The ecological effects of individual exposures and nonlinear disease dynamics in populations

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Publicat a:American Journal of Public Health vol. 84, no. 5 (May 1994), p. 836-842
Autor principal: Koopman, James S
Altres autors: Longini, Ira M, Jr
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American Public Health Association
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Accés en línia:Citation/Abstract
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100 1 |a Koopman, James S 
245 1 |a The ecological effects of individual exposures and nonlinear disease dynamics in populations 
260 |b American Public Health Association  |c May 1994 
513 |a Journal Article 
520 3 |a To describe causally predictive relationships, model parameters and the data used to estimate them must correspond to the social context of causal actions. Causes may act directly upon the individual, during a contact between individuals, or upon a group dynamic. Assuming that outcomes in different individuals are independent puts the causal action directly upon individuals. Analyses making this assumption are thus inappropriate for infectious diseases, for which risk factors alter the outcome of contacts between individuals. Transmission during contact generates nonlinear infection dynamics. These dynamics can so attenuate exposure-infection relationships at the individual level that even risk factors causing the vast majority of infections can be missed by individual-level analyses. On the other hand, these dynamics amplify causal associations between exposure and infection at the ecological level. The amplification and attenuation derive from chains of transmission initiated by exposed individuals but involving unexposed individuals. A study of household exposure to the only vector of dengue in Mexico illustrates the phenomenon. An individual-level analysis demonstrated almost no association between exposure and infection. Ecological analysis, in contrast, demonstrated a strong association. Transmission models that are devoid of any sources of the ecological fallacy are used to illustrate how nonlinear dynamics generate such results. 
650 1 2 |a Dengue  |x transmission 
650 1 2 |a Ecology 
650 2 2 |a Epidemiologic Factors 
650 1 2 |a Epidemiologic Methods 
650 2 2 |a Humans 
650 2 2 |a Infection  |x transmission 
650 2 2 |a Models, Biological 
650 2 2 |a Regression Analysis 
650 2 2 |a Risk Factors 
653 |a Social research 
653 |a Public health 
653 |a Disease 
653 |a Infections 
653 |a Ecological effects 
653 |a Vector-borne diseases 
653 |a Exposure 
653 |a Infectious diseases 
653 |a Action 
653 |a Group dynamics 
653 |a Dengue fever 
653 |a Causality 
653 |a Inappropriateness 
653 |a Social environment 
653 |a Individual differences 
653 |a Social 
700 1 |a Longini, Ira M, Jr 
773 0 |t American Journal of Public Health  |g vol. 84, no. 5 (May 1994), p. 836-842 
786 0 |d ProQuest  |t ABI/INFORM Global 
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