伊维菌素和牲畜可用性对疟疾传播的最佳控制效果

Josephine Elamma Ochigbo, J. Ndam, Wipuni U. Sirisena
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摘要

疟疾仍然是一个全球性威胁,而用于防治疟疾的传统方法忽略了在室外觅食的蚊子,本研究利用一种名为伊维菌素的药物来应对此类蚊子带来的挑战,这种药物对摄入含有一定浓度伊维菌素的血药的蚊子具有杀伤力。我们建立了一个数学模型,其中包含三种控制工具(驱虫蚊帐、对感染者的治疗以及对牲畜和人类使用伊维菌素药物),用于在最佳条件下传播和控制疟疾。对模型的基本繁殖数 R0 进行了估算,并对模型的无病平衡点和流行平衡点的局部和全局稳定性进行了分析。敏感性分析表明,R0 对蚊虫叮咬率和人与牛的血粉比例最为敏感,任何一个参数值增加一个百分点,都会导致 R0 值增加相同的百分点。基于三种时间相关控制的最优控制分析结果表明,将所有三种控制结合在一起可获得最佳结果,其次是将伊维菌素药物的使用和对感染人类的治疗结合在一起的策略。根据现有资源情况,建议在疟疾干预方案中采用其中任何一种方法,因为它们对受感染的人类和蚊子种群都很有效,有可能在最短的时间内为消除疾病做出重大贡献。
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Optimal control with the effects of ivermectin and livestock availability on malaria transmission
Malaria remains a global threat and the conventional methods used for combating the disease leave out mosquitoes that feed outdoors and this study addresses the challenge posed by such mosquitoes based on a tool called ivermectin drug which is lethal to mosquitoes that ingest bloodmeal containing a concentration of it. We formulated a mathematical model with three control tools (insecticide treated nets, treatment of infective individuals and ivermectin drug on livestock and human) for the transmission and control of malaria under optimal condition. The model’s basic reproduction number, R0 was estimated and the local and global stability analyses of the disease-free and endemic equilibrium points of the model were analyzed. Sensitivity analysis carried out showed that R0 is most sensitive to the mosquito biting rate and to the proportion of blood meal on human with cattle availability in such a way that any percent increase in the value of any of these parameters will lead to an equal percent increase in the value of R0. The result of an optimal control analysis based on three time dependent controls suggests that the combination of all three controls gives the best result followed by the strategy that combines the use of ivermectin drug and the treatment of infective human. Depending on available resources, any of these is recommended to be adopted in malaria intervention programmes because of their effectiveness on both the infective human and mosquito populations with the potential of contributing significantly to the disease elimination within a minimal time frame.
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