Statistical communications in infectious diseases最新文献

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Who will Benefit from a Wide-Scale Introduction of Vaginal Microbicides in Developing Countries? 谁将从发展中国家大规模使用阴道杀菌剂中受益?

Statistical communications in infectious diseases

Pub Date : 2010-01-01 DOI: 10.2202/1948-4690.1012

Dobromir T Dimitrov, Benoit Masse, Marie-Claude Boily

Vaginal microbicides (VMB) are currently among the few biomedical interventions designed to help women reduce their risk of acquiring HIV infection. However, the microbicide containing antiretroviral (ARV-VMB) may lead to the development of antiretroviral resistance and could paradoxically become more beneficial to men at the population level. We developed a mathematical model to study the impact of a wide-scale population usage of VMB in a heterosexual population. Gender ratios of prevented infections and prevalence reduction are evaluated in 63 different intervention schedules including continuous and interrupted ARV-VMB use by HIV-positive women. The influence of different factors on population-level benefits is also studied through Monte Carlo simulations using parameters sampled from primary ranges representative of developing countries. Our analysis indicates that women are more likely than men to benefit from ARV-VMB use since 78-80% of the total 63,000 simulations investigated (under different parameter sets) showed a female advantage whether benefit is measured as cumulative number of infections prevented, the percentage of cumulative infections prevented, or the expected reduction in prevalence. Stratified analysis by scenarios indicates that the likelihood of a male advantage with respect to the fractions of prevented infections varies from 6% to 49% among the scenarios. It is substantial only if the risk of systemic absorption and development of resistance to ARV-VMB is high and the HIV-positive women use VMB indefinitely without interruption. Therefore, the use of ARV-VMB, with successful control measures restricting usage by HIV-positive women, is still very much a female prevention tool.

阴道杀微生物剂是目前为数不多的旨在帮助妇女减少感染艾滋病毒风险的生物医学干预措施之一。然而，含有抗逆转录病毒的杀微生物剂(ARV-VMB)可能导致抗逆转录病毒耐药性的发展，并可能矛盾地在人口水平上对男性更有利。我们建立了一个数学模型来研究在异性恋人群中大规模使用VMB的影响。在63种不同的干预方案中，包括艾滋病毒阳性妇女持续和中断使用抗逆转录病毒药物治疗方案，评估了预防感染和减少流行率的性别比例。还通过蒙特卡罗模拟，利用从具有代表性的发展中国家的主要范围取样的参数，研究了不同因素对人口水平效益的影响。我们的分析表明，女性比男性更有可能从使用ARV-VMB中受益，因为在调查的63,000个模拟中(在不同参数集下)，78-80%的模拟显示，无论以预防的累计感染数量、预防的累计感染百分比或预期的患病率降低来衡量，女性都具有优势。按情景进行的分层分析表明，在不同情景中，男性在预防感染的比例方面具有优势的可能性从6%到49%不等。只有当对ARV-VMB的全身吸收和产生耐药性的风险很高，并且艾滋病毒阳性妇女无限期地不间断地使用VMB时，它才是实质性的。因此，使用ARV-VMB，通过成功的控制措施限制艾滋病毒阳性妇女的使用，仍然是一种非常重要的女性预防工具。

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引用次数: 20

Infectious Disease Modeling: Creating a Community to Respond to Biological Threats 传染病建模:创建社区以应对生物威胁

Statistical communications in infectious diseases

Pub Date : 2009-08-06 DOI: 10.2202/1948-4690.1001

J. Kaufman, S. Edlund, Judith V. Douglas

The rise of global economies in the 21st century, the rapid national and international movement of people, and the increased reliance of developed countries on global trade, all greatly increase the potential and possible magnitude of a worldwide pandemic. New epidemics may be the result of global climate change, vector-borne diseases, food-borne illness, new naturally occurring pathogens, or bio-terrorist attacks. The threat is most severe for highly communicable diseases. When rapidly spreading microparasitic infections coincide with the rapid transportation, propagation, and dissemination of the pathogens and vectors for infection, the risks associated with emerging infectious disease increase. We discuss the use of publicly-available technologies in assisting public health officials and scientists in protecting populations from emerging disease or in implementing improved response measures. We illustrate possibilities using the SpatioTemporal Epidemiological Modeler (STEM) that was developed to run on the Open Health Framework (OHF) created by the Eclipse Foundation in 2004. An illustration regarding the spread of the influenza H1N1 virus from Mexico to the United States via air travel in Spring 2009 is briefly discussed.

21世纪全球经济的崛起、人口在国内和国际间的迅速流动以及发达国家对全球贸易的日益依赖，都大大增加了全球大流行病的可能性和可能的严重程度。新的流行病可能是全球气候变化、媒介传播疾病、食源性疾病、新的自然发生的病原体或生物恐怖袭击的结果。高度传染性疾病的威胁最为严重。当迅速蔓延的微寄生虫感染与病原体和感染媒介的快速运输、繁殖和传播同时发生时，与新发传染病相关的风险就会增加。我们讨论利用公开技术协助公共卫生官员和科学家保护民众免受新出现疾病的侵害或实施改进的应对措施。我们使用时空流行病学建模器(STEM)来说明可能性，该模型是为运行在Eclipse基金会于2004年创建的开放健康框架(OHF)上而开发的。本文简要讨论了2009年春季H1N1流感病毒通过航空旅行从墨西哥传播到美国的情况。

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引用次数: 11

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