Photo credit: Sitara (Gogi) Grewal

Multiple factors can contribute to the development of anemia. Population attributable fraction (PAF) can be a useful measure to quantify the impact of risk factors on anemia burden. PAF estimates the proportion of disease burden in a population that can be attributed to a specific risk factor. Two components are required for calculating PAF, including the Prevalence of Exposure (i.e., proportion of the population exposed to the risk factor of interest) and Relative Risk (a measure of the association between the risk factor and anemia). We illustrate the calculation of PAF for iron deficiency in Malawi preschool children. The SAS and R sample code and a sample data set are provided in the following. 

References:

Counil E. Contribution of causal factors to disease burden: how to interpret attributable fractions. Breathe. 2021;17: 210086. 

Ko Y-A, Williams AM, Peerson JM, Luo H, Flores-Ayala R, et al. Approaches to quantify the contribution of multiple anemia risk factors in children and women from cross-sectional national surveys. PLOS Glob Public Health. 2022; 2(10): e0001071. 

Levine B. What does the population attributable fraction mean? Prev Chronic Dis. 2007;4(1):A14. 

Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. Am J Public Health. 1998;88(1):15-9. 

Yimgang DP, Buchwald AG, Coalson JE, Walldorf JA, Bauleni A, Kapito-Tembo A, et al. Population Attributable Fraction of Anemia Associated with Plasmodium falciparum Infection in Children in Southern Malawi. Am J Trop Med Hyg. 2021;104(3):1013-1017.