Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology

<div><p>We aimed to develop a conceptual framework of diabetes mellitus (DM) effects on tuberculosis (TB) natural history and treatment outcomes, and to assess the impact of these effects on TB-transmission dynamics. The model was calibrated using TB data for India. A conceptual framewor...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Susanne F. Awad (11607966) (author)
مؤلفون آخرون: Soha R. Dargham (3613250) (author), Ryosuke Omori (114776) (author), Fiona Pearson (4607545) (author), Julia A. Critchley (11619720) (author), Laith J. Abu-Raddad (9262524) (author)
منشور في: 2019
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author Susanne F. Awad (11607966)
author2 Soha R. Dargham (3613250)
Ryosuke Omori (114776)
Fiona Pearson (4607545)
Julia A. Critchley (11619720)
Laith J. Abu-Raddad (9262524)
author2_role author
author
author
author
author
author_facet Susanne F. Awad (11607966)
Soha R. Dargham (3613250)
Ryosuke Omori (114776)
Fiona Pearson (4607545)
Julia A. Critchley (11619720)
Laith J. Abu-Raddad (9262524)
author_role author
dc.creator.none.fl_str_mv Susanne F. Awad (11607966)
Soha R. Dargham (3613250)
Ryosuke Omori (114776)
Fiona Pearson (4607545)
Julia A. Critchley (11619720)
Laith J. Abu-Raddad (9262524)
dc.date.none.fl_str_mv 2019-06-11T03:00:00Z
dc.identifier.none.fl_str_mv 10.1038/s41598-019-44916-7
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Analytical_Exploration_of_Potential_Pathways_by_which_Diabetes_Mellitus_Impacts_Tuberculosis_Epidemiology/25907566
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
Tuberculosis
Natural History
Treatment Outcomes
TB-Transmission Dynamics
Conceptual Framework
Mathematical Model
Diabetes Mellitus
dc.title.none.fl_str_mv Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <div><p>We aimed to develop a conceptual framework of diabetes mellitus (DM) effects on tuberculosis (TB) natural history and treatment outcomes, and to assess the impact of these effects on TB-transmission dynamics. The model was calibrated using TB data for India. A conceptual framework was developed based on a literature review, and then translated into a mathematical model to assess the impact of the DM-on-TB effects. The impact was analyzed using TB-disease incidence hazard ratio (HR) and population attributable fraction (PAF) measures. Evidence was identified for 10 plausible DM-on-TB effects. Assuming a flat change of 300% (meaning an effect size of 3.0) for each DM-on-TB effect, the HR ranged between 1.0 (Effect 9-Recovery) and 2.7 (Effect 2-Fast progression); most effects did not have an impact on the HR. Meanwhile, TB-disease incidence attributed directly and indirectly to each effect ranged between −4.6% (Effect 7-TB mortality) and 34.5% (Effect 2-Fast progression). The second largest impact was for Effect 6-Disease infectiousness at 29.9%. In conclusion, DM can affect TB-transmission dynamics in multiple ways, most of which are poorly characterized and difficult to assess in epidemiologic studies. The indirect (e.g. onward transmission) impacts of some DM-on-TB effects are comparable in scale to the direct impacts. While the impact of several effects on the HR was limited, the impact on the PAF was substantial suggesting that DM could be impacting TB epidemiology to a larger extent than previously thought.</p><p> </p></div><h2>Other Information</h2> <p> Published in: Scientific Reports<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1038/s41598-019-44916-7" target="_blank">https://dx.doi.org/10.1038/s41598-019-44916-7</a></p>
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identifier_str_mv 10.1038/s41598-019-44916-7
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/25907566
publishDate 2019
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spelling Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis EpidemiologySusanne F. Awad (11607966)Soha R. Dargham (3613250)Ryosuke Omori (114776)Fiona Pearson (4607545)Julia A. Critchley (11619720)Laith J. Abu-Raddad (9262524)Biomedical and clinical sciencesClinical sciencesHealth sciencesEpidemiologyTuberculosisNatural HistoryTreatment OutcomesTB-Transmission DynamicsConceptual FrameworkMathematical ModelDiabetes Mellitus<div><p>We aimed to develop a conceptual framework of diabetes mellitus (DM) effects on tuberculosis (TB) natural history and treatment outcomes, and to assess the impact of these effects on TB-transmission dynamics. The model was calibrated using TB data for India. A conceptual framework was developed based on a literature review, and then translated into a mathematical model to assess the impact of the DM-on-TB effects. The impact was analyzed using TB-disease incidence hazard ratio (HR) and population attributable fraction (PAF) measures. Evidence was identified for 10 plausible DM-on-TB effects. Assuming a flat change of 300% (meaning an effect size of 3.0) for each DM-on-TB effect, the HR ranged between 1.0 (Effect 9-Recovery) and 2.7 (Effect 2-Fast progression); most effects did not have an impact on the HR. Meanwhile, TB-disease incidence attributed directly and indirectly to each effect ranged between −4.6% (Effect 7-TB mortality) and 34.5% (Effect 2-Fast progression). The second largest impact was for Effect 6-Disease infectiousness at 29.9%. In conclusion, DM can affect TB-transmission dynamics in multiple ways, most of which are poorly characterized and difficult to assess in epidemiologic studies. The indirect (e.g. onward transmission) impacts of some DM-on-TB effects are comparable in scale to the direct impacts. While the impact of several effects on the HR was limited, the impact on the PAF was substantial suggesting that DM could be impacting TB epidemiology to a larger extent than previously thought.</p><p> </p></div><h2>Other Information</h2> <p> Published in: Scientific Reports<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1038/s41598-019-44916-7" target="_blank">https://dx.doi.org/10.1038/s41598-019-44916-7</a></p>2019-06-11T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1038/s41598-019-44916-7https://figshare.com/articles/journal_contribution/Analytical_Exploration_of_Potential_Pathways_by_which_Diabetes_Mellitus_Impacts_Tuberculosis_Epidemiology/25907566CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/259075662019-06-11T03:00:00Z
spellingShingle Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
Susanne F. Awad (11607966)
Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
Tuberculosis
Natural History
Treatment Outcomes
TB-Transmission Dynamics
Conceptual Framework
Mathematical Model
Diabetes Mellitus
status_str publishedVersion
title Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
title_full Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
title_fullStr Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
title_full_unstemmed Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
title_short Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
title_sort Analytical Exploration of Potential Pathways by which Diabetes Mellitus Impacts Tuberculosis Epidemiology
topic Biomedical and clinical sciences
Clinical sciences
Health sciences
Epidemiology
Tuberculosis
Natural History
Treatment Outcomes
TB-Transmission Dynamics
Conceptual Framework
Mathematical Model
Diabetes Mellitus