Table 2.
The epidemiologic implications* of each of the plausible diabetes mellitus (DM) effects on tuberculosis (TB) natural history and treatment outcomes as measured by the “true” population attributable fraction (PAFTrue) and incidence hazard ratio (HR).
| Effect# | PAF True | HR |
|---|---|---|
| Effect 2-Fast progression | 34.5% | 2.7 |
| Effect 6-Disease infectiousness | 29.9% | 1.0 |
| Effect 8-Treatment failure | 14.8% | 1.0 |
| Effect 4-Latent reinfection | 11.1% | 1.4 |
| Effect 1-Susceptibility | 9.9% | 1.4 |
| Effect 3-Reactivation | 8.2% | 1.3 |
| Effect 9-Recovery | 3.8% | 1.0 |
| Effect 10-Cured reinfection | 1.7% | 1.1 |
| Effect 5-Smear positivity | 1.3% | 1.0 |
| Effect 7-TB mortality | −4.6% | 1.0 |
| If no effect of DM on TB | 0.0% | 1.0 |
| Relevant reference measure | 14.7%$ | 3.0€ |
#Effects are ordered from largest to lowest PAF. $PAF estimated using Levin’s formula23. €Typical effect size using different, but closely-related statistical measures (such as hazard ratio, relative risk, rate ratio, and odds ratio) of the strength of the observed TB-DM association5,6,8.
*We assumed a standard effect size of 3.0 for each mechanism with an expected effect size ≥1 and (an inverse) effect size of 1/3 for each mechanism with an effect size ≤1.