用于量化预测限制耐多药疟疾流行的抗疟药物的确定性数学模型

Akindele Akano Onifade , Isaiah Oluwafemi Ademola , Jan Rychtář , Dewey Taylor
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摘要

在尼日利亚,对多种药物产生抗药性的疟疾菌株十分普遍,这对消灭疟疾构成了重大挑战。抗药性测试虽可进行,但利用率不高。因此,我们建立了一个数学模型,将测试作为一种控制策略。这使我们能够量化预测检测利用率对疟疾流行率的影响。通过将模型与疟疾数据进行拟合,并利用文献中报道的实地数据,我们估算并计算出了与疾病动态相关的重要参数。首先,我们分析了疟疾模型的无疾病状态,并计算了基线控制繁殖数。敏感性分析用于研究参数对控制疾病的影响。利用数值模拟来探索模型解决方案的行为,包括检测菌株和野生菌株疟疾的抗药性。我们发现,实施检测将:(a) 阻止疟疾流行率从 30% 上升到 35%;(b) 显著减缓抗药性菌株对野生菌株的替代;(c) 避免约 6% 的治疗失败。我们还发现,提高蚊子死亡率或降低蚊子叮咬率、蚊子出生率、蚊子传播或蚊子传播对降低社区疟疾流行率的贡献最大。总之,治疗失败是社区疟疾流行的重要组成部分。对多药耐药性的检测可显著减少病例,对遏制尼日利亚的疟疾有许多影响。
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A deterministic mathematical model for quantifiable prediction of antimalarials limiting the prevalence of multidrug-resistant malaria

The malaria’s multidrug-resistant strain in Nigeria is prevalent and it poses a significant challenge for disease elimination. The testing for resistance is available but underutilized. Therefore, we develop a mathematical model incorporating the testing as a control strategy. This allows us to make quantifiable predictions about the effects of testing utilization on the malaria prevalence. By fitting the model to data on malaria and using field data reported in the literature, important parameters associated with the disease dynamics are estimated and calculated. First, we analyze the disease-free state of the malaria model and calculate the baseline control reproduction number. Sensitivity analysis is used to investigate the influence of the parameters in curtailing the disease. Numerical simulations are used to explore the behavior of the model solutions involving testing for resistance of the strain and wild strain malaria. We found that the implementation of testing would (a) prevent the increase of malaria prevalence from 30% to 35%, (b) significantly slow down the replacement of the wild strain by the resistant strain, and (c) avert about 6% of treatment failures. We also found that increasing mosquito death rate or reducing mosquito biting rate, mosquito birth rate, transmission to or from mosquitoes would contribute most significantly to the reduction of malaria prevalence in the community. In conclusion, the treatment failure is a significant component of the community malaria epidemic. Testing for multidrug resistance yields a significant reduction in cases with many implications regarding the containment of malaria in Nigeria.

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来源期刊
Healthcare analytics (New York, N.Y.)
Healthcare analytics (New York, N.Y.) Applied Mathematics, Modelling and Simulation, Nursing and Health Professions (General)
CiteScore
4.40
自引率
0.00%
发文量
0
审稿时长
79 days
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