CystiHuman: A model of human neurocysticercosis.
CystiHuman: A model of human neurocysticercosis.
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DOI：
10.1371/journal.pcbi.1010118
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发表时间：
2022-05
影响因子：
4.3
通讯作者：
中科院分区：
文献类型：
--
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猪带绦虫是囊虫病的罪魁祸首，囊虫病是一种被忽视的热带疾病，在吸食带绦虫卵后，以幼虫的形式出现在宿主体内。脑囊虫病(NCC)是一种影响人类中枢神经系统的疾病，在发展中国家是癫痫的主要原因，也可导致颅内高压、脑积水和死亡。模拟模型可以帮助在实施之前确定最具成本效益的干预措施。建立NCC模型应能够比较各种干预措施，从治疗人类带绦虫病(人体肠道内存在成虫)到缓解NCC。它还允许关注疾病的实际影响，而不是像其他模型那样使用代理。这个基于代理的模型是第一个模拟人类NCC及其相关病理的模型。它使用了另一个模型CystiAgents的输出，该模型模拟了猪囊虫病和人带绦虫病的演变，添加了人和包囊试剂，包括包囊位置和阶段、人类症状和治疗的模型。CystiHuman也解释了NCC相关症状出现延迟的原因。它包括三个模块，分别详细说明了囊性病变的发展、癫痫发作的概率和时机，以及颅内高压/脑积水。它已经在爪哇梅森实施，并在秘鲁的三个流行村庄进行了校准，然后应用到另一个村庄(Ricia Playa)，将模拟结果与该村庄的现场数据进行比较。尽管可用现场数据有限，但通过校准找到的参数值是可信的，在Rica Playa的模拟结果接近NCC患病率的实际值以及随年龄和单个病变病例增加的方式。初步模拟进一步表明，短期干预之后，带绦虫病流行率迅速增加到原来的水平，对NCC流行率的影响可能有限。本文介绍了人类脑囊虫病的第一个模型，脑囊虫病是一种寄生虫病，在发展中国家导致了很大一部分癫痫病例，也导致了颅内高压、脑积水和死亡。到目前为止，现有的建模工作主要集中在寄生虫的传播上，即导致脑囊虫病的寄生虫--猪带绦虫--如何通过人与猪之间的相互作用而持续存在。然而，这些模型通常不会模拟脑囊虫病本身或相关症状。CystiHuman通过提出脑囊虫病的模型、相关症状和治疗的可能性来补充这些努力。总体而言，最初的模型结果与有关脑囊虫病患病率和年龄模式的现场数据是一致的。该模型表明，成功地将寄生虫传播减少到最初水平的一小部分，但随后(就像迄今经常发生的情况一样)迅速恢复传播水平的短期干预措施，很可能无法大幅降低脑囊虫病的患病率。我们认为目前的模型是CystiHuman的第一次迭代。未来的迭代应该使用新的现场数据来改进模型的各个方面，并确保其充分验证。它们还应包括成本信息，为防治该疾病的干预措施的成本效益分析提供信息。
The Taenia solium tapeworm is responsible for cysticercosis, a neglected tropical disease presenting as larvae in the body of a host following taenia egg ingestion. Neurocysticercosis (NCC), the name of the disease when it affects the human central nervous system, is a major cause of epilepsy in developing countries, and can also cause intracranial hypertension, hydrocephalus and death. Simulation models can help identify the most cost-effective interventions before their implementation. Modelling NCC should enable the comparison of a broad range of interventions, from treatment of human taeniasis (presence of an adult taenia worm in the human intestine) to NCC mitigation. It also allows a focus on the actual impact of the disease, rather than using proxies as is the case for other models. This agent-based model is the first model that simulates human NCC and associated pathologies. It uses the output of another model, CystiAgent, which simulates the evolution of pig cysticercosis and human taeniasis, adding human and cyst agents, including a model of cyst location and stage, human symptoms, and treatment. CystiHuman also accounts for delays in the appearance of NCC-related symptoms. It comprises three modules detailing cyst development, seizure probability and timing, and intracranial hypertension/hydrocephalus, respectively. It has been implemented in Java MASON and calibrated in three endemic villages in Peru, then applied to another village (Rica Playa) to compare simulation results with field data in that village. Despite limitations in available field data, parameter values found through calibration are plausible and simulated outcomes in Rica Playa are close to actual values for NCC prevalence and the way it increases with age and cases with single lesions. Initial simulations further suggest that short-term interventions followed by a rapid increase in taeniasis prevalence back to original levels may have limited impacts on NCC prevalence. This paper presents CystiHuman, the first model of human neurocysticercosis, a parasitic disease that is responsible for a large proportion of epilepsy cases in developing countries and also contributes to intracranial hypertension, hydrocephalus and death. Existing modelling efforts have focused so far on parasite transmission i.e., how the parasite responsible for neurocysticercosis, Taenia solium, persists through interactions between humans and pigs. Such models, however, generally do not simulate neurocysticercosis itself or associated symptoms. CystiHuman complements these efforts by proposing a model of neurocysticercosis, associated symptoms, and likelihood of treatment. Overall, initial model outcomes are coherent with field data regarding neurocysticercosis prevalence and age patterns. The model suggests that short-term interventions that successfully reduce parasite transmission to a small fraction of its original level, but are followed (as has often been the case so far) by a rapid recuperation in transmission levels, will likely fail to produce a substantial reduction in neurocysticercosis prevalence. We view the present model as a first iteration of CystiHuman. Future iterations should use new field data to refine aspects of the model and ensure its full validation. They should also include cost information to inform cost-effectiveness analyses of interventions to address the disease.
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影响因子：
9.9
作者：
de Andrade, D. Ciampi;Rodrigues, C. L.;Caramelli, P.
通讯作者：
Caramelli, P.
影响因子：
2.5
作者：
de Coster, T;Van Damme, I;Gabriel, S
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影响因子：
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作者：
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通讯作者：
FORJAZ, SD
影响因子：
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作者：
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通讯作者：
Thennarasu, K.
影响因子：
3.6
作者：
Baranwal, AK;Singhi, PD;Singhi, SC
通讯作者：
Singhi, SC