Defining the population attributable fraction for infectious diseases

Brooks-Pollock, Ellen; Danon, León

doi:10.1093/ije/dyx055

Cited by 20 publications

(16 citation statements)

References 20 publications

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“…Levin's formula is oriented towards non-communicable disease phenomena and this formula does not take into account transmission that occurs when prisoners leave prison and infect people in the general population 18 . More complex PAF modeling techniques were recently proposed which show higher PAFs for communicable disease than those obtained with traditional analyses, but still need to be validated 30 .…”

Section: Discussionmentioning

confidence: 99%

Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay

Sequera

Aguirre²,

Estigarribia³

et al. 2020

Sci Rep

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Incarcerated populations are at high-risk to develop tuberculosis (TB), however their impact on the population-level tuberculosis epidemic has been scarcely studied. We aimed to describe the burden and trends of TB among incarcerated populations over time in Paraguay, its clinical and epidemiological differences and the population attributable fraction. This is an observational, descriptive study including all TB cases notified to the National TB control Program in Paraguay during the period 2009–2018. We also used case registries of prisoners diagnosed with tuberculosis from the Minister of Justice. The population attributable fraction of TB in the community due to incarcerated cases was estimated through Levin’s formula. The characteristics of TB cases in and outside of prison were compared as well as the characteristics of TB in prisons were modified over time. During 2009–2018, 2764 (9.7%) of the 28,534 TB reported cases in Paraguay occurred in prisons. The number of prisoners in Paraguay increased from 6258 in 2009 to 14,627 in 2018 (incarceration rate, 101 to 207 per 100,000 persons) while the number of TB cases among prisoners increased by 250% (n = 192 in 2009 versus n = 480 in 2018). The annual TB notification rate among male prisoners was 3218 and 3459 per 100,000 inmates in 2009 and 2018, respectively. The percentage of all TB cases occurring among prisoners increased from 7.1% in 2009 to 14.5% in 2018. The relative risk of TB in prisons compared to community was 70.3 (95% CI, 67.7–73.1); the overall population attributable risk was 9.5%. Among the 16 penitentiary centers in the country, two of them—Tacumbú (39.0%) and Ciudad del Este (23.3%)—represent two thirds of all TB cases in prisons. TB among inmates is predominantly concentrated in those 20–34 years old (77.3% of all), twice the percentage of cases for the same age group outside of prison. Our findings show that the TB epidemic in prisons represents one of the most important challenges for TB control in Paraguay, especially in the country’s largest cities. Appropriate TB control measures among incarcerated populations are needed and may have substantial impact on the overall TB burden in the country.

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Section: Discussionmentioning

confidence: 99%

Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay

Sequera

Aguirre²,

Estigarribia³

et al. 2020

Sci Rep

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“…Close proximity to the slaughterhouse (< 1,000 m) increased the risk of PEDV infection 7.15-fold relative to that on farms further from the slaughterhouse. Population attributed fraction is the proportion of disease in the population that is due to expose (29,31). The population attributable fraction for this risk factor was 20.57% (95% CI 10.26-29.70), so eliminating or completely preventing its effects would reduce the incidence of PEDV by 20.57%.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Risk Factors for Porcine Epidemic Diarrhea Virus Infection in an Endemic Area of Vietnam

Ngan

Bui²,

Huynh

et al. 2020

Front. Vet. Sci.

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Porcine epidemic diarrhea virus (PEDV) causes enteritis, vomiting, watery diarrhea, and high mortality in suckling pigs, threatening the swine industry. Porcine epidemic diarrhea (PED) re-emerged globally in 2013 in many important swine-producing countries in Asia and the Americas. Several studies have identified the risk factors for the spread of PEDV in acute outbreaks. However, limited information is available on the risk factors for the transmission of PEDV in endemic regions. We hypothesized that poor biosecurity, location, and some social or cultural practices are the main risk factors for PEDV transmission in the Vietnamese pig population. The aim of this study was to evaluate the potential risk factors for the transmission of PEDV in an endemic area in Vietnam. In this case-control study, questionnaires containing 51 questions were completed for 92 PEDV-positive and 95 PEDV-negative farms. A logistic regression analysis was performed to assess the risk factors associated with PEDV infection. Province and the total number of pigs were included as random effects to determine their influence on the risk of PEDV infection. Twenty-nine variables of interest that have been associated with PEDV status were analyzed in a univariate analysis (P < 0.20), with backward stepwise selection. Only three of these 29 variables in four models remained significant PEDV risk factors in the final model: farrow-to-wean production type, distance from the farm to the slaughterhouse (< 1,000 m), and the presence of chickens on site (P < 0.05). This is the first study to identify the main risk factors for PEDV infection in an endemic area. Our findings suggest that hygiene measures should be strictly implemented on farms for the effective control and prevention of PEDV infection.

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“…The PAF due with a risk factor is the percentage of disease burden or mortality that can be attributed to the presence of that increased risk. In previous work, we demonstrated that for infectious diseases, the PAF can be estimated as the percentage change in the Basic Reproduction Number (average number of secondary cases per infectious case in an otherwise susceptible population [11]) in the absence of the risk factor [12].…”

Section: Reproduction Numbers and Population Attributable Fractionmentioning

confidence: 99%

The Population Attributable Fraction (PAF) of cases due to gatherings and groups with relevance to COVID-19 mitigation strategies

Brooks-Pollock

Read

House

et al. 2020

Preprint

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BackgroundMany countries have banned groups and gatherings as part of their response to the pandemic caused by the coronavirus, SARS-CoV-2. Although there are outbreak reports involving mass gatherings, the contribution to overall transmission is unknown. MethodsWe used data from a survey of social contact behaviour that specifically asked about contact with groups to estimate the Population Attributable Fraction (PAF) due to groups as the relative change in the Basic Reproduction Number when groups are prevented. FindingsWe estimate that PAF due to groups of 50+ people is 2.2% (95%CI 1.1%, 3.6%); the PAF due to groups of 20+ people is 6.4% (5.0%, 8.0%); the PAF due to groups of 10+ is 11.3% (9.9%, 13.0%) Interpretation Large groups of individuals have a small epidemiological impact; small and medium sized groups between 10 and 50 people have a larger impact on an epidemic. FundingThe funders had no role in the design of this study.is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

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Defining the population attributable fraction for infectious diseases

Abstract: General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above.

Cited by 20 publications

References 20 publications

Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay

Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay

Evaluating the Risk Factors for Porcine Epidemic Diarrhea Virus Infection in an Endemic Area of Vietnam

The Population Attributable Fraction (PAF) of cases due to gatherings and groups with relevance to COVID-19 mitigation strategies

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