Household Tuberculosis Contact Risk Effects

Abbreviations

Label

Definition

TB

Tuberculosis

LTBI

Latent Tuberculosis Infection

AcTB

Active Tuberculosis

HTC

Household Tuberculosis Contact

TMREL

Theoretical Minimum Risk Exposure Level

PAF

Population Attributable Fraction

Risk Overview

Todo

Provide a brief description of the HTC risk.

Vivarium Modeling Strategy

Note

This section will describe the Vivarium modeling strategy for risk effects. For a description of Vivarium modeling strategy for risk exposure, see the Household Tuberculosis Contact page.

Entities Affected by HTC

Outcome

Outcome type

Outcome ID

Affected measure

Note

LTBI

Cause

954

Incidence

Incidence of LTBI is calculated from IHME’s Bayesian disease modeling software, DisMod-MR. More information can be found on Latent Tuberculosis Cause Model Document.

Relative Risks

We conducted a meta-analysis by reviewing over 200 papers to determine the relative risk (RR) for HTC exposure, among the under 5 and the 5+ population. The reference group was defined as indivudals without exposure to HTC. After discussion with a TB expert, we selected 11 papers for inclusion in the under 5 meta-analysis and approximately 20 papers for the 5+ meta-analysis (see References for full list of cited works). Based on the evidence, the risk model incorporates a RR of 4.72 (95%CI 3.87 to 5.76) for under 5 HTC-exposed population, and a RR of 1.75 (95%CI 1.6 to 1.91) for 5+ HTC-exposed population.

Relative risk of HTC exposure for under 5 population

../../../_images/rr_under_5.png

Relative risk of HTC exposure for 5+ population

../../../_images/rr_over_5.png
Relative Risks

Exposure Category

Relative Risk

Note

Under 5 HTC-exposed

4.72 (95%CI 3.87 to 5.76)

Specific to individuals under age of 5 years who live in a household with AcTB case, does not vary by sex and location

5+ HTC-exposed

1.75 (95%CI 1.6 to 1.91)

Specific to individuals above age of 5 years who live in a household with AcTB case, does not vary by sex and location

HTC-unexposed

1

TMREL

The incidence of LTBI for individuals with exposure to HTC is:

\(i_{HTC-exposed} = i_{LTBI}\times (1 - PAF)\times RR_{HTC}\)

The incidence of LTBI for individuals without exposure to HTC is:

\(i_{HTC-unexposed} = i_{LTBI}\times (1 - PAF)\)

The PAF is derived from the relative risk and risk exposure of HTC:

\(PAF = \frac{p\times (RR_{HTC} - 1)}{p\times (RR_{HTC} - 1) + 1}\)

Where:

  • \(i_{LTBI}\) is the incidence of LTBI, calculated from DisMod-MR;

  • \(RR_{HTC}\) is the age-dependent relative risk of developing LTBI for HTC-exposed versus HTC-unexposed, developed by meta-analysis;

  • \(p\) is the risk exposure/probability of HTC, deveried from prevalence of AcTB and household structure data.

Assumptions and Limitations

Todo

List assumptions and limitations of risk modeling strategy (confounding, mediation, modification, etc.)

Validation and Verification Criteria

References

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