Development and application of SIS model on C. sinensis transmission and intervention with preventive chemotherapy
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摘要:
目的 通过构建华支睾吸虫病动力学模型,评价预防性化疗措施对疾病控制的长期效果。 方法 构建符合华支睾吸虫病传播特征的SIS(susceptible-infected-susceptible)仓室模型。以典型流行地区为例,采用数据驱动(data-driven)的贝叶斯融合方法进行模型参数估计。利用模型模拟不同给药方式(脉冲/连续)、覆盖率、频次和时长的预防性化疗,以观察其长期动态变化和效果。 结果 模型具有较好的拟合和预测效果。脉冲式与连续式给药方式长期效果相似。预防性化疗对华支睾吸虫病控制的效果显著,化疗覆盖率越高、频次越多以及干预时间越长,防治效果越显著。但其效果并不持续,化疗停止后感染率出现反弹,一般强度的单纯化疗并不能达到疾病消除效果。 结论 应用华支睾吸虫病的传播动力学模型,可以有效模拟预防性化疗对疾病控制的长期效果。预防性化疗单独应用时效果不持续,需结合健康教育或环境改善等措施共同防治,以增强疾病控制的持续性。 Abstract:Objective To develop a clonorchis sinensis(C. sinensis) transmission dynamic model for the assessment of the long-term effects of preventive chemotherapy. Methods A susceptible-infected-susceptible (SIS) compartmental transmission model was developed to describe the dynamics of C. sinensis infection. The corresponding parameters were estimated through a data-driven Bayesian melding approach, based on data from a typical setting of clonorchiasis. With application of the model, we simulated the long-term effects of preventive chemotherapy under different delivery modes (pulse/continuous), coverages, frequencies and intervention durations. Results The model evaluation showed good capacities of fitting and prediction. The long-term effects of preventive chemotherapy against clonorchiasis between pulse and continuous delivery modes were similar. Preventive chemotherapy had significant control effects against clonorchiasis. Particularly, higher coverages, higher frequencies and longer duration of intervention could result in better effects. However, the effects were not sustainable, as the prevalence would rebound after intervention stopped. Conclusions The model we developed is able to assess the long-term effects of preventive chemotherapy against clonorchiasis effectively. The effects of preventive chemotherapy are not sustainable. Health education and environmental improvement should be combined to improve the sustainability for disease control. -
Key words:
- Clonorchis sinensis /
- Dynamic model /
- Data-driven /
- Preventive chemotherapy /
- Long-term effects
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表 1 模型参数的先验分布及后验估计结果
(天) Table 1. The prior distributions and posterior estimations of model parameters
(d) 参数 先验信息 后验信息 众数(Min,Max) 来源 最佳估计值(95% CI值) 来源 λh - - 0.067 [10, 14] λs 0.249(0.025,0.497) [10, 15-16] 0.234(0.155~0.403) 估计 λf 0.183(0.018,0.365) [10, 16-17] 0.206(0.092~0.269) 估计 βh 1.22×105(1.22×106,2.44×105) 求解微分方程 1.06×105(7.25×106~1.85×105) 估计 βs 4.78×108(4.78×109,9.55×108) 同βh 4.96×108(3.05×108~7.41×108) 估计 βf 6.99×104(6.99×105,1.40×103) 同βh 7.22×104(3.94×104~1.10×103) 估计 μh - - 1.92×10-5 [14] μs - - 1/365 [15] μf 1/(1.5×365)(1/(3.0×365),1/365) [17] 1/(1.5×365)(1/(2.0×365)~1/(1.2×365)) 估计 γ1 0.140/365(0.014/365,0.200/365) [9] 0.139/365(0.077/365~0.172/365) 估计 -
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