Enhancing Disease Control in Resource-Limited Settings Through Bidirectional Behavioral Responses.

Human behavior plays a pivotal role in mitigating the global spread of infectious diseases, rendering it an indispensable characteristic of effective disease control efforts. While prior research has examined behavioral changes in disease control either through the force of infection or prevalence-based recruitment, the combined effects of these approaches remain largely unexplored. To bridge this gap, we develop a mathematical model that integrates behavioral modifications from both perspectives, with a focus on resource-limited settings-a critical factor for managing re-emerging diseases. Our analytical results indicate that disease dynamics are influenced not only by the basic reproduction number ( $R_0$ ) but also regulated by a threshold value ( $R_c$ ), which can lead to disease persistence through backward bifurcation. The model reveals a complex dynamic view, highlighting the intricate role of behavioral modifications in suppressing multiple waves of infection. To optimize behavioral strategies, we introduce a contour-area optimization method to identify the most effective responses. Using real-world data from the Monkeypox outbreaks in the United States of America. and the Democratic Republic of Congo (spanning January 7 to August 13, 2024), we estimated critical parameters for both regions. The results highlight a significant reduction in $R_0$ when behavioral interventions targeted both transmission pathways, compared to focusing solely on one. Furthermore, we provide short- and long-term forecasts of the effects of these interventions, offering actionable insights for resource-constrained countries. This research underscores the importance of behavioral adaptations in strengthening disease control measures and advancing sustainable public health efforts, even in regions with sparse resources.