Development and validation of an agent-based model to promote evidence-based control of Taenia solium cysticercosis

项目总结 猪带绦虫是低收入和中等收入国家后天性癫痫的主要原因。 地方性传播主要发生在农村地区，那里的猪可以自由漫步，吃人 粪便。通过应用抗寄生虫剂可以控制和/或消除索氏锥虫的传播 对人类绦虫携带者或猪的治疗、猪的疫苗接种或其他社会行为干预(例如， 卫生设施、畜栏)。政策制定者现在面临的关键问题是，哪些干预策略应该 建议用于不同的流行环境--具体地说，什么干预组合、频率、 持续时间和目标人群是实现给定控制结果的最佳选择吗？传染病模型 是回答这些问题的优秀工具，因为可以部署它们来测试各种策略 在投入大量资源进行前瞻性试验之前的各种设置。而以前的索氏木霉模型 之前已经开发了变速箱，没有现有的模型用预期的数据进行验证 试验，没有一个包含空间框架，可以解释观察到的聚集性传播模式 在流行地区。这些限制严重限制了以前的模型的实用性。具体来说，这项建议 解决这些限制，以确保交付的模型可以直接应用于改进控制和 杜绝苏云金芽胞杆菌。 这项拟议研究的目标是开发一个名为CystiMASON的确定的T.solium模拟模型， 它将建立在我们组以前的建模经验(CystiSim和CystiAgent模型)的基础上，并解决 以前的松材线虫模型的缺点。为了实现这一目标，我们提出了一系列的田间和实验室 将确定对CystiMASON准确性至关重要的环境和生物参数的实验(目标1)。 这些实验将提高模型参数的精度，减少模型结果的不确定性。 当这些研究的数据产生时，它们将被整合到连续版本的CystiMASON中， 它将使用秘鲁(AIM)进行的预期试验的数据存储库进行校准和验证 2)。最后，我们将使用在赞比亚进行的预期试验的数据来验证CystiMASON是否符合 并将CyistMASON在这种流行环境中的准确性与其他 可供选择的型号(目标3)。在这项研究完成后，最终的CystiMASON模型将是关键 为寻求评估控制或消除囊虫病战略的政策制定者提供的拉丁文资源 美洲和撒哈拉以南非洲。

PROJECT SUMMARY Taenia solium, the pork tapeworm, is a leading cause of acquired epilepsy in low and middle income countries. Endemic transmission occurs primarily in rural areas where pigs are allowed to roam freely and consume human feces. Control and/or elimination of T. solium transmission is possible through application of anti-parasitic treatment to human tapeworm carriers or pigs, vaccination of pigs, or other social-behavioral interventions (e.g., sanitation, corralling). The critical question that policy-makers now face is which intervention strategies should be recommended for different endemic settings – specifically, what intervention combinations, frequencies, durations, and target populations are optimal for achieving a given control outcome? Infectious disease models are excellent tools for answering these questions, as they can be deployed to test a wide range of strategies in a variety of settings prior to investing massive resources in prospective trials. While prior models for T. solium transmission have been previously developed, no existing model has been validated with data from prospective trials, and none incorporate a spatial framework that can account for clustered transmission patterns observed in endemic areas. These limitations have severely limited the utility of prior models. This proposal specifically addresses these limitations to ensure that the delivered model can be directly applied to improve control and elimination for T. solium. The objective of the proposed research is to develop a definitive T. solium simulation model called CystiMASON, which will build on our group’s prior modeling experience (CystiSim and CystiAgent models), and address the shortcomings of previous T. solium models. To achieve this goal, we propose a series of field and laboratory experiments that will define environmental and biological parameters critical to CystiMASON accuracy (Aim 1). These experiments will increase the precision of model parameters and reduce uncertainty in model outcomes. As data from these studies are generated, they will be integrated into the successive version of CystiMASON, which will be calibrated and validated using a repository of data from prospective trials conducted in Peru (Aim 2). Finally, we will use data available from prospective trials conducted in Zambia to validate CystiMASON to a sub-Saharan African setting and compare the accuracy of CyistMASON in this endemic setting with other available models (Aim 3). After the completion of this research, the final CystiMASON model will be a key resource for policy-makers who seek to evaluate strategies for the control or elimination of cysticercosis in Latin America and sub-Saharan Africa.