1998 - 2017年中国大陆地区结核病模型与动态分析:DOTS策略的效果及进一步控制。

Q1 Mathematics
Siyu Liu, Yingjie Bi, Yawen Liu
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引用次数: 13

摘要

背景:结核病(TB)是世界上最重要的卫生问题之一。直接观察治疗和短程化疗(DOTS)战略是医学护理与现代卫生体系的紧密结合,自1997年以来一直由世界卫生组织(WHO)实施。在与结核病的斗争中,中国积极推进结核病控制进程,2004年前后实现了DOTS战略的全覆盖。数学建模是研究疾病传播的一个非常有用的工具。了解DOTS战略对结核病控制的影响对设计进一步的预防战略具有重要意义。方法:采用动态模型研究控制策略对中国结核病传播的影响。并从开发新疫苗和改进治疗方法等方面对结核病的进一步控制进行了探讨。利用庞特里亚金极大值原理,提出并分析了以最小代价最小化感染个体总数的最优控制问题。数值模拟验证了理论结果。结果:对疫情模型进行了理论分析。根据中国国家统计局公布的数据,估算和比较各阶段的基本再现数,分别为[公式:见文]和[公式:见文]。设计并验证了进一步控制的最优控制策略。给出了最优控制策略与当前控制策略的直观比较。结论:DOTS战略的全覆盖大大促进了中国结核病的诊断和治疗,减少了结核病的成本。然而,现在中国的[公式:见文本]仍然大于1。显示了[公式:见文本]与疫苗接种策略之间的关系。针对暴露人群和感染人群提出了进一步控制的最优策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Modeling and dynamic analysis of tuberculosis in mainland China from 1998 to 2017: the effect of DOTS strategy and further control.

Modeling and dynamic analysis of tuberculosis in mainland China from 1998 to 2017: the effect of DOTS strategy and further control.

Modeling and dynamic analysis of tuberculosis in mainland China from 1998 to 2017: the effect of DOTS strategy and further control.

Modeling and dynamic analysis of tuberculosis in mainland China from 1998 to 2017: the effect of DOTS strategy and further control.

Background: Tuberculosis (TB) is one of the most important health topics in the world. Directly observed treatment and short course chemotherapy (DOTS) strategy combines medicine care and modern health system firmly, and it has been carried out by World Health Organization (WHO) since 1997. In the struggle with TB, China has promoted the process of controlling the disease actively, and the full coverage of DOTS strategy has been reached around 2004. Mathematical modeling is a very useful tool to study the transmission of diseases. Understanding the impact of DOTS strategy on the control of TB is important for designing further prevention strategy.

Methods: We investigate the impact of control strategy on the transmission of TB in China by dynamic model. Then we discuss further control for TB aiming at developing new vaccine and improving treatment. The optimal control problem, minimizing the total number of infectious individuals with the lowest cost, is proposed and analyzed by Pontryagin's maximum principle. Numerical simulations are provided to illustrate the theoretical results.

Results: Theoretical analysis for the epidemic model is given. Based on the data reported by National Bureau of Statistics of China (NBSC), the basic reproduction number of each stage is estimated and compared, and they are [Formula: see text] and [Formula: see text], respectively. Optimal control strategy for further control is designed and proved well. An intuitionistic comparison between the optimal control strategy and the current control strategy is given.

Conclusions: The diagnosis and treatment of TB in China have been promoted a lot and the [Formula: see text] is reduced by the full coverage of DOTS strategy. However, the [Formula: see text] in China is still greater than 1 now. The relationship between [Formula: see text] and vaccination strategy is shown. Optimal strategy aiming at exposed and infected population is suggested for further control.

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来源期刊
Theoretical Biology and Medical Modelling
Theoretical Biology and Medical Modelling MATHEMATICAL & COMPUTATIONAL BIOLOGY-
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Theoretical Biology and Medical Modelling is an open access peer-reviewed journal adopting a broad definition of "biology" and focusing on theoretical ideas and models associated with developments in biology and medicine. Mathematicians, biologists and clinicians of various specialisms, philosophers and historians of science are all contributing to the emergence of novel concepts in an age of systems biology, bioinformatics and computer modelling. This is the field in which Theoretical Biology and Medical Modelling operates. We welcome submissions that are technically sound and offering either improved understanding in biology and medicine or progress in theory or method.
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