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MEDICAL STATISTICS – EXERCISE

Clamydia is a sexually transmitted infection that is often asymtomatic in women. A cross-sectional study
conducted in East Africa looked at the association between Clamydia infection and marital status among
women aged 15-39 years. The study collected information regarding age in years, place of residence (urban
or rural), marital status (married or unmarried) and Clamydia diagnosis. The following variables will be
used:

age, area of residence (urban=0, rural=1), marital status (married=0, unmarried=1), clamydia (no clamydia
infection diagnosed=0, clamydia infection diagnosed=1)

1) State: the outcome, the study population, and the main exposure of the study

The following table was obtained:

Clamydia infection No Clamydia

diagnosed infection diagnosed
1 0
married 0 91 628
unmarried 1 64 1021

2) Draw an appropriate graph to represent the tabulated information

3) Calculate the overall percentage of women with Clamydia in this population

The 95% confidence intervals for the above proportion were 7,3% and 9,9%.

4) What is the interpretation of these lower and upper confidence intervals?

A chi-squared test was used to determine if the prevalence of Clamydia infection was different among
married and unmarried women. This gave a chi-square value of 25,15 with one degree of freedom, and a P-
value <0,0001.

5) State the null and alternative hypotheses of the chi-square test of association

6) Explain the P-value of <0,0001

In comparing Clamydia infection among married and unmarried women, the crude ODDS RATIO was 0,43
with a 95% Confidence Interval of 0,31 to 0,60.

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 7) Interpret the crude and the adjusted ODDS RATIOs estimates, and the 95% Confidence Intervals

Logistic regression was performed looking at the relationship between Clamydia infection and age as a
categorical variable. The effect of age is greater at younger ages and there is less difference between the
older age groups than between the youger age groups. After correcting for age the adjusted ODDS RATIO
was 0,52 with a 95% confidence interval of 0,42 to 0,58%.

8) Comment on the confounding effect of age on the association between marital status and
Clamydia infection