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Transmission models of respiratory infections in carceral settings: A systematic review 呼吸道感染在医疗机构的传播模式:系统综述。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-06 DOI: 10.1016/j.epidem.2024.100809
Sara N. Levintow , Molly Remch , Emily P. Jones , Justin Lessler , Jessie K. Edwards , Lauren Brinkley-Rubinstein , Dana K. Rice , David L. Rosen , Kimberly A. Powers

Background

The prevention and control of infectious disease outbreaks in carceral settings face unique challenges. Transmission modeling is a powerful tool for understanding and addressing these challenges, but reviews of modeling work in this context pre-date the proliferation of outbreaks in jails and prisons during the SARS-CoV-2 pandemic. We conducted a systematic review of studies using transmission models of respiratory infections in carceral settings before and during the pandemic.

Methods

We searched PubMed, Embase, Scopus, CINAHL, and PsycInfo to identify studies published between 1970 and 2024 that modeled transmission of respiratory infectious diseases in carceral settings. We extracted information on the diseases, populations, and settings modeled; approaches used for parameterizing models and simulating transmission; outcomes of interest and techniques for model calibration, validation, and sensitivity analyses; and types, impacts, and ethical aspects of modeled interventions.

Results

Forty-six studies met eligibility criteria, with transmission dynamics of tuberculosis modeled in 24 (52 %), SARS-CoV-2 in 20 (43 %), influenza in one (2 %), and varicella-zoster virus in one (2 %). Carceral facilities in the United States were the most common focus (15, 33 %), followed by Brazil (8, 17 %). Most studies (36, 80 %) used compartmental models (vs. individual- or agent-based). Tuberculosis studies typically modeled transmission within a single facility, while most SARS-CoV-2 studies simulated transmission in multiple places, including between carceral and community settings. Half of studies fit models to epidemiological data; three validated model predictions. Models were used to estimate past or potential future intervention impacts in 32 (70 %) studies, forecast the status quo (without changing conditions) in six (13 %), and examine only theoretical aspects of transmission in eight (17 %). Interventions commonly involved testing and treatment, quarantine and isolation, and/or facility ventilation. Modeled interventions substantially reduced transmission, but some were not well-defined or did not consider ethical issues.

Conclusion

The pandemic prompted urgent attention to transmission dynamics in jails and prisons, but there has been little modeling of respiratory infections other than SARS-CoV-2 and tuberculosis. Increased attention to calibration, validation, and the practical and ethical aspects of intervention implementation could improve translation of model estimates into tangible benefits for the highly vulnerable populations in carceral settings.
背景:在医疗环境中预防和控制传染病暴发面临着独特的挑战。传播建模是理解和应对这些挑战的有力工具,但在此背景下对建模工作的审查早于SARS-CoV-2大流行期间监狱和监狱中疫情的扩散。我们对大流行之前和大流行期间使用呼吸道感染传播模型的研究进行了系统回顾。方法:我们检索了PubMed、Embase、Scopus、CINAHL和PsycInfo,以确定1970年至2024年间发表的模拟呼吸道传染病在癌症环境中传播的研究。我们提取了疾病、人群和建模环境的信息;用于参数化模型和模拟传输的方法;模型校准、验证和敏感性分析的相关结果和技术;以及模型干预的类型,影响和伦理方面。结果:46项研究符合资格标准,其中24项(52 %)模拟了结核病的传播动力学,20项(43 %)模拟了SARS-CoV-2, 1项(2 %)模拟了流感,1项(2 %)模拟了水痘-带状疱疹病毒的传播动力学。美国的监狱设施是最常见的焦点(15.33 %),其次是巴西(8.17 %)。大多数研究(36.80 %)使用隔间模型(相对于基于个体或主体的模型)。结核病研究通常模拟在单一设施内的传播,而大多数SARS-CoV-2研究模拟在多个地方的传播,包括在监狱和社区环境之间。一半的研究使模型符合流行病学数据;三个经过验证的模型预测。在32项(70 %)研究中使用模型估计过去或潜在的未来干预影响,在6项(13 %)研究中预测现状(没有改变条件),在8项(17 %)研究中仅检查传播的理论方面。干预措施通常涉及检测和治疗、检疫和隔离和/或设施通风。模拟干预措施大大减少了传播,但有些干预措施没有明确定义或没有考虑伦理问题。结论:大流行促使人们迫切关注监狱和监狱中的传播动态,但除了SARS-CoV-2和结核病之外,很少有呼吸道感染的建模。加强对干预措施实施的校准、验证以及实践和伦理方面的关注,可以改善将模型估计转化为癌症环境中高度脆弱人群的切实利益。
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引用次数: 0
Estimating effective reproduction numbers using wastewater data from multiple sewersheds for SARS-CoV-2 in California counties 利用加州各县多个下水道的污水数据估计SARS-CoV-2的有效繁殖数量。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-06 DOI: 10.1016/j.epidem.2024.100803
Sindhu Ravuri , Elisabeth Burnor , Isobel Routledge , Natalie M. Linton , Mugdha Thakur , Alexandria Boehm , Marlene Wolfe , Heather N. Bischel , Colleen C. Naughton , Alexander T. Yu , Lauren A. White , Tomás M. León
The effective reproduction number serves as a metric of population-wide, time-varying disease spread. During the early years of the COVID-19 pandemic, this metric was primarily derived from case data, which has varied in quality and representativeness due to changes in testing volume, test-seeking behavior, and resource constraints. Deriving nowcasting estimates from alternative data sources such as wastewater provides complementary information that could inform future public health responses. We estimated county-aggregated, sewershed-restricted wastewater-based SARS-CoV-2 effective reproduction numbers from May 1, 2022 to April 30, 2023 for five counties in California with heterogeneous population sizes, clinical testing rates, demographics, wastewater coverage, and sampling frequencies. We used two methods to produce sewershed-restricted effective reproduction numbers, both based on smoothed and deconvolved wastewater concentrations. We then population-weighted and aggregated these sewershed-level estimates to arrive at county-level effective reproduction numbers. Using mean absolute error (MAE), Spearman’s rank correlation (ρ), confusion matrix classification, and cross-correlation analyses, we compared the timing and trajectory of our two wastewater-based models to: (1) a publicly available, county-level ensemble of case-based estimates, and (2) county-aggregated, sewershed-restricted case-based estimates. Both wastewater models demonstrated high concordance with the traditional case-based estimates, as indicated by low mean absolute errors (MAE ≤ 0.09), significant positive Spearman correlation (ρ ≥ 0.66), and high confusion matrix classification accuracy (≥ 0.81). The relative timings of wastewater- and case-based estimates were less clear, with cross-correlation analyses suggesting strong associations for a wide range of temporal lags that varied by county and wastewater model type. This methodology provides a generalizable, robust, and operationalizable framework for estimating county-level wastewater-based effective reproduction numbers. Our retrospective evaluation supports the potential usage of real-time wastewater-based nowcasting as a complementary epidemiological tool for surveillance by public health agencies at the state and local levels. Based on this research, we produced publicly available wastewater-based nowcasts for the California Communicable diseases Assessment Tool (calcat.cdph.ca.gov).
有效繁殖数可作为种群范围内随时间变化的疾病传播的度量。在COVID-19大流行的最初几年,这一指标主要来自病例数据,由于检测量、寻求检测行为和资源限制的变化,这些数据的质量和代表性各不相同。从废水等替代数据来源得出临近预报估计数,可提供补充信息,为今后的公共卫生对策提供信息。我们估计了2022年5月1日至2023年4月30日期间加州5个县的县聚集性、下水道限制废水的SARS-CoV-2有效繁殖数,这些县的人口规模、临床检测率、人口统计学、废水覆盖率和采样频率各不相同。我们使用了两种方法来产生下水道限制的有效繁殖数,这两种方法都是基于平滑和反卷积的废水浓度。然后,我们对这些下水道水平的估计进行人口加权和汇总,以得出县级的有效再生产数字。利用平均绝对误差(MAE)、斯皮尔曼秩相关(ρ)、混淆矩阵分类和交叉相关分析,我们将两个基于废水的模型的时间和轨迹进行了比较:(1)公开可用的、县级的基于病例的估计集合,以及(2)县级汇总的、受下水道限制的基于病例的估计。这两种废水模型都与传统的基于案例的估计具有很高的一致性,这表明平均绝对误差低(MAE≤0.09),Spearman正相关显著(ρ≥0.66),混淆矩阵分类精度高(≥0.81)。基于废水和基于案例的估算的相对时间不太清楚,相互关联分析表明,随着国家和废水模型类型的不同,时间滞后的范围也有所不同。该方法为估计县级废水有效再生产数提供了一个可推广、可靠和可操作的框架。我们的回顾性评估支持将基于废水的实时临近预报作为州和地方各级公共卫生机构监测的补充流行病学工具的潜力。基于这项研究,我们为加州传染病评估工具(calcat.cdph.ca.gov)制作了公开可用的基于废水的临近预报。
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引用次数: 0
Predicting the impact of non-pharmaceutical interventions against COVID-19 on Mycoplasma pneumoniae in the United States 预测美国针对COVID-19的非药物干预措施对肺炎支原体的影响
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-01 DOI: 10.1016/j.epidem.2024.100808
Sang Woo Park , Brooklyn Noble , Emily Howerton , Bjarke F. Nielsen , Sarah Lentz , Lilliam Ambroggio , Samuel Dominguez , Kevin Messacar , Bryan T. Grenfell
The introduction of non-pharmaceutical interventions (NPIs) against COVID-19 disrupted circulation of many respiratory pathogens and eventually caused large, delayed outbreaks, owing to the build up of the susceptible pool during the intervention period. In contrast to other common respiratory pathogens that re-emerged soon after the NPIs were lifted, longer delays (> 3 years) in the outbreaks of Mycoplasma pneumoniae (Mp), a bacterium commonly responsible for respiratory infections and pneumonia, have been reported in Europe and Asia. As Mp cases are continuing to increase in the US, predicting the size of an imminent outbreak is timely for public health agencies and decision makers. Here, we use simple mathematical models to provide robust predictions about a large Mp outbreak ongoing in the US. Our model further illustrates that NPIs and waning immunity are important factors in driving long delays in epidemic resurgence.
针对COVID-19的非药物干预措施(npi)的引入扰乱了许多呼吸道病原体的循环,并最终由于干预期间易感人群的积累而导致大规模延迟暴发。与其他常见呼吸道病原体在国家行动计划解除后不久重新出现的情况相反,据报道,在欧洲和亚洲,肺炎支原体(一种通常导致呼吸道感染和肺炎的细菌)暴发的时间延迟较长(50至30年)。随着美国的新冠肺炎病例持续增加,对公共卫生机构和决策者来说,预测即将爆发的疫情规模是及时的。在这里,我们使用简单的数学模型来提供关于美国正在发生的大规模Mp爆发的可靠预测。我们的模型进一步表明,npi和免疫力下降是导致流行病长期延迟复发的重要因素。
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引用次数: 0
Serodynamics: A primer and synthetic review of methods for epidemiological inference using serological data 血清动力学:血清动力学:利用血清学数据进行流行病学推断的方法入门与综合评述。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-01 DOI: 10.1016/j.epidem.2024.100806
James A. Hay , Isobel Routledge , Saki Takahashi
We present a review and primer of methods to understand epidemiological dynamics and identify past exposures from serological data, referred to as serodynamics. We discuss processing and interpreting serological data prior to fitting serodynamical models, and review approaches for estimating epidemiological trends and past exposures, ranging from serocatalytic models applied to binary serostatus data, to more complex models incorporating quantitative antibody measurements and immunological understanding. Although these methods are seemingly disparate, we demonstrate how they are derived within a common mathematical framework. Finally, we discuss key areas for methodological development to improve scientific discovery and public health insights in seroepidemiology.
我们回顾并介绍了从血清学数据中了解流行病学动态和确定过去暴露情况的方法,这些方法被称为血清动力学。我们讨论了在拟合血清动力学模型之前对血清学数据的处理和解释,并回顾了估计流行病学趋势和过去暴露情况的方法,包括应用于二元血清状态数据的血清催化模型,以及结合定量抗体测量和免疫学理解的更复杂模型。虽然这些方法看似各不相同,但我们展示了它们是如何在一个共同的数学框架内衍生出来的。最后,我们讨论了方法论发展的关键领域,以提高血清流行病学的科学发现和公共健康洞察力。
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引用次数: 0
Real-time estimates of the emergence and dynamics of SARS-CoV-2 variants of concern: A modeling approach 关注的SARS-CoV-2变体的出现和动态的实时估计:一种建模方法
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-01 DOI: 10.1016/j.epidem.2024.100805
Nicolò Gozzi , Matteo Chinazzi , Jessica T. Davis , Kunpeng Mu , Ana Pastore y Piontti , Marco Ajelli , Alessandro Vespignani , Nicola Perra
The emergence of SARS-CoV-2 variants of concern (VOCs) punctuated the dynamics of the COVID-19 pandemic in multiple occasions. The stages subsequent to their identification have been particularly challenging due to the hurdles associated with a prompt assessment of transmissibility and immune evasion characteristics of the newly emerged VOC. Here, we retrospectively analyze the performance of a modeling strategy developed to evaluate, in real-time, the risks posed by the Alpha and Omicron VOC soon after their emergence. Our approach utilized multi-strain, stochastic, compartmental models enriched with demographic information, age-specific contact patterns, the influence of non-pharmaceutical interventions, and the trajectory of vaccine distribution. The models’ preliminary assessment about Omicron’s transmissibility and immune evasion closely match later findings. Additionally, analyses based on data collected since our initial assessments demonstrate the retrospective accuracy of our real-time projections in capturing the emergence and subsequent dominance of the Alpha VOC in seven European countries and the Omicron VOC in South Africa. This study shows the value of relatively simple epidemic models in assessing the impact of emerging VOCs in real time, the importance of timely and accurate data, and the need for regular evaluation of these methodologies as we prepare for future global health crises.
SARS-CoV-2关注变体(VOCs)的出现在多个场合突显了COVID-19大流行的动态。由于与迅速评估新出现的挥发性有机化合物的传播性和免疫逃避特性相关的障碍,鉴定后的阶段尤其具有挑战性。在这里,我们回顾性地分析了建模策略的性能,该策略用于实时评估Alpha和Omicron VOC出现后不久所带来的风险。我们的方法利用了多毒株、随机、区室模型,丰富了人口统计信息、年龄特异性接触模式、非药物干预的影响以及疫苗分布轨迹。这些模型对Omicron的传播性和免疫逃避的初步评估与后来的发现非常吻合。此外,基于我们最初评估以来收集的数据的分析表明,我们的实时预测在捕捉七个欧洲国家Alpha VOC的出现和随后的主导地位以及南非的Omicron VOC方面的回顾性准确性。这项研究显示了相对简单的流行病模型在实时评估新出现的挥发性有机化合物的影响方面的价值,及时和准确数据的重要性,以及在我们为未来的全球卫生危机做准备时定期评估这些方法的必要性。
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引用次数: 0
Building in-house capabilities in health agencies and outsourcing to academia or industry: Considerations for effective infectious disease modelling 卫生机构内部能力建设和外包给学术界或产业界:建立有效传染病模型的考虑因素。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-01 DOI: 10.1016/j.epidem.2024.100802
Rachael Pung, Adam J. Kucharski
Infectious disease models provide a systematic way to estimate crucial features of epidemic dynamics and explore different transmission and control scenarios. Given the importance of model-based analysis in managing public health crises, there has been an increase in post-pandemic creation of both academia-driven modelling centres, hubs and consortiums and government-driven public health agencies with in-house modelling units or teams. However, in the past, the delineation of roles and responsibilities between government- and academia-led modelling groups has often been unclear. Who should perform which tasks and when? This ambiguity can increase the risk of duplicated work or unaddressed gaps in analysis. It also raises questions about the sustainability of modelling capacity for addressing routine operational analytical needs while also developing new approaches that can be tailored for emergencies. In the sections below, we discuss factors that could inform decisions about where to locate infectious disease modelling activity. Rather than giving a fixed set of rules, we outlined key considerations and trade-offs that could be taken into account to enable academic and government modelling activities to complement each other effectively, which can in turn be refined as new public health crises emerge in future.
传染病模型为估算流行病动态的关键特征以及探索不同的传播和控制方案提供了一种系统的方法。鉴于基于模型的分析在管理公共卫生危机中的重要性,疫情过后,学术界驱动的建模中心、中心和联盟,以及政府驱动的公共卫生机构内部建模单位或团队都在增加。然而,在过去,政府和学术界主导的建模小组之间的角色和责任划分往往并不明确。谁应该在何时执行哪些任务?这种不明确性可能会增加重复工作的风险,或在分析中出现无法解决的漏洞。它还会引发建模能力的可持续性问题,既要满足日常业务分析需求,又要开发适合紧急情况的新方法。在下面的章节中,我们将讨论一些因素,这些因素可以为我们决定在哪里开展传染病建模活动提供参考。我们并没有给出一套固定的规则,而是概述了可以考虑的关键因素和权衡,以使学术界和政府的建模活动能够有效互补,并随着未来新的公共卫生危机的出现而不断完善。
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引用次数: 0
Hospital population density and risk of respiratory infection: Is close contact density dependent? 医院人口密度与呼吸道感染风险:密切接触密度依赖吗?
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-12-01 DOI: 10.1016/j.epidem.2024.100807
George Shirreff , Anne C.M. Thiébaut , Bich-Tram Huynh , NODS-Cov2 Investigation Group , Guillaume Chelius , Antoine Fraboulet , Didier Guillemot , Lulla Opatowski , Laura Temime
Respiratory infections acquired in hospital depend on close contact, which may be affected by hospital population density. Models of infectious disease transmission typically assume that contact rates are independent of density (frequency dependence) or proportional to it (linear density dependence), without justification. We evaluate these assumptions by measuring contact rates in hospitals under different population densities. We analysed data from a study in 15 wards in which staff, patients and visitors carried wearable sensors which detected close contacts. We proposed a general model, non-linear density dependence, and fit this to data on several types of interactions. Finally, we projected the fitted models to predict the effect of increasing population density on epidemic risk. We identified considerable heterogeneity in density dependence between wards, even those with the same medical specialty. Interactions between all persons present usually depended little on the population density. However, increasing patient density was associated with higher rates of patient contact for staff and for other patients. Simulations suggested that a 10 % increase in patient population density would carry a markedly increased risk in many wards. This study highlights the variance in density dependent dynamics and the complexity of predicting contact rates.
在医院感染呼吸道疾病取决于密切接触,而密切接触可能会受到医院人口密度的影响。传染病传播模型通常假设接触率与密度无关(频率依赖性)或成正比(线性密度依赖性),但并不说明理由。我们通过测量不同人口密度下的医院接触率来评估这些假设。我们分析了 15 个病房的研究数据,在这些病房中,工作人员、病人和来访者都带着可穿戴传感器,传感器可以检测到密切接触。我们提出了一个通用模型,即非线性密度依赖性模型,并将其与几种类型的互动数据进行了拟合。最后,我们利用拟合模型预测人口密度增加对流行病风险的影响。我们发现,即使是同一医学专业的病房,不同病房之间的密度依赖性也存在很大差异。所有在场人员之间的互动通常与人口密度关系不大。然而,病人密度的增加与工作人员和其他病人接触病人的比率增加有关。模拟结果表明,病人密度每增加 10%,许多病房的风险就会明显增加。这项研究强调了与密度相关的动态变化以及预测接触率的复杂性。
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引用次数: 0
Forecasting SARS-CoV-2 epidemic dynamic in Poland with the pDyn agent-based model 利用基于 pDyn 的代理模型预测波兰的 SARS-CoV-2 流行动态。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-12 DOI: 10.1016/j.epidem.2024.100801
Karol Niedzielewski , Rafał P. Bartczuk , Natalia Bielczyk , Dominik Bogucki , Filip Dreger , Grzegorz Dudziuk , Łukasz Górski , Magdalena Gruziel-Słomka , Jędrzej Haman , Artur Kaczorek , Jan Kisielewski , Bartosz Krupa , Antoni Moszyński , Jędrzej M. Nowosielski , Maciej Radwan , Marcin Semeniuk , Urszula Tymoszuk , Jakub Zieliński , Franciszek Rakowski
We employ pDyn (derived from “pandemics dynamics”), an agent-based epidemiological model, to forecast the fourth wave of the SARS-CoV-2 epidemic, primarily driven by the Delta variant, in Polish society. The model captures spatiotemporal dynamics of the epidemic spread, predicting disease-related states based on pathogen properties and behavioral factors. We assess pDyn’s validity, encompassing pathogen variant succession, immunization level, and the proportion of vaccinated among confirmed cases. We evaluate its predictive capacity for pandemic dynamics, including wave peak timing, magnitude, and duration for confirmed cases, hospitalizations, ICU admissions, and deaths, nationally and regionally in Poland. Validation involves comparing pDyn’s estimates with real-world data (excluding data used for calibration) to evaluate whether pDyn accurately reproduced the epidemic dynamics up to the simulation time. To assess the accuracy of pDyn’s predictions, we compared simulation results with real-world data acquired after the simulation date. The findings affirm pDyn’s accuracy in forecasting and enhancing our understanding of epidemic mechanisms.
我们采用基于代理的流行病学模型 pDyn(源于 "大流行病动力学")来预测 SARS-CoV-2 在波兰社会的第四波流行(主要由 Delta 变种驱动)。该模型捕捉了疫情传播的时空动态,根据病原体特性和行为因素预测疾病相关状态。我们评估了 pDyn 的有效性,包括病原体变异的继承、免疫水平以及确诊病例中接种疫苗的比例。我们评估了 pDyn 对大流行动态的预测能力,包括波峰时间、波峰规模以及确诊病例、住院人数、重症监护室入院人数和死亡人数在波兰全国和各地区的持续时间。验证包括将 pDyn 的估计值与真实世界的数据(不包括用于校准的数据)进行比较,以评估 pDyn 是否准确再现了模拟时间内的疫情动态。为了评估 pDyn 预测的准确性,我们将模拟结果与模拟日期之后获得的真实世界数据进行了比较。研究结果肯定了 pDyn 预测的准确性,并加深了我们对流行病机制的理解。
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引用次数: 0
Optimizing spatial distribution of wastewater-based epidemiology to advance health equity 优化基于废水的流行病学空间分布,促进健康公平。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-10 DOI: 10.1016/j.epidem.2024.100804
Maria L. Daza-Torres , J. Cricelio Montesinos-López , César Herrera , Yury E. García , Colleen C. Naughton , Heather N. Bischel , Miriam Nuño
In 2022, the US Centers for Disease Control and Prevention commissioned the National Academies of Sciences, Engineering, and Medicine to assess the role of community-level wastewater-based epidemiology (WBE) beyond COVID-19. WBE is recognized as a promising mechanism for promptly identifying infectious diseases, including COVID-19 and other novel pathogens. An important conclusion from this initiative is the critical importance of maintaining equity and expanding access to fully realize the benefits of wastewater surveillance for marginalized communities. To address this need, we propose an optimization framework that strategically allocates wastewater monitoring resources at the wastewater treatment plant (WWTP) level, ensuring more effective and equitable distribution of surveillance efforts to serve underserved populations.
The purpose of the framework is to obtain a balanced spatial distribution, inclusive population coverage, and efficient representation of disadvantaged groups in the allocation of resources for WBE. Furthermore, the framework concentrates on areas with high population density and gives priority to vulnerable regions, as well as identifying signals that display significant variations from other monitored sources. The optimization objective is to maximize a weighted combination of these critical factors. This problem is formulated as an integer optimization problem and solved using simulated annealing. We evaluate various scenarios, considering different weighting factors, to optimize the allocation of WWTPs with monitoring systems. This optimization framework provides an opportunity to enhance WBE by providing customized monitoring strategies created to address specific priorities and situations, thus enhancing the decision-making processes in public health responses.
2022 年,美国疾病控制和预防中心委托美国国家科学、工程和医学院评估社区级废水流行病学 (WBE) 在 COVID-19 之后的作用。WBE 被认为是及时发现传染病(包括 COVID-19 和其他新型病原体)的一种有前途的机制。这项计划得出的一个重要结论是,要充分实现废水监测为边缘化社区带来的益处,保持公平和扩大普及至关重要。为了满足这一需求,我们提出了一个优化框架,在污水处理厂 (WWTP) 层面战略性地分配污水监测资源,确保更有效、更公平地分配监测工作,为得不到充分服务的人群提供服务。该框架的目的是在分配 WBE 资源时实现均衡的空间分布、全面的人口覆盖和弱势群体的有效代表。此外,该框架集中于人口密度高的地区,优先考虑易受影响的地区,并识别与其他监测来源有显著差异的信号。优化目标是最大化这些关键因素的加权组合。这个问题被表述为一个整数优化问题,并使用模拟退火法加以解决。考虑到不同的加权因素,我们对各种方案进行了评估,以优化配备监控系统的污水处理厂的分配。这一优化框架提供了一个机会,通过提供针对特定优先事项和情况的定制监测策略来提高水环境经济效益,从而加强公共卫生应对措施的决策过程。
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引用次数: 0
Direct and indirect effects of hepatitis B vaccination in four low- and middle-income countries 四个中低收入国家乙肝疫苗接种的直接和间接影响。
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-06 DOI: 10.1016/j.epidem.2024.100798
Margaret J. de Villiers , Edward de Villiers , Shevanthi Nayagam , Timothy B. Hallett
Population-level vaccination effects of the hepatitis B vaccine were investigated in four low- and middle-income countries with different levels of vertical and horizontal transmission. Indirect vaccination effects constitute a large proportion of overall vaccination effects of the vaccination programmes in all four countries (over 70% by 2030 in all four countries). However, countries with higher levels of vertical transmission benefit less from indirect vaccination effects from the infant hepatitis B vaccine series during the first decades of the vaccination programme, making the birth dose vaccine more important in these countries. Vaccination, even at levels that do not fully control transmission, has a great effect on the development of disease as it also increases the average age of infection, thereby causing a decrease in the number of chronic infections relative to the number of acute infections.
在纵向和横向传播程度不同的四个中低收入国家调查了乙肝疫苗在人口层面的接种效果。间接接种效果在所有四个国家的疫苗接种计划的总体接种效果中占很大比例(到 2030 年,所有四个国家的间接接种效果均超过 70%)。然而,纵向传播水平较高的国家在疫苗接种计划的前几十年从婴儿乙肝疫苗系列的间接接种效果中获益较少,因此出生剂量疫苗在这些国家更为重要。接种疫苗,即使不能完全控制传播,也会对疾病的发展产生巨大影响,因为它还会提高平均感染年龄,从而使慢性感染人数相对于急性感染人数有所减少。
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Epidemics
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