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dc.contributor.authorChami, Goyletteen
dc.contributor.authorKabatereine, Narcis Ben
dc.contributor.authorTukahebwa, Edridah Men
dc.contributor.authorDunne, Daviden
dc.date.accessioned2018-12-05T00:31:12Z
dc.date.available2018-12-05T00:31:12Z
dc.date.issued2018-10-31en
dc.identifier.issn1742-5689
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286326
dc.description.abstractIn low-income countries, complex comorbidities and weak health systems confound disease diagnosis and treatment. Yet, data-driven approaches have not been applied to develop better diagnostic strategies or to tailor treatment delivery for individuals within rural poor communities. We observed symptoms/diseases reported within three months by 16,357 individuals aged 1+ years in 17 villages of Mayuge District, Uganda. Symptoms were mapped to the Human Phenotype Ontology. Comorbidity networks were constructed. An edge between two symptoms/diseases was generated if the relative risk >1, ɸ correlation >0, and local false discovery rate<0.05. We studied how network structure and flagship symptom profiles varied against biosocial factors. 88.05% of individuals (14402/16357) reported at least one symptom/disease. Young children and individuals in worse-off households—low socioeconomic status, poor water, sanitation, and hygiene, and poor medical care—had dense network structures with the highest comorbidity burden and/or were conducive to the onset of new comorbidities from existing flagship symptoms, such as fever. Flagship symptom profiles for fever revealed self-misdiagnoses of fever as malaria and sexually-transmitted infections as a potentially missed cause of fever in individuals of reproductive age. Network analysis may inform the development of new diagnostic and treatment strategies for flagship symptoms used to characterize syndromes/diseases of global concern.
dc.format.mediumElectronicen
dc.languageengen
dc.publisherThe Royal Society
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumansen
dc.subjectCommunicable Diseasesen
dc.subjectHygieneen
dc.subjectCluster Analysisen
dc.subjectSanitationen
dc.subjectComorbidityen
dc.subjectWater Supplyen
dc.subjectDeveloping Countriesen
dc.subjectSocioeconomic Factorsen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectMiddle Ageden
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectInfanten
dc.subjectRural Populationen
dc.subjectDelivery of Health Careen
dc.subjectUgandaen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.subjectGlobal Healthen
dc.titlePrecision global health and comorbidity: a population-based study of 16 357 people in rural Uganda.en
dc.typeArticle
prism.issueIdentifier147en
prism.publicationDate2018en
prism.publicationNameJournal of the Royal Society, Interfaceen
prism.volume15en
dc.identifier.doi10.17863/CAM.33636
dcterms.dateAccepted2018-10-09en
rioxxterms.versionofrecord10.1098/rsif.2018.0248en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-10-31en
dc.contributor.orcidChami, Goylette [0000-0002-4653-0846]
dc.contributor.orcidDunne, David [0000-0002-8940-9886]
dc.identifier.eissn1742-5662
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idWellcome Trust (100891/Z/13/Z)
pubs.funder-project-idWellcome Trust (083931/Z/07/Z)


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International