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Estimating pathogen spread using structured coalescent and birth–death models: A quantitative comparison 使用结构化聚合模型和出生-死亡模型估计病原体传播:定量比较。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1016/j.epidem.2024.100795
Elucidating disease spread between subpopulations is crucial in guiding effective disease control efforts. Genomic epidemiology and phylodynamics have emerged as key principles to estimate such spread from pathogen phylogenies derived from molecular data. Two well-established structured phylodynamic methodologies – based on the coalescent and the birth–death model – are frequently employed to estimate viral spread between populations. Nonetheless, these methodologies operate under distinct assumptions whose impact on the accuracy of migration rate inference is yet to be thoroughly investigated.
In this manuscript, we present a simulation study, contrasting the inferential outcomes of the structured coalescent model with constant population size and the multitype birth–death model with a constant rate. We explore this comparison across a range of migration rates in endemic diseases and epidemic outbreaks. The results of the epidemic outbreak analysis revealed that the birth–death model exhibits a superior ability to retrieve accurate migration rates compared to the coalescent model, regardless of the actual migration rate. Thus, to estimate accurate migration rates, the population dynamics have to be accounted for. On the other hand, for the endemic disease scenario, our investigation demonstrates that both models produce comparable coverage and accuracy of the migration rates, with the coalescent model generating more precise estimates. Regardless of the specific scenario, both models similarly estimated the source location of the disease.
This research offers tangible modelling advice for infectious disease analysts, suggesting the use of either model for endemic diseases. For epidemic outbreaks, or scenarios with varying population size, structured phylodynamic models relying on the Kingman coalescent with constant population size should be avoided as they can lead to inaccurate estimates of the migration rate. Instead, coalescent models accounting for varying population size or birth–death models should be favoured. Importantly, our study emphasises the value of directly capturing exponential growth dynamics which could be a useful enhancement for structured coalescent models.
阐明疾病在亚群之间的传播对于指导有效的疾病控制工作至关重要。基因组流行病学和系统动力学已成为从分子数据得出的病原体系统发育中估算这种传播的关键原则。基于聚合模型和出生-死亡模型的两种成熟的结构系统动力学方法经常被用来估算病毒在种群间的传播。然而,这些方法在不同的假设条件下运行,其对迁移率推断准确性的影响还有待深入研究。在本手稿中,我们进行了一项模拟研究,对比了具有恒定种群规模的结构化聚合模型和具有恒定迁移率的多型出生-死亡模型的推论结果。我们探讨了在地方病和流行病爆发的一系列迁移率下的这种比较。流行病爆发分析的结果表明,与凝聚模型相比,无论实际迁移率如何,出生-死亡模型在检索准确迁移率方面都表现出更强的能力。因此,要估算准确的迁移率,就必须考虑到人口动态。另一方面,对于地方病情景,我们的调查表明,两种模型的覆盖范围和迁移率的准确性相当,而凝聚模型的估计结果更为精确。无论具体情景如何,两种模型对疾病来源地点的估算结果相似。这项研究为传染病分析人员提供了切实可行的建模建议,建议对地方病使用两种模型中的任何一种。对于流行病爆发或人口规模变化的情况,应避免使用依赖于人口规模恒定的金曼聚合的结构化系统动力学模型,因为它们可能导致对迁移率的不准确估计。取而代之的是考虑不同种群规模的凝聚模型或出生-死亡模型。重要的是,我们的研究强调了直接捕捉指数增长动态的价值,这对结构化凝聚模型是一个有用的增强。
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引用次数: 0
Quantifying the impact of prevalence-dependent adaptive behavior on COVID-19 transmission: A modeling case study in Maryland 量化流行依赖性适应行为对 COVID-19 传播的影响:马里兰州的模型案例研究
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-11 DOI: 10.1016/j.epidem.2024.100799
The COVID-19 pandemic highlighted the need for robust epidemic forecasts, projecting health burden over short- and medium-term time horizons. Many COVID-19 forecasting models incorporate information on infection transmission, disease progression, and the effects of interventions, but few combine information on how individuals change their behavior based on altruism, fear, risk perception, or personal economic circumstances. Moreover, early models of COVID-19 produced under- and over-estimates, failing to consider the complexity of human responses to disease threat and prevention measures. In this study, we modeled adaptive behavior during the first year of the COVID-19 pandemic in Maryland, USA. The adapted compartmental model incorporates time-varying transmissibility informed on data of environmental factors (e.g., absolute humidity) and behavioral factors (aggregate mobility and perceived risk). We show that humidity and mobility alone did little to explain transmissibility after the first 100 days. Including adaptive behavior in the form of perceived risk as a function of hospitalizations more effectively explained inferred transmissibility and improved out-of-sample fit, demonstrating the model’s potential in real-time forecasting. These results demonstrate the importance of incorporating endogenous behavior in models, particularly during a pandemic, to produce more accurate projections, which could lead to more impactful and efficient decision making and resource allocation.
COVID-19 大流行突显了对强有力的流行病预测的需求,预测中短期的健康负担。许多 COVID-19 预测模型都包含了有关感染传播、疾病进展和干预效果的信息,但很少有模型结合了有关个人如何因利他主义、恐惧、风险意识或个人经济状况而改变其行为的信息。此外,早期的 COVID-19 模型产生了过低或过高的估计值,没有考虑到人类对疾病威胁和预防措施反应的复杂性。在本研究中,我们对美国马里兰州 COVID-19 大流行第一年的适应行为进行了建模。经过改编的分区模型结合了环境因素(如绝对湿度)和行为因素(总流动性和感知风险)的时变传播性数据。我们的研究表明,在最初的 100 天之后,仅凭湿度和流动性几乎无法解释传播性。将作为住院函数的感知风险形式的适应性行为纳入其中,可以更有效地解释推断的传播性,并提高样本外拟合度,证明了该模型在实时预测方面的潜力。这些结果表明了在模型中加入内生行为的重要性,尤其是在大流行期间,这样可以产生更准确的预测,从而做出更有影响力和更有效的决策并分配资源。
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引用次数: 0
Impact of COVID-19 control measures on respiratory syncytial virus and hand-foot-and-mouth disease transmission in Hong Kong and South Korea COVID-19 控制措施对香港和韩国呼吸道合胞病毒和手足口病传播的影响。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-10 DOI: 10.1016/j.epidem.2024.100797
The public health and social measures (PHSMs) for mitigation/control of COVID-19 pandemic influenced the transmission dynamics of many other infectious diseases, including respiratory syncytial virus (RSV) infection, and hand, foot and mouth disease (HFMD) and their disease-burden. This study aimed to infer the transmission dynamics of these respiratory viruses and assess the impact of COVID-19 PHSMs on their community activity. We developed a compartmental framework to infer the transmission dynamics of RSV and HFMD in Hong Kong and South Korea from January 2014 to May 2024. We assessed the impact of PHSMs by comparing the change in virus transmissibility, reproduction number and population susceptibility before, during, and after the COVID-19 pandemic period. A significant reduction in RSV and HFMD activity was observed starting in January 2020, with a resurgence since late 2021. Transmissibility of both diseases decreased by 46 % - 95 % during the lull, while population susceptibility was estimated to increase by maximum of 19 %. On relaxation of the PHSMs, the transmissibility were recovered up to 70 % in Hong Kong and nearly 100 % in South Korea in 2023 with significant epidemics for these viruses. Strict implementation of COVID-19 PHSMs led to low RSV and HFMD activity, but the absence of community infection resulted in reductions in population immunity, and slightly larger epidemics when these diseases re-emerged following the COVID-19 pandemic.
为缓解/控制 COVID-19 大流行而采取的公共卫生和社会措施(PHSMs)影响了许多其他传染病的传播动态,包括呼吸道合胞病毒(RSV)感染和手足口病(HFMD)及其疾病负担。本研究旨在推断这些呼吸道病毒的传播动态,并评估 COVID-19 PHSMs 对其社区活动的影响。我们建立了一个分区框架,以推断 2014 年 1 月至 2024 年 5 月期间 RSV 和手足口病在香港和韩国的传播动态。我们通过比较 COVID-19 大流行之前、期间和之后病毒传播能力、繁殖数量和人群易感性的变化,评估了 PHSMs 的影响。从 2020 年 1 月开始,RSV 和手足口病的活动明显减少,2021 年下半年开始重新抬头。在低潮期,这两种疾病的传播率下降了 46% - 95%,而人群易感性估计最多增加了 19%。放宽PHSM后,2023年香港和韩国的传播率分别恢复到70%和近100%,这些病毒将出现显著流行。严格执行 COVID-19 PHSMs 可降低 RSV 和手足口病的活动性,但由于缺乏社区感染,导致人群免疫力下降,当这些疾病在 COVID-19 大流行后再次出现时,流行范围会稍大一些。
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引用次数: 0
The effects of HIV self-testing on HIV incidence and awareness of status among men who have sex with men in the United States: Insights from a novel compartmental model 艾滋病病毒自我检测对美国男男性行为者中艾滋病病毒感染率和对感染状况认识的影响:新颖分区模型的启示。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-05 DOI: 10.1016/j.epidem.2024.100796

Background

The OraQuick In-Home HIV self-test represents a fast, inexpensive, and convenient method for users to assess their HIV status. If integrated thoughtfully into existing testing practices, accompanied by efficient pathways to formal diagnosis, self-testing could enhance both HIV awareness and reduce HIV incidence. However, currently available self-tests are less sensitive, particularly for recent infection, when compared to gold-standard laboratory tests. It is important to understand the impact if some portion of standard testing is replaced by self-tests. We used a compartmental model to evaluate the effects of self-testing in diverse scenarios among gay, bisexual and other men who have sex with men (MSM) in the United States for the period 2020–2030, and to understand which scenarios maximize the advantages of self-testing.

Methods

We introduced a novel 4-compartment model for HIV self-testing. We employed the model under different screening rates, self-test proportions, and delays to diagnosis for those identified through self-tests to determine the potential effects of self-testing on HIV incidence and awareness of status when applied to the US MSM population. We studied scenarios in which self-tests supplement laboratory-based tests, with no replacement, and scenarios in which some replacement occurs. We also examined how future improvements in self-test sensitivity may affect our results.

Results

When HIV self-tests are supplemental rather than substitutes for laboratory-based testing, self-testing can decrease HIV incidence among MSM in the US by up to 10 % and increase awareness of status among MSM from 85 % to 91 % over a 10-year period, provided linkage to care and formal diagnosis occur promptly following a positive self-test (90 days or less). As self-tests replace a higher percentage laboratory-based testing algorithms, increases in overall testing rates were necessary to ensure reductions in HIV incidence. However, such needed increases were relatively small (under 10 % for prompt engagement in care and moderate levels of replacement). Improvements in self-test sensitivity and/or decreases in the detection period may further reduce any necessary increases in overall testing by up to 40 %.

Conclusions

If properly utilized, self-testing can provide significant long-term reductions to HIV incidence and improve awareness of HIV status. Ensuring that self-testing increases overall testing and that formal diagnosis and engagement in care occur promptly following a positive self-test are necessary to maximize the benefits of self-testing. Future improvements in self-test sensitivity and reductions in the detection period would further reduce HIV incidence and the potential risks associated with replacing laboratory tests with self-tests.
背景:OraQuick 居家 HIV 自我检测是一种快速、廉价、方便的方法,用户可以通过它来评估自己的 HIV 感染状况。如果能将其与现有的检测方法周到地结合起来,并辅以高效的正规诊断途径,那么自我检测既能提高人们对艾滋病的认识,又能降低艾滋病的发病率。然而,与黄金标准的实验室检测相比,目前可用的自我检测灵敏度较低,尤其是对近期感染的检测。了解由自我检测取代部分标准检测的影响非常重要。我们使用了一个分室模型来评估 2020-2030 年期间在美国男同性恋、双性恋和其他男男性行为者(MSM)中不同情况下自我检测的影响,并了解哪种情况能最大限度地发挥自我检测的优势:方法:我们为 HIV 自我检测引入了一个新颖的四室模型。我们在不同的筛查率、自我检测比例以及通过自我检测发现者的诊断延迟条件下使用了该模型,以确定自我检测在应用于美国男男性行为人群时对 HIV 感染率和感染状况认知度的潜在影响。我们研究了自我检测作为实验室检测的补充(不存在替代)和存在一定替代的两种情况。我们还研究了未来自我检测灵敏度的提高会如何影响我们的结果:结果:如果艾滋病毒自我检测是实验室检测的补充而非替代,那么自我检测可在 10 年内将美国男男性行为者中的艾滋病毒发病率降低 10%,并将男男性行为者对自身状况的认知度从 85% 提高到 91%,前提是在自我检测呈阳性后(90 天或更短)及时联系医疗机构并进行正式诊断。由于自我检测取代了较高比例的实验室检测算法,因此有必要提高总体检测率,以确保降低艾滋病毒发病率。然而,这种所需的提高幅度相对较小(对于及时参与护理和中等程度的替代来说,低于 10%)。自我检测灵敏度的提高和/或检测期的缩短可能会进一步减少总体检测率的必要增长,增幅可达 40%:如果使用得当,自我检测可显著降低艾滋病的长期发病率,并提高人们对艾滋病状况的认识。要使自我检测的益处最大化,就必须确保自我检测能提高总体检测率,并在自我检测呈阳性后及时进行正式诊断和参与护理。未来自我检测灵敏度的提高和检测周期的缩短将进一步降低艾滋病毒的发病率,并降低用自我检测取代实验室检测的潜在风险。
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引用次数: 0
Wastewater-based epidemiology for COVID-19 surveillance and beyond: A survey 基于废水的流行病学,用于 COVID-19 监测及其他:调查。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-26 DOI: 10.1016/j.epidem.2024.100793
The pandemic of COVID-19 has imposed tremendous pressure on public health systems and social economic ecosystems over the past years. To alleviate its social impact, it is important to proactively track the prevalence of COVID-19 within communities. The traditional way to estimate the disease prevalence is to estimate from reported clinical test data or surveys. However, the coverage of clinical tests is often limited and the tests can be labor-intensive, requires reliable and timely results, and consistent diagnostic and reporting criteria. Recent studies revealed that patients who are diagnosed with COVID-19 often undergo fecal shedding of SARS-CoV-2 virus into wastewater, which makes wastewater-based epidemiology for COVID-19 surveillance a promising approach to complement traditional clinical testing. In this paper, we survey the existing literature regarding wastewater-based epidemiology for COVID-19 surveillance and summarize the current advances in the area. Specifically, we have covered the key aspects of wastewater sampling, sample testing, and presented a comprehensive and organized summary of wastewater data analytical methods. Finally, we provide the open challenges on current wastewater-based COVID-19 surveillance studies, aiming to encourage new ideas to advance the development of effective wastewater-based surveillance systems for general infectious diseases.
在过去几年中,COVID-19 的流行给公共卫生系统和社会经济生态系统带来了巨大压力。为减轻其社会影响,必须积极跟踪 COVID-19 在社区内的流行情况。估算疾病流行率的传统方法是根据报告的临床检测数据或调查进行估算。然而,临床检测的覆盖范围往往有限,而且检测可能需要大量人力,需要可靠、及时的结果,以及一致的诊断和报告标准。最近的研究表明,确诊为 COVID-19 的患者通常会将 SARS-CoV-2 病毒随粪便排入废水中,这使得基于废水的 COVID-19 监测流行病学成为补充传统临床检测的一种可行方法。在本文中,我们调查了有关基于废水的 COVID-19 监测流行病学的现有文献,并总结了该领域的最新进展。具体而言,我们介绍了废水采样、样本检测的关键环节,并对废水数据分析方法进行了全面、有序的总结。最后,我们提出了当前基于废水的 COVID-19 监测研究面临的公开挑战,旨在鼓励新思路,推动基于废水的一般传染病有效监测系统的发展。
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引用次数: 0
Outbreak reconstruction with a slowly evolving multi-host pathogen: A comparative study of three existing methods on Mycobacterium bovis outbreaks 缓慢进化的多宿主病原体的疫情重建:对三种现有牛分枝杆菌疫情爆发方法的比较研究
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-21 DOI: 10.1016/j.epidem.2024.100794
In a multi-host system, understanding host-species contribution to transmission is key to appropriately targeting control and preventive measures. Outbreak reconstruction methods aiming to identify who-infected-whom by combining epidemiological and genetic data could contribute to achieving this goal. However, the majority of these methods remain untested on realistic simulated multi-host data. Mycobacterium bovis is a slowly evolving multi-host pathogen and previous studies on outbreaks involving both cattle and wildlife have identified observation biases. Indeed, contrary to cattle, sampling wildlife is difficult. The aim of our study was to evaluate and compare the performances of three existing outbreak reconstruction methods (seqTrack, outbreaker2 and TransPhylo) on M. bovis multi-host data simulated with and without biases. Extending an existing transmission model, we simulated 30 bTB outbreaks involving cattle, badgers and wild boars and defined six sampling schemes mimicking observation biases. We estimated general and specific to multi-host systems epidemiological indicators. We tested four alternative transmission scenarios changing the mutation rate or the composition of the epidemiological system. The reconstruction of who-infected-whom was sensitive to the mutation rate and seqTrack reconstructed prolific super-spreaders. TransPhylo and outbreaker2 poorly estimated the contribution of each host-species and could not reconstruct the presence of a dead-end epidemiological host. However, the host-species of cattle (but not badger) index cases was correctly reconstructed by seqTrack and outbreaker2. These two specific indicators improved when considering an observation bias. We found an overall poor performance for the three methods on simulated biased and unbiased bTB data. This seemed partly attributable to the low evolutionary rate characteristic of M. bovis leading to insufficient genetic information, but also to the complexity of the simulated multi-host system. This study highlights the importance of an integrated approach and the need to develop new outbreak reconstruction methods adapted to complex epidemiological systems and tested on realistic multi-host data.
在多宿主系统中,了解宿主物种对传播的贡献是适当确定控制和预防措施目标的关键。疫情重建方法旨在通过结合流行病学和基因数据来确定谁感染了谁,有助于实现这一目标。然而,这些方法中的大多数仍未在现实的多宿主模拟数据中得到验证。牛分枝杆菌是一种进化缓慢的多宿主病原体,以往对牛和野生动物疫情的研究发现了观察偏差。事实上,与牛相反,对野生动物进行采样非常困难。我们研究的目的是评估和比较现有的三种疫情重建方法(seqTrack、outbreaker2 和 TransPhylo)在模拟有偏差和无偏差的牛口蹄疫多宿主数据上的性能。我们扩展了现有的传播模型,模拟了 30 次涉及牛、獾和野猪的牛结核病爆发,并定义了六种模拟观察偏差的采样方案。我们估算了多宿主系统的一般和特定流行病学指标。我们测试了改变变异率或流行病学系统组成的四种替代传播方案。谁感染谁的重建对突变率很敏感,seqTrack 重建了多产的超级传播者。TransPhylo 和 outbreaker2 对每种宿主的贡献估计不足,无法重建流行病学中存在的死亡宿主。然而,seqTrack 和 outbreaker2 能正确地重建牛(而不是獾)指数病例的宿主物种。在考虑观察偏差时,这两个特定指标都有所改善。我们发现这三种方法在模拟有偏差和无偏差的 bTB 数据上的总体表现不佳。这似乎部分归因于牛海绵状芽孢杆菌的低进化率特征导致遗传信息不足,但也归因于模拟多宿主系统的复杂性。这项研究强调了综合方法的重要性,以及开发适应复杂流行病学系统的新疫情重建方法并在现实的多宿主数据上进行测试的必要性。
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引用次数: 0
Directly observed social contact patterns among school children in rural Gambia 直接观察冈比亚农村学童的社会接触模式
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-11 DOI: 10.1016/j.epidem.2024.100790

Introduction

School-aged children play a major role in the transmission of many respiratory pathogens due to high rate of close contacts in schools. The validity and accuracy of proxy-reported contact data may be limited, particularly for children when attending school. We observed social contacts within schools and assessed the accuracy of proxy-reported versus observed physical contact data among students in rural Gambia.

Methods

We enrolled school children who had also been recruited to a survey of Streptococcus pneumoniae carriage and social contacts. We visited participants at school and observed their contact patterns within and outside the classroom for two hours. We recorded the contact type, gender and approximate age of the contactee, and class size. We calculated age-stratified contact matrices to determine in-school contact patterns. We compared proxy-reported estimated physical contacts for the subset of participants (18 %) randomised to be observed on the same day for which the parent or caregiver reported the school contacts.

Results

We recorded 3822 contacts for 219 participants from 114 schools. The median number of contacts was 15 (IQR: 11–20). Contact patterns were strongly age-assortative, and mainly involved physical touch (67.5 %). Those aged 5–9 years had the highest mean number of contacts [19.0 (95 %CI: 16.7–21.3)] while the ≥ 15-year age group had fewer contacts [12.8 (95 %CI: 10.9–14.7)]. Forty (18 %) participants had their school-observed contact data collected on the same day as their caregiver reported their estimated physical contacts at school; only 22.5 % had agreement within ±2 contacts between the observed and reported contacts. Fifty-eight percent of proxy-reported contacts were under-estimates.

Conclusions

Social contact rates observed among pupils at schools in rural Gambia were high, strongly age-assortative, and physical. Reporting of school contacts by proxies may underestimate the effect of school-age children in modelling studies of transmission of infections. New approaches are needed to quantify contacts within schools.

导言:由于学校中密切接触者较多,学龄儿童在许多呼吸道病原体的传播中扮演着重要角色。代理报告的接触数据的有效性和准确性可能有限,尤其是对上学的儿童而言。我们观察了学校内的社会接触情况,并评估了冈比亚农村地区学生的代理报告数据与观察到的身体接触数据的准确性。我们到学校探访了参与者,并在两个小时内观察了他们在教室内外的接触模式。我们记录了接触类型、接触者的性别和大致年龄以及班级人数。我们计算了年龄分层接触矩阵,以确定校内接触模式。我们比较了家长或看护人在报告校内接触的同一天随机接受观察的参与者(18%)的委托人报告的估计身体接触情况。接触次数的中位数为 15 次(IQR:11-20)。接触模式与年龄密切相关,主要涉及身体接触(67.5%)。5-9 岁年龄组的平均接触次数最多[19.0(95 %CI:16.7-21.3)],而≥15 岁年龄组的接触次数较少[12.8(95 %CI:10.9-14.7)]。有 40 名参与者(18%)的学校观察接触数据是在其看护人报告其估计的在校身体接触次数的同一天收集的;只有 22.5% 的参与者的观察接触次数与报告接触次数的一致性在 ±2 次以内。结论在冈比亚农村地区的学校中观察到的学生社会接触率很高,具有很强的年龄排序性和身体接触性。在对传染病传播进行模拟研究时,代理报告的学校接触率可能会低估学龄儿童的影响。需要新的方法来量化校内接触。
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引用次数: 0
The impact of household size on measles transmission: A long-term perspective 家庭规模对麻疹传播的影响:长期视角
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-06 DOI: 10.1016/j.epidem.2024.100791

Households play an important role in the transmission of infectious diseases due to the close contact therein. Previous modeling studies on disease transmission with household-level mixing have explored the relationship between household size distribution and epidemic characteristics such as final epidemic sizes and the basic reproduction number but have not considered the epidemic impact of declining household sizes caused by demographic shifts. Here, we use a disease transmission model that incorporates demographic changes in household sizes to study the long-term transmission dynamics of measles in communities with varying household size distributions. We explore the impact of incorporating both household- and age-structured mixing on the dynamic properties of the transmission model and compare these dynamics across different household size distributions. Our analysis, based on the household- and age-structured model, shows that communities with larger household sizes require higher vaccination thresholds and bear a greater burden of infections. However, simulations show the apparent impact of changing household sizes is the combined result of changing birth rates and household mixing, and that changing birth rates likely play a larger role than changes in household mixing in shaping measles transmission dynamics (n.b, life-long immunity makes replenishment of population susceptibility from births a crucial transmission driver for measles). In addition, simulations of endemic transmission of measles within a hypothetical population formulated using aggregated world demographic data suggest the decline in household size (driven by changing fertility rates of the population), in addition to increasing vaccination coverage, could have had a significant impact on the incidence of measles over time.

由于住户之间的密切接触,住户在传染病的传播中发挥着重要作用。以往关于家庭层面混合的疾病传播模型研究探讨了家庭规模分布与最终流行病规模和基本繁殖数量等流行病特征之间的关系,但没有考虑人口结构变化导致家庭规模下降对流行病的影响。在此,我们使用一个包含家庭规模人口变化的疾病传播模型来研究麻疹在不同家庭规模分布社区的长期传播动态。我们探讨了家庭和年龄结构混合对传播模型动态特性的影响,并比较了不同家庭规模分布的动态特性。我们基于家庭和年龄结构模型的分析表明,家庭规模较大的社区需要更高的疫苗接种门槛,并承受更大的感染负担。然而,模拟结果表明,家庭规模变化的明显影响是出生率和家庭混合变化的综合结果,而且出生率的变化可能比家庭混合变化在影响麻疹传播动态方面发挥更大的作用(注:终身免疫使出生人口易感性的补充成为麻疹传播的关键驱动因素)。此外,利用世界人口总数数据模拟麻疹在假定人口中的地方性传播,结果表明,除了疫苗接种覆盖率的提高外,家庭规模的缩小(由人口生育率的变化驱动)也会对麻疹的发病率产生重大影响。
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引用次数: 0
Preface: COVID-19 Scenario Modeling Hubs 前言:COVID-19 情景建模中心。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/j.epidem.2024.100788
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引用次数: 0
Investigation of P. vivax elimination via mass drug administration: A simulation study 通过大规模给药消除间日疟原虫的研究:模拟研究
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/j.epidem.2024.100789

Plasmodium vivax is the most geographically widespread malaria parasite. P. vivax has the ability to remain dormant (as a hypnozoite) in the human liver and subsequently reactivate, which makes control efforts more difficult. Given the majority of P. vivax infections are due to hypnozoite reactivation, targeting the hypnozoite reservoir with a radical cure is crucial for achieving P. vivax elimination. Stochastic effects can strongly influence dynamics when disease prevalence is low or when the population size is small. Hence, it is important to account for this when modelling malaria elimination. We use a stochastic multiscale model of P. vivax transmission to study the impacts of multiple rounds of mass drug administration (MDA) with a radical cure, accounting for superinfection and hypnozoite dynamics. Our results indicate multiple rounds of MDA with a high-efficacy drug are needed to achieve a substantial probability of elimination. This work has the potential to help guide P. vivax elimination strategies by quantifying elimination probabilities for an MDA approach.

间日疟原虫是地域分布最广的疟疾寄生虫。间日疟原虫能够在人的肝脏中保持休眠(作为下生虫),随后重新活化,这就增加了控制工作的难度。鉴于大多数间日疟原虫感染都是由次原虫再活化引起的,因此针对次原虫库的根治方法对于消灭间日疟原虫至关重要。当疾病流行率较低或种群规模较小时,随机效应会对动力学产生很大影响。因此,在建立消除疟疾模型时必须考虑到这一点。我们利用间日疟传播的随机多尺度模型,研究了多轮大规模用药(MDA)和根治的影响,并考虑了超级感染和低佐虫动态。我们的研究结果表明,需要使用高效药物进行多轮大规模给药,才能达到很高的根除概率。这项研究通过量化 MDA 方法的消除概率,有可能帮助指导消灭间日疟原虫的战略。
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Epidemics
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