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Even now, doctors are revising treatment regimens and mortality estimates based on the experiences of anthrax patients in the recent outbreaks in the United States.
Statistical techniques were used to adjust mortality estimates based on information obtained from located LTFU patients.
This observation implies that the mortality estimates based on patients under observation and successfully located dropouts might have overestimated mortality.
By formulating this problem in terms of missing data we obtained adjusted mortality estimates, based on assumed hazard ratios for excess mortality in patients lost to follow-up.
Analysis of these data allows adjustment of mortality estimates based on information obtained on patient dropouts that were located as part of the AMPATH outreach program.
The incidence estimates using the WHO case definition were generally higher than those using a physician diagnosis, so we report incidence estimates separately by case definition; there was no clear trend in mortality estimates based on case definition, so we did not separate these estimates by case definition.
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The one-year mortality estimate based on all deaths but stratifying according to the relative size of the dropout and non-dropout groups (Method 3) is 9.2% (7.8%–10.6%).
Furthermore, in the full population we additionally adjusted for area-level smoking-related mortality estimated based upon observed lung cancer rates (Janssen and Spriensma 2012).
Deaths are highest in west and central Africa, at around 450 per 100,000 abortions, although the study authors warn that the mortality estimates are based on data from different time periods.
Mortality estimates were based on Kaplan-Meier estimates of the survival probability by age.
*Excess mortality estimates were based on a seasonal regression model applied to monthly deaths.
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