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Incorporating Transmission Into Causal Models of Infectious Diseases for Improved Understanding of the Effect and Impact of Risk Factors.
- Source :
- American Journal of Epidemiology; 3/15/2016, Vol. 183 Issue 6, p574-582, 9p
- Publication Year :
- 2016
-
Abstract
- Conventional measures of causality (which compare risks between exposed and unexposed individuals) do not factor in the population-scale dynamics of infectious disease transmission. We used mathematical models of 2 childhood infections (respiratory syncytial virus and rotavirus) to illustrate this problem. These models incorporated 3 causal pathways whereby malnutrition could act to increase the incidence of severe infection: increasing the proportion of infected children who develop severe infection, increasing the children's susceptibility to infection, and increasing infectiousness. For risk factors that increased the proportion of infected children who developed severe infection, the population attributable fraction (PAF) calculated conventionally was the same as the PAF calculated directly from the models. However, for risk factors that increased transmission (by either increasing susceptibility to infection or increasing infectiousness), the PAF calculated directly from the models was much larger than that predicted by the conventional PAF calculation. The models also showed that even when conventional studies find no association between a risk factor and an outcome, risk factors that increase transmission can still have a large impact on disease burden. For a complete picture of infectious disease causality, transmission effects must be incorporated into causal models. [ABSTRACT FROM AUTHOR]
- Subjects :
- INFECTIOUS disease transmission
COMMUNICABLE disease epidemiology
MALNUTRITION
COMMUNICABLE diseases
EPIDEMIOLOGICAL research
MATHEMATICAL models
RETROVIRUS diseases
STATISTICS
THEORY
CAUSAL models
RELATIVE medical risk
DISEASE incidence
DESCRIPTIVE statistics
RESPIRATORY syncytial virus infections
DISEASE complications
CHILDREN
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 00029262
- Volume :
- 183
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- American Journal of Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 113626335
- Full Text :
- https://doi.org/10.1093/aje/kwv234