The epidemiological dynamics of infectious trachoma may facilitate elimination.
The epidemiological dynamics of infectious trachoma may facilitate elimination.
复制标题
DOI：
10.1016/j.epidem.2011.03.004
复制
发表时间：
2011-06
期刊：
影响因子：
3.8
通讯作者：
Porco, Travis C.
中科院分区：
文献类型：
--
作者：
Lietman, Thomas M.;Gebre, Teshome;Ayele, Berhan;Ray, Kathryn J.;Maher, M. Cyrus;See, Craig W.;Emerson, Paul M.;Porco, Travis C.
关键词：
沙眼项目使用大量分发的口服阿奇霉素来治疗引起该疾病的沙眼衣原体眼部菌株。对于感染是可以根除还是只能控制存在争议。大规模使用抗生素明显降低了衣原体在流行社区的流行率。然而，完美的覆盖率是无法实现的，世界卫生组织的目标是将感染控制在一定程度上，使失明不会成为公共卫生问题。在这里，我们使用数学模型来评估是否有可能实现更雄心勃勃的目标，如局部消除甚至全球根除。我们适合一类非线性，随机，易感染的易感（SIS）模型，允许积极或消极的反馈，从最近的社区随机试验在埃塞俄比亚的数据，并使用模型平均进行预测。这些模型预测，重新引入的感染可能不会重新填充社区，或者可能会非常缓慢，以至于监测可能有效。首选的模型表现出正反馈，允许一种随机滞后的形式，其中感染在大规模治疗后缓慢返回，如果它返回的话。不同地方性地区的结果表明，消除可能比早期模型预测的更可行。如果沙眼可以通过反复大规模分发抗生素来根除，那么它将鼓励对其他细菌性疾病采取类似的策略，这些疾病的唯一宿主是人类，并且没有有效的疫苗。
Trachoma programs use mass distributions of oral azithromycin to treat the ocular strains of Chlamydia trachomatis that cause the disease. There is debate whether infection can be eradicated or only controlled. Mass antibiotic administrations clearly reduce the prevalence of chlamydia in endemic communities. However, perfect coverage is unattainable, and the World Health Organization's goal is to control infection to a level where resulting blindness is not a public health concern. Here, we use mathematical models to assess whether more ambitious goals such as local elimination or even global eradication are possible. We fit a class of non-linear, stochastic, susceptible–infectious–susceptible (SIS) models which allow positive or negative feedback, to data from a recent community-randomized trial in Ethiopia, and make predictions using model averaging. The models predict that reintroduced infection may not repopulate the community, or may do so sufficiently slowly that surveillance might be effective. The preferred model exhibits positive feedback, allowing a form of stochastic hysteresis in which infection returns slowly after mass treatment, if it returns at all. Results for regions of different endemicity suggest that elimination may be more feasible than earlier models had predicted. If trachoma can be eradicated with repeated mass antibiotic distributions, it would encourage similar strategies against other bacterial diseases whose only host is humans and for which effective vaccines are not available.
登录
查看更多内容
影响因子：
3.8
作者：
Gambhir M;Basáñez MG;Burton MJ;Solomon AW;Bailey RL;Holland MJ;Blake IM;Donnelly CA;Jabr I;Mabey DC;Grassly NC
通讯作者：
Grassly NC
影响因子：
4.3
作者：
Nåsell, I
通讯作者：
Nåsell, I
DOI：
10.1098/rspb.1998.0284
发表时间：
1998-02-07
影响因子：
4.7
作者：
Finkenstädt, B;Grenfell, B
通讯作者：
Grenfell, B
影响因子：
120.7
作者：
Chidambaram, JD;Alemayehu, W;Lietman, TM
通讯作者：
Lietman, TM
影响因子：
2.9
作者：
Koelle, K;Pascual, M
通讯作者：
Pascual, M