Cholera modeling: challenges to quantitative analysis and predicting the impact of interventions.
Cholera modeling: challenges to quantitative analysis and predicting the impact of interventions.
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DOI：
10.1097/ede.0b013e3182572581
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Lipsitch M
中科院分区：
文献类型：
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作者：
Grad YH;Miller JC;Lipsitch M
为了应对津巴布韦和海地的霍乱暴发，最近提出了几个霍乱流行的数学模型。这些模型旨在评估霍乱传播的动态和可能的干预措施的影响，目的是为政策制定者提供指导，以便在包括接种疫苗、提供清洁水和抗生素在内的替代行动方案中做出决定。在这里，我们讨论了霍乱模型固有的模型错误规范、参数不确定性和空间异质性的问题。我们主张在解释定量预测时要谨慎，尤其是对干预效果的预测。我们具体说明了提高基于模型的定量预测的可信度所必需的敏感性分析，并建议了未来疫情环境中将改进分析和预测的监测类型。
Several mathematical models of epidemic cholera have recently been proposed in response to outbreaks in Zimbabwe and Haiti. These models aim to estimate the dynamics of cholera transmission and the impact of possible interventions, with a goal of providing guidance to policy-makers in deciding among alternative courses of action, including vaccination, provision of clean water, and antibiotics. Here we discuss concerns about model misspecification, parameter uncertainty, and spatial heterogeneity intrinsic to models for cholera. We argue for caution in interpreting quantitative predictions, particularly predictions of the effectiveness of interventions. We specify sensitivity analyses that would be necessary to improve confidence in model-based quantitative prediction, and suggest types of monitoring in future epidemic settings that would improve analysis and prediction.