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Population attributable fraction (PAF) refers to the proportion of all cases with a particular outcome in a population that could be prevented by eliminating a specific exposure. The authors of a recent paper evaluated the prevalence and estimated the PAFs for risk factors of TB among elderly people in China [Inf Dis Poverty. 2019;8:7]. Confounding is inevitable in observational studies and Levin’s formula is of limited use in practice for unbiasedly estimating PAF. In a complex survey design, an unbiased estimation of the PAF can be calculated using a sample-weighted version of the Miettinen formula or a sample weighed parametric g-formula. With respect to causal interpretation of PAF in public health setting, computation of PAF is logical and practical when the exposure is amenable to intervention.   Electronic supplementary material  The online version of this article (10.1186/s40249-019-0587-8) contains supplementary material, which is available to authorized users.

infectious diseases of poverty

Recommendation on unbiased estimation of population attributable fraction calculated in “prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study”