Comparing effectiveness of top-down and bottom-up strategies in containing influenza.

Comparing effectiveness of top-down and bottom-up strategies in containing influenza.
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DOI:
10.1371/journal.pone.0025149
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发表时间:
2011
期刊:
影响因子:
3.7
通讯作者:
Ma Y
Ma Y
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Marathe A;Lewis B;Barrett C;Chen J;Marathe M;Eubank S;Ma Y

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这项研究比较了自下而上、自我激励的行为干预和自上而下的干预措施的表现,这些干预措施的目标是控制“流感样疾病”。这两种类型的干预都使用了环战略的一种变体。在第一种情况下,当确诊的人的直接接触者的比例超过阈值时,该人决定寻求预防措施,例如疫苗或抗病毒药物;在第二种情况下,我们考虑两种干预方案,表示为块和学校:当在人口普查区(分别为学校)被诊断的人的一部分超过阈值时,对整个块(对应的学校)进行预防。结果表明,在我们的参数设置下,自下而上策略的性能优于自上而下策略。即使在拦网策略很好地降低了总体攻击率的情况下,它也会产生更高的成本。这些发现证实了这样一种观点,即如果人们有效地使用抗病毒药物,让普通公民按需快速获得这些药物可能是控制疫情的非常有效的方法。
This research compares the performance of bottom-up, self-motivated behavioral interventions with top-down interventions targeted at controlling an “Influenza-like-illness”. Both types of interventions use a variant of the ring strategy. In the first case, when the fraction of a person's direct contacts who are diagnosed exceeds a threshold, that person decides to seek prophylaxis, e.g. vaccine or antivirals; in the second case, we consider two intervention protocols, denoted Block and School: when a fraction of people who are diagnosed in a Census Block (resp., School) exceeds the threshold, prophylax the entire Block (resp., School). Results show that the bottom-up strategy outperforms the top-down strategies under our parameter settings. Even in situations where the Block strategy reduces the overall attack rate well, it incurs a much higher cost. These findings lend credence to the notion that if people used antivirals effectively, making them available quickly on demand to private citizens could be a very effective way to control an outbreak.
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