具有成本效益优化控制的伤寒动态模型

Kazeem A. Tijani, C. E. Madubueze, R. I. Gweryina
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引用次数: 0

摘要

伤寒是一种传染性极强的传染病,如果不及时处理,可能会致命并引起严重的并发症。随着抗生素疗效的降低,这种感染有时会变得更加复杂、更具挑战性,甚至无法治疗。因此,本文通过建立伤寒直接和间接传播模式的确定性模型,考虑了抗生素临床疗效有限以及相应的治疗复发反应对受感染人类的影响。通过分析得出了基本繁殖数,并利用该繁殖数进行了全局敏感性分析。根据敏感性分析结果,进行了最优控制分析,并对四种控制措施进行了数值模拟:环境卫生和个人卫生习惯及宣传活动控制、灭菌和消毒控制、抗生素效力控制和筛查控制。最后,对四种情况下感染者和易感者的成本效益分析进行了分析,比较了 15 种策略。结果表明,在实施单一控制时,环境卫生和个人卫生习惯以及宣传活动是很好的选择;而在实施双重控制时,策略 6,即策略 1 和伤寒患者抗生素效力的组合,是最好的选择。在实施三重控制时,将策略 6 与筛查控制相结合最具成本效益。此外,在所有最具成本效益的控制措施中,综合计算的成本效益表明,要根除人群中的伤寒感染并防止易感人群感染该细菌,环境卫生和个人卫生做法以及宣传活动是最具成本效益的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Typhoid fever dynamical model with cost-effective optimalcontrol
Typhoid fever is a highly communicable and infectious disease that can be fatal and causes severe complications if unattended to timely. The infection, at times, can be more complex, challenging, and impossible to treat as antibiotics become less effective. Hence, the effect of limited clinical efficacy of the antibiotics with corresponding relapse response to treatment on infected humans is considered in this paper by formulating a deterministic model for direct and indirect transmission mode of Typhoid infection. The basic reproduction number is analytically derived and used to implement the global sensitivity analysis. Following the sensitivity analysis result, the optimal control analysis is carried out and simulated numerically with four controls: sanitation and hygiene practice and awareness campaign control, sterilisation and disinfection control, the potency of antibiotics control and screening control. Finally, the cost-effectiveness analysis for infected and susceptible humans with four cases that compared fifteen strategies is analysed. The results indicate that the sanitation and hygiene practice and awareness campaign is good to implement for single control implementation, while for double control implementation, Strategy 6, which is the combination of Strategy 1 and the potency of antibiotics administered to typhoid patients, is the best to consider. Combining Strategy 6 and screening control is the most cost-effective for triple controls. Furthermore, the overall computation of cost-effectiveness among all the most cost-effective with all the controls combined suggests that sanitation and hygiene practice and awareness campaign is the most cost-effective strategy to implement for eradicating typhoid infection in the population and for preventing susceptible populations from contracting the bacteria.
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