Modelling the effects of chemotherapy and relapse on the transmission dynamics of leprosy
Modelling the effects of chemotherapy and relapse on the transmission dynamics of leprosy
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DOI：
10.1186/2251-7456-6-12
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发表时间：
2012-12-01
影响因子：
2
通讯作者：
Bhunu, Claver Pedzisai
中科院分区：
文献类型：
--
作者：
Mushayabasa, Steady;Bhunu, Claver Pedzisai
目的：虽然全球麻风病负担呈下降趋势，但亚洲和非洲有15个国家占全球新病例检出率的94%。在这里，我们评估不同的干预策略，旨在通过针对无症状和有症状的individual.Methods根除麻风病的影响：我们开发了一个数学模型，麻风病的传播和治疗之间的症状和无症状的，为了调查麻风病复发病例的影响，无症状的个人和个人管理的治疗依从性的病例发现。利用比较理论定性地分析了无病平衡点的全局稳定性。借助于中心流形理论，研究了地方病平衡点的局部稳定性。人口水平的影响，增加的情况下发现和高治疗率（保证通过教育活动的依从性和完成治疗）进行了评估，通过数值模拟和支持的分析结果：结果：全面和定性的数学分析的模型表明，无病平衡是全球性的，渐近稳定的生殖数小于1。此外，我们已经建立了该模型有一个局部的，渐近稳定的地方病平衡点时，再生数较大，但接近1。数值模拟结果表明，无症状麻风病带菌者的发现率大于40%是降低麻风病流行率的必要条件，可能有助于实现麻风病的根除。在最好的情况下，该研究表明，针对无症状和有症状个体的高水平病例发现，以及个体对治疗的高水平依从性，可能对控制麻风病复发产生重大影响，并可能有助于实现麻风病的根除。
Purpose: Although there is a declining trend in the global burden of leprosy, there are 15 countries in Asia and Africa which account for 94% of the global total of the new-case detection rate. Here, we assess the impact of different intervention strategies aimed at leprosy eradication through targeting non-symptomatic and symptomatic individuals.Methods: We develop a mathematical model of leprosy transmission and treatment amongst symptomatic and non-symptomatic, in order to investigate the effects of leprosy relapse cases, case finding of non-symptomatic individuals and compliance to therapy of individuals administered with treatment. Comparison theory has been qualitatively used to analyze the global stability of the disease-free equilibrium. With the aid of centre manifold theory, the local stability of the endemic equilibrium has been investigated. Population-level effects of increased case findings and high treatment rate (guaranteed by compliance and completion of therapy via educational campaigns) are evaluated through numerical simulations and presented in support of the analytical results.Results: Comprehensive and qualitative mathematical analysis of the model reveals that, the disease-free equilibrium is globally, asymptotically stable whenever the reproductive number is less than unity. Further, we have established that the model has a locally, asymptotically stable endemic equilibrium when the reproductive number is greater, but close to unity. Numerical simulation suggests that case finding of non-symptomatic leprosy carriers, greater that 40% is necessary for reducing leprosy prevalence and maybe useful on attaining leprosy eradication.Conclusions: At its best, the study suggests that high level of case finding targeting non-symptomatic and symptomatic individuals, together with high level of compliance by individuals on treatment, may have a substantial effect on controlling leprosy relapses and possible may assist on attaining leprosy eradication.