MAUTI, Clare Nyabonyi

MAUTI, Clare Nyabonyi

Student Bio

I'm a data scientist with passion in survival analysis and machine learning especially in the field of medicine with a MSc. Biometry training from the University of Nairobi from where I was also awarded my undergraduate degree in BSc. Statistics. My masters project was looking at the incidence and determinants of lost to follow-up among patients on antiretroviral therapy (application of the competing risks regression). Currently I work as an Impact analyst at Living Goods where I'm part of a team that designs and implements research studies in community health in order to improve the lives of the poor.

Project Summary



Death is ofttimes ignored in lost to follow up studies yet it is a competing event in such cases as it is informative of its probability. A couple of studies have been done on incidence and determinants of lost to follow up however solid estimates may be found if death as a competing event is taken into account rather than censoring. The goal of the study seeks to find out the incidence and determinants of lost to follow up with and without death as a competing event. Cox proportional hazards model and Fine-Gray's subdistribution hazards model were employed to model the outcome of the determinants on lost to follow up. Kaplan-Meier graph was done to describe the probability of lost to follow up in the cox proportional hazards model while cumulative incidence function was done to describe the incidence of lost to follow up while taking death as competing event into account. Each variable was tested for the assumption of proportional hazards before inclusion in the final model using Schoenfeld residuals. 1047 patients were included in the study. The overall lost to follow up rate was 14% with 2.4 per 100-person years incidence rate. Being male, having CD4 count of < 200 mm^3 and a younger age (15-30 years) were significant determinants of lost to follow up, hence there is need to give extra attention to these groups of people in order to improve HIV care service delivery.