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Identifying Fevered Children Who Received an Antimalarial [message #9336] Mon, 14 March 2016 18:09 Go to next message
dccasey is currently offline  dccasey
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Registered: March 2016
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I'm trying to estimate the fraction of fevered kids (h22) who receive any antimalarial using the child module, variables h22, h37* and ml13*. For the h37 series and the ml13 series, I set 'received an antimalarial' to 1 if the child is reported to have taken/been given an antimalarial (e.g. fansidar, ACT). In some surveys (e.g. Malawi, 2004) a fevered child might be tagged as not receiving an antimalarial in h37* variables but is tagged if ml13* variables are looked at.

I guess my broad question is: what is the difference between the h37* variables and ml13* variables? For example, in the MWI 2004 survey, the labels suggest that h37a==1 if the child received fansidar for a fever while ml13a ==1 if fansidar was taken for fever/convulsion. Yet for some reason, these two answers are not always the same.

From the recode files, they seem to represent the same data, but the variable labels occasionally disagree (various combinations of fever, convulsions and coughs).

Thoughts/insights?

[Updated on: Mon, 14 March 2016 18:13]

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Re: Identifying Fevered Children Who Received an Antimalarial [message #9394 is a reply to message #9336] Thu, 24 March 2016 00:40 Go to previous messageGo to next message
Liz-DHS
Messages: 1516
Registered: February 2013
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Dear User,
We have referred your post to one of our technical experts. As soon as we have a response, we will post. Thanks!
Re: Identifying Fevered Children Who Received an Antimalarial [message #9447 is a reply to message #9394] Tue, 29 March 2016 14:37 Go to previous messageGo to next message
dccasey is currently offline  dccasey
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Thanks! I look forward to hearing the results.
Re: Identifying Fevered Children Who Received an Antimalarial [message #9507 is a reply to message #9447] Wed, 06 April 2016 20:49 Go to previous messageGo to next message
Trevor-DHS is currently offline  Trevor-DHS
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Registered: January 2013
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The general rule currently for the h37 series and the ml13 series is that ml variables are used whenever the malaria module is used in a questionnaire and the h37 variables are not used in that case. For both sets of variables the questions are applicable for children with fever or cough in the last 2 weeks (h22 == 1 | h31 == 1 | h31 == 2) [Note h31 code 1 (cough in last 24 hours) is rarely used but is still permitted where the data are collected for 24 hours and for 2 weeks.]

In some surveys though, particularly older ones, this general rule has not been followed for various reasons, and we find non-standard denominators for some variables. In earlier surveys there were some differences with ml13 sometimes including treatment for fever and convulsions, sometimes fever or convulsions, and sometimes fever alone, while the h37 series ignored the questions related to convulsions. Additionally, in many earlier surveys, questions about treatment were asked separately about treatment for fever and for cough, and the variables were typically presented separately in that case.

Consequently it is necessary to check the questionnaires and to review the data and see which cases are applicable for each variable.

To check data for a particular survey I would suggest doing some simple crosstabs, such as:
gen fevercough = (h22 == 1 | h31 == 1 | h31 == 2)
tab h37a fevercough,m
tab h37a h22,m
tab h37a h31,m
* and similarly with ml13a instead of h37a.
tab ml13a fevercough,m
tab ml13a h22,m
tab ml13a h31,m
tab ml13a ml12,m

Look at the cases which are not missing for h37a or ml13a compared with the cases that are code 1 on fevercough, code 1 on h22, code 1 or 2 on h31, or code 1 on ml12. For example, for Malawi 2004 I can deduce that the h37 series are applicable only for children with fever in the last 2 weeks from the following table:
. tab h37a h22,m

  fansidar |
 taken for |              had fever in last two weeks
     fever |        no        yes         dk          9          . |     Total
-----------+-------------------------------------------------------+----------
        no |         0      2,823          0          0          0 |     2,823 
       yes |         0        879          0          0          0 |       879 
         . |     5,995          0        157          4      1,056 |     7,212 
-----------+-------------------------------------------------------+----------
     Total |     5,995      3,702        157          4      1,056 |    10,914

as the only cases that are not missing for h37a are those where h22 is 1, and when h22 is not 1 then h37 is missing (not applicable).

In this survey ml12 is labeled as convulsions in the last 2 weeks, but crosstabbing ml12 with h22 shows that they are identical and ml12 should just say fever in the last 2 weeks. If you look at s472 you will find information about convulsions in the last 2 weeks. However, looking at the questions following question 472 in the questionnaire, no information was asked about treatment with different drugs so there is no data on treatment with, say, Fansidar for convulsions.

On checking the programs used for the Malawi 2004 survey it appears that the h37 series uses data from questions 466C, 466H, 466M, 466R, 466W. In contrast, the ml13 series only use data from question 466C which is only asked if the child was given medicine from home or from a pharmacy without prescription. In this case I would say that the ml12 and ml13 series are mis-labeled.

Where the questionnaire differ from standard questionnaires (and the Malawi 2004 questionnaires differ quite a bit) you may find differences like this. Unfortunately I cannot give you a hard and fast rule and I suggest that you use some simple crosstabs, such as above, and you review the country specific variables (e.g. s472) to work out who certain questions apply to. I hope this helps.
Re: Identifying Fevered Children Who Received an Antimalarial [message #25629 is a reply to message #9507] Sun, 20 November 2022 17:52 Go to previous messageGo to next message
hamiltonresearch is currently offline  hamiltonresearch
Messages: 3
Registered: November 2022
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Hi,

I have a similar question. I am currently using children who received any form of anti-malarial for fever treatment in Ghana. I am looking at the 1988, 1993, 1998, 2003, and 2008 DHS datasets. For 1988 I use the variable h24, h33a for 1993, s449bc for 1998. For 2003 and 2008, I am wondering what variable is consistent/similar to those variables that identifies children who has taken anti-malarial for fever. This is a very important variable I will be using to run my difference-in-differences model. Thank you in advance for you help!
Re: Identifying Fevered Children Who Received an Antimalarial [message #25648 is a reply to message #25629] Tue, 22 November 2022 09:05 Go to previous messageGo to next message
Janet-DHS is currently offline  Janet-DHS
Messages: 258
Registered: April 2022
Senior Member
Following is a response from DHS staff member Tom Pullum:

To search for such variables, I use "lookfor" in Stata. It will identify any variables that include a keyword in the variable label. Specifically, I searched with "lookfor anti" and "lookfor malaria". In the 2003 survey (GH4B) I didn't find such variables. In the 2008 survey (GH5A) the malaria module was used and the relevant variables are ml13a-z plus some other codes.

It appears that at some point the term "antimalarial" in the variable names was replaced with specific medications such as quinine and chloroquine and amodiaquine. I went back to the 2003 survey and entered "lookfor quin" and was led to variables with names beginning with h37 and ml13.

What I have described is a search strategy using keywords in the variable name that will almost always lead you to those hard-to-find variables. You can also look at the questionnaire (in an appendix to the final report) so search questions and response codes, and that will usually help.
Re: Identifying Fevered Children Who Received an Antimalarial [message #25690 is a reply to message #25648] Sat, 26 November 2022 12:09 Go to previous messageGo to next message
hamiltonresearch is currently offline  hamiltonresearch
Messages: 3
Registered: November 2022
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Hello,

Thank you for the insight! I am running a summary statistics / descriptive table using Ghana DHS data for the years 1988, 1993, 1998, 2003, and 2008, and I am wondering why is the unit of observation for the variable h22 (incidence of fever in the last two weeks) so low?

Thank you in advance for your help!
Re: Identifying Fevered Children Who Received an Antimalarial [message #25721 is a reply to message #25690] Wed, 30 November 2022 15:48 Go to previous message
Janet-DHS is currently offline  Janet-DHS
Messages: 258
Registered: April 2022
Senior Member
Following is a response from DHS staff member Tom Pullum:

When you say "so low", is this relative to other countries? When I run "tab h22 if b9==0 [iweight=v005/1000000]" for this survey (restricting to children who are living with their mother) in the KR file for the Ghana 2008 survey, I get "yes" for 20.3% of children. Considering that the reference period is just the last two weeks before the interview, what would you expect the level to be?
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