{"title":"中国江苏省控制戊型肝炎的可行性:模型研究。","authors":"Meng Yang, Xiao-Qing Cheng, Ze-Yu Zhao, Pei-Hua Li, Jia Rui, Sheng-Nan Lin, Jing-Wen Xu, Yuan-Zhao Zhu, Yao Wang, Xing-Chun Liu, Li Luo, Bin Deng, Chan Liu, Jie-Feng Huang, Tian-Long Yang, Zhuo-Yang Li, Wei-Kang Liu, Wen-Dong Liu, Ben-Hua Zhao, Yue He, Qi Yin, Si-Ying Mao, Yan-Hua Su, Xue-Feng Zhang, Tian-Mu Chen","doi":"10.1186/s40249-021-00873-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hepatitis E, an acute zoonotic disease caused by the hepatitis E virus (HEV), has a relatively high burden in developing countries. The current research model on hepatitis E mainly uses experimental animal models (such as pigs, chickens, and rabbits) to explain the transmission of HEV. Few studies have developed a multi-host and multi-route transmission dynamic model (MHMRTDM) to explore the transmission feature of HEV. Hence, this study aimed to explore its transmission and evaluate the effectiveness of intervention using the dataset of Jiangsu Province.</p><p><strong>Methods: </strong>We developed a dataset comprising all reported HEV cases in Jiangsu Province from 2005 to 2018. The MHMRTDM was developed according to the natural history of HEV cases among humans and pigs and the multi-transmission routes such as person-to-person, pig-to-person, and environment-to-person. We estimated the key parameter of the transmission using the principle of least root mean square to fit the curve of the MHMRTDM to the reported data. We developed models with single or combined countermeasures to assess the effectiveness of interventions, which include vaccination, shortening the infectious period, and cutting transmission routes. The indicator, total attack rate (TAR), was adopted to assess the effectiveness.</p><p><strong>Results: </strong>From 2005 to 2018, 44 923 hepatitis E cases were reported in Jiangsu Province. The model fits the data well (R<sup>2</sup> = 0.655, P < 0.001). The incidence of the disease in Jiangsu Province and its cities peaks are around March; however, transmissibility of the disease peaks in December and January. The model showed that the most effective intervention was interrupting the pig-to-person route during the incidence trough of September, thereby reducing the TAR by 98.11%, followed by vaccination (reducing the TAR by 76.25% when the vaccination coefficient is 100%) and shortening the infectious period (reducing the TAR by 50.05% when the infectious period is shortened to 15 days).</p><p><strong>Conclusions: </strong>HEV could be controlled by interrupting the pig-to-person route, shortening the infectious period, and vaccination. Among these interventions, the most effective was interrupting the pig-to-person route.</p>","PeriodicalId":13587,"journal":{"name":"Infectious Diseases of Poverty","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240442/pdf/","citationCount":"0","resultStr":"{\"title\":\"Feasibility of controlling hepatitis E in Jiangsu Province, China: a modelling study.\",\"authors\":\"Meng Yang, Xiao-Qing Cheng, Ze-Yu Zhao, Pei-Hua Li, Jia Rui, Sheng-Nan Lin, Jing-Wen Xu, Yuan-Zhao Zhu, Yao Wang, Xing-Chun Liu, Li Luo, Bin Deng, Chan Liu, Jie-Feng Huang, Tian-Long Yang, Zhuo-Yang Li, Wei-Kang Liu, Wen-Dong Liu, Ben-Hua Zhao, Yue He, Qi Yin, Si-Ying Mao, Yan-Hua Su, Xue-Feng Zhang, Tian-Mu Chen\",\"doi\":\"10.1186/s40249-021-00873-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hepatitis E, an acute zoonotic disease caused by the hepatitis E virus (HEV), has a relatively high burden in developing countries. The current research model on hepatitis E mainly uses experimental animal models (such as pigs, chickens, and rabbits) to explain the transmission of HEV. Few studies have developed a multi-host and multi-route transmission dynamic model (MHMRTDM) to explore the transmission feature of HEV. Hence, this study aimed to explore its transmission and evaluate the effectiveness of intervention using the dataset of Jiangsu Province.</p><p><strong>Methods: </strong>We developed a dataset comprising all reported HEV cases in Jiangsu Province from 2005 to 2018. The MHMRTDM was developed according to the natural history of HEV cases among humans and pigs and the multi-transmission routes such as person-to-person, pig-to-person, and environment-to-person. We estimated the key parameter of the transmission using the principle of least root mean square to fit the curve of the MHMRTDM to the reported data. We developed models with single or combined countermeasures to assess the effectiveness of interventions, which include vaccination, shortening the infectious period, and cutting transmission routes. The indicator, total attack rate (TAR), was adopted to assess the effectiveness.</p><p><strong>Results: </strong>From 2005 to 2018, 44 923 hepatitis E cases were reported in Jiangsu Province. The model fits the data well (R<sup>2</sup> = 0.655, P < 0.001). The incidence of the disease in Jiangsu Province and its cities peaks are around March; however, transmissibility of the disease peaks in December and January. The model showed that the most effective intervention was interrupting the pig-to-person route during the incidence trough of September, thereby reducing the TAR by 98.11%, followed by vaccination (reducing the TAR by 76.25% when the vaccination coefficient is 100%) and shortening the infectious period (reducing the TAR by 50.05% when the infectious period is shortened to 15 days).</p><p><strong>Conclusions: </strong>HEV could be controlled by interrupting the pig-to-person route, shortening the infectious period, and vaccination. 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引用次数: 0
摘要
背景:戊型肝炎是由戊型肝炎病毒(HEV)引起的一种急性人畜共患疾病,在发展中国家的发病率相对较高。目前有关戊型肝炎的研究模型主要使用实验动物模型(如猪、鸡和兔)来解释戊型肝炎病毒的传播。很少有研究建立多宿主和多路径传播动态模型(MHMRTDM)来探讨 HEV 的传播特征。因此,本研究旨在利用江苏省的数据集探索其传播途径并评估干预效果:我们建立了一个数据集,其中包括江苏省从 2005 年至 2018 年报告的所有 HEV 病例。方法:我们建立了江苏省 2005 年至 2018 年所有报告 HEV 病例的数据集,并根据人和猪之间 HEV 病例的自然史以及人传人、猪传人和环境传人等多传播途径开发了 MHMRTDM。我们利用最小均方根原理估算了传播的关键参数,使 MHMRTDM 曲线与报告数据相匹配。我们建立了单一对策或综合对策模型,以评估干预措施的效果,其中包括接种疫苗、缩短传染期和切断传播途径。采用总发病率(TAR)这一指标来评估有效性:结果:2005 年至 2018 年,江苏省共报告戊型肝炎病例 44 923 例。该模型与数据拟合良好(R2 = 0.655,P 结论:戊型肝炎的传播途径主要是通过传播途径:戊型肝炎病毒可通过阻断猪-人传播途径、缩短传染期和接种疫苗来控制。在这些干预措施中,最有效的是阻断猪-人传播途径。
Feasibility of controlling hepatitis E in Jiangsu Province, China: a modelling study.
Background: Hepatitis E, an acute zoonotic disease caused by the hepatitis E virus (HEV), has a relatively high burden in developing countries. The current research model on hepatitis E mainly uses experimental animal models (such as pigs, chickens, and rabbits) to explain the transmission of HEV. Few studies have developed a multi-host and multi-route transmission dynamic model (MHMRTDM) to explore the transmission feature of HEV. Hence, this study aimed to explore its transmission and evaluate the effectiveness of intervention using the dataset of Jiangsu Province.
Methods: We developed a dataset comprising all reported HEV cases in Jiangsu Province from 2005 to 2018. The MHMRTDM was developed according to the natural history of HEV cases among humans and pigs and the multi-transmission routes such as person-to-person, pig-to-person, and environment-to-person. We estimated the key parameter of the transmission using the principle of least root mean square to fit the curve of the MHMRTDM to the reported data. We developed models with single or combined countermeasures to assess the effectiveness of interventions, which include vaccination, shortening the infectious period, and cutting transmission routes. The indicator, total attack rate (TAR), was adopted to assess the effectiveness.
Results: From 2005 to 2018, 44 923 hepatitis E cases were reported in Jiangsu Province. The model fits the data well (R2 = 0.655, P < 0.001). The incidence of the disease in Jiangsu Province and its cities peaks are around March; however, transmissibility of the disease peaks in December and January. The model showed that the most effective intervention was interrupting the pig-to-person route during the incidence trough of September, thereby reducing the TAR by 98.11%, followed by vaccination (reducing the TAR by 76.25% when the vaccination coefficient is 100%) and shortening the infectious period (reducing the TAR by 50.05% when the infectious period is shortened to 15 days).
Conclusions: HEV could be controlled by interrupting the pig-to-person route, shortening the infectious period, and vaccination. Among these interventions, the most effective was interrupting the pig-to-person route.
期刊介绍:
Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application.
The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings.
In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.