PROVIDER: S-EPMC6449488 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Misreporting Month of Birth: Diagnosis and Implications for Research on Nutrition and Early Childhood in Developing Countries.

Larsen Anna Folke AF Headey Derek D Masters William A WA

Demography 20190401 2

A large literature has used children's birthdays to identify exposure to shocks and estimate their impacts on later outcomes. Using height-for-age z scores (HAZ) for more than 990,000 children in 62 countries from 163 Demographic and Health Surveys (DHS), we show how random errors in birth dates create artifacts in HAZ that can be used to diagnose the extent of age misreporting. The most important artifact is an upward gradient in HAZ by recorded month of birth (MOB) from start to end of calenda ...[more]

PMID: 30693449

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Project description:BackgroundCanine rabies is a neglected disease causing 55,000 human deaths worldwide per year, and 99% of all cases are transmitted by dog bites. In N'Djaména, the capital of Chad, rabies is endemic with an incidence of 1.71/1,000 dogs (95% C.I. 1.45-1.98). The gold standard of rabies diagnosis is the direct immunofluorescent antibody (DFA) test, requiring a fluorescent microscope. The Centers for Disease Control and Prevention (CDC, Atlanta, United States of America) developed a histochemical test using low-cost light microscopy, the direct rapid immunohistochemical test (dRIT).Methodology/principal findingsWe evaluated the dRIT in the Chadian National Veterinary Laboratory in N'Djaména by testing 35 fresh samples parallel with both the DFA and dRIT. Additional retests (n = 68 in Chad, n = 74 at CDC) by DFA and dRIT of stored samples enhanced the power of the evaluation. All samples were from dogs, cats, and in one case from a bat. The dRIT performed very well compared to DFA. We found a 100% agreement of the dRIT and DFA in fresh samples (n = 35). Results of retesting at CDC and in Chad depended on the condition of samples. When the sample was in good condition (fresh brain tissue), we found simple Cohen's kappa coefficient related to the DFA diagnostic results in fresh tissue of 0.87 (95% C.I. 0.63-1) up to 1. For poor quality samples, the kappa values were between 0.13 (95% C.I. -0.15-0.40) and 0.48 (95% C.I. 0.14-0.82). For samples stored in glycerol, dRIT results were more likely to agree with DFA testing in fresh samples than the DFA retesting.Conclusion/significanceThe dRIT is as reliable a diagnostic method as the gold standard (DFA) for fresh samples. It has an advantage of requiring only light microscopy, which is 10 times less expensive than a fluorescence microscope. Reduced cost suggests high potential for making rabies diagnosis available in other cities and rural areas of Africa for large populations for which a capacity for diagnosis will contribute to rabies control.

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Dataset Information

Misreporting Month of Birth: Diagnosis and Implications for Research on Nutrition and Early Childhood in Developing Countries.

Publications

Misreporting Month of Birth: Diagnosis and Implications for Research on Nutrition and Early Childhood in Developing Countries.

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