scholarly journals The impact of control strategies and behavioural changes on the elimination of Ebola from Lofa County, Liberia

2017 ◽  
Vol 372 (1721) ◽  
pp. 20160302 ◽  
Author(s):  
Sebastian Funk ◽  
Iza Ciglenecki ◽  
Amanda Tiffany ◽  
Etienne Gignoux ◽  
Anton Camacho ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Control Strategies ◽  
Clinical Intervention ◽  
Credible Interval ◽  
Transmission Model ◽  
Public Health Response ◽  
Healthcare Seeking ◽  
Behavioural Changes ◽  
Treatment Centre ◽  
The Impact

The Ebola epidemic in West Africa was stopped by an enormous concerted effort of local communities and national and international organizations. It is not clear, however, how much the public health response and behavioural changes in affected communities, respectively, contributed to ending the outbreak. Here, we analyse the epidemic in Lofa County, Liberia, lasting from March to November 2014, by reporting a comprehensive time line of events and estimating the time-varying transmission intensity using a mathematical model of Ebola transmission. Model fits to the epidemic show an alternation of peaks and troughs in transmission, consistent with highly heterogeneous spread. This is combined with an overall decline in the reproduction number of Ebola transmission from early August, coinciding with an expansion of the local Ebola treatment centre. We estimate that healthcare seeking approximately doubled over the course of the outbreak, and that isolation of those seeking healthcare reduced their reproduction number by 62% (mean estimate, 95% credible interval (CI) 59–66). Both expansion of bed availability and improved healthcare seeking contributed to ending the epidemic, highlighting the importance of community engagement alongside clinical intervention. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.

scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan H. van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin C. J. Bootsma ◽  
Janneke H. H. M. van de Wijgert ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Additional Benefit ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Admission Data ◽  
Age Structured ◽  
The Impact ◽  
Pandemic Wave

AbstractThe role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We use an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures at different time points during the COVID-19 pandemic in the Netherlands. Our analyses suggest that the impact of measures reducing school-based contacts depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce the effective reproduction number (Re) with non-school-based measures are exhausted or undesired and Re is still close to 1, the additional benefit of school-based measures may be considerable, particularly among older school children. As two examples, we demonstrate that keeping schools closed after the summer holidays in 2020, in the absence of other measures, would not have prevented the second pandemic wave in autumn 2020 but closing schools in November 2020 could have reduced Re below 1, with unchanged non-school-based contacts.

scholarly journals The effects of non-pharmaceutical interventions on SARS-CoV-2 transmission in different socioeconomic populations in Kuwait: a modeling study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatima Khadadah ◽  
Abdullah A. Al-Shammari ◽  
Ahmad Alhashemi ◽  
Dari Alhuwail ◽  
Bader Al-Saif ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Reproduction Number ◽  
Transmission Model ◽  
Socioeconomic Groups ◽  
Before And After ◽  
Cross Transmission ◽  
Community Transmission ◽  
The Impact ◽  
Pharmaceutical Interventions ◽  
The Basic Reproduction Number

Abstract Background Aggressive non-pharmaceutical interventions (NPIs) may reduce transmission of SARS-CoV-2. The extent to which these interventions are successful in stopping the spread have not been characterized in countries with distinct socioeconomic groups. We compared the effects of a partial lockdown on disease transmission among Kuwaitis (P1) and non-Kuwaitis (P2) living in Kuwait. Methods We fit a modified metapopulation SEIR transmission model to reported cases stratified by two groups to estimate the impact of a partial lockdown on the effective reproduction number ($$ {\mathcal{R}}_e $$ R e ). We estimated the basic reproduction number ($$ {\mathcal{R}}_0 $$ R 0 ) for the transmission in each group and simulated the potential trajectories of an outbreak from the first recorded case of community transmission until 12 days after the partial lockdown. We estimated $$ {\mathcal{R}}_e $$ R e values of both groups before and after the partial curfew, simulated the effect of these values on the epidemic curves and explored a range of cross-transmission scenarios. Results We estimate $$ {\mathcal{R}}_e $$ R e at 1·08 (95% CI: 1·00–1·26) for P1 and 2·36 (2·03–2·71) for P2. On March 22nd, $$ {\mathcal{R}}_e $$ R e for P1 and P2 are estimated at 1·19 (1·04–1·34) and 1·75 (1·26–2·11) respectively. After the partial curfew had taken effect, $$ {\mathcal{R}}_e $$ R e for P1 dropped modestly to 1·05 (0·82–1·26) but almost doubled for P2 to 2·89 (2·30–3·70). Our simulated epidemic trajectories show that the partial curfew measure greatly reduced and delayed the height of the peak in P1, yet significantly elevated and hastened the peak in P2. Modest cross-transmission between P1 and P2 greatly elevated the height of the peak in P1 and brought it forward in time closer to the peak of P2. Conclusion Our results indicate and quantify how the same lockdown intervention can accentuate disease transmission in some subpopulations while potentially controlling it in others. Any such control may further become compromised in the presence of cross-transmission between subpopulations. Future interventions and policies need to be sensitive to socioeconomic and health disparities.

scholarly journals Investigating the effects of accelerated partner therapy (APT) on chlamydia transmission in Britain: a mathematical modelling study

2020 ◽  
Author(s):  
Christian L Althaus ◽  
Catherine H Mercer ◽  
Jackie A Cassell ◽  
Claudia S Estcourt ◽  
Nicola Low
Keyword(s):  
Sexual Activity ◽  
Control Strategies ◽  
Controlled Trial ◽  
Partner Notification ◽  
Cluster Randomised Controlled Trial ◽  
Credible Interval ◽  
Population Based ◽  
Transmission Model ◽  
Transmitted Infection ◽  
Potential Increase

Understanding the effects of partner notification (PN) on the transmission of chlamydia, the most prevalent bacterial sexual transmitted infection worldwide, is critical for implementing optimal control strategies. Accelerated partner therapy (APT) aims to increase the numbers of partners treated and reduce the time to partner treatment. Our objective was to study the effects of APT interventions on partner treatment and chlamydia transmission in order to better understand the results of LUSTRUM, an APT cross-over cluster randomised controlled trial in the UK. We developed a novel deterministic, population-based chlamydia transmission model including the process of PN. We considered a population aged 16-34 years and calibrated the model to sexual behaviour data between people of the opposite-sex and chlamydia prevalence data reported by 3,671 participants in Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3, 2010-2012) using Approximate Bayesian Computation (ABC). We investigated the potential effects of APT on chlamydia transmission by increasing the number of treated partners and reducing the time to partner treatment compared to standard PN. The median prevalence of chlamydia in the model was 1.84% (95% credible interval, CrI: 1.60%-2.62%) in women and 1.78% (95% CrI: 1.13%-2.14%) in men. Chlamydia positivity was highest in partners of symptomatic index cases with low sexual activity. Infected partners were typically asymptomatic and belonged to the high sexual activity group, i.e., are naturally those infected individuals that will contribute most to onward transmission. Reducing the time to partner treatment without achieving higher numbers of partners treated had only minor effects on reducing chlamydia prevalence. In contrast, the model predicts that a potential increase in the number of partners treated from current levels in Britain (0.51, 95% CrI: 0.21-0.80) by 25% would reduce chlamydia prevalence by 18% (95% CrI: 5%-44%) in both women in men within 5 years. These results suggest that APT, through a potential increase in the proportion of partners treated, would be an effective method to reduce ongoing chlamydia transmission in Britain.

scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2021 ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin Bootsma ◽  
Janneke van de Wijgert ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Additional Benefit ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Admission Data ◽  
Age Structured ◽  
The Impact ◽  
Pandemic Wave

Abstract The role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We used an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures at different time points during the COVID-19 pandemic in the Netherlands. Our analyses suggest that the impact of measures reducing school-based contacts depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce the effective reproduction number (Re) with non-school-based measures are exhausted or undesired and Re is still close to 1, the additional benefit of school-based measures may be considerable, particularly among older school children. As two examples, we demonstrate that keeping schools closed after the summer holidays in 2020, in the absence of other measures, would not have prevented the second pandemic wave in autumn 2020 but closing schools in November 2020 could have reduced Re below 1, with unchanged non-school-based contacts.

scholarly journals Modeling the Effects of Helminth Infection on the Transmission Dynamics of Mycobacterium tuberculosis under Optimal Control Strategies

2020 ◽  
Vol 2020 ◽  
pp. 1-21
Author(s):  
Aristide G. Lambura ◽  
Gasper G. Mwanga ◽  
Livingstone Luboobi ◽  
Dmitry Kuznetsov
Keyword(s):  
Optimal Control ◽  
Equilibrium Point ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Helminth Infection ◽  
Reproduction Number ◽  
Control Strategies ◽  
Active Tuberculosis ◽  
Control Measures ◽  
The Impact

A deterministic mathematical model for the transmission and control of cointeraction of helminths and tuberculosis is presented, to examine the impact of helminth on tuberculosis and the effect of control strategies. The equilibrium point is established, and the effective reproduction number is computed. The disease-free equilibrium point is confirmed to be asymptotically stable whenever the effective reproduction number is less than the unit. The analysis of the effective reproduction number indicates that an increase in the helminth cases increases the tuberculosis cases, suggesting that the control of helminth infection has a positive impact on controlling the dynamics of tuberculosis. The possibility of bifurcation is investigated using the Center Manifold Theorem. Sensitivity analysis is performed to determine the effect of every parameter on the spread of the two diseases. The model is extended to incorporate control measures, and Pontryagin’s Maximum Principle is applied to derive the necessary conditions for optimal control. The optimal control problem is solved numerically by the iterative scheme by considering vaccination of infants for Mtb, treatment of individuals with active tuberculosis, mass drug administration with regular antihelminthic drugs, and sanitation control strategies. The results show that a combination of educational campaign, treatment of individuals with active tuberculosis, mass drug administration, and sanitation is the most effective strategy to control helminth-Mtb coinfection. Thus, to effectively control the helminth-Mtb coinfection, we suggest to public health stakeholders to apply intervention strategies that are aimed at controlling helminth infection and the combination of vaccination of infants and treatment of individuals with active tuberculosis.

scholarly journals Evolution of disease transmission rate during the course of SARS-COV-2: Patterns and determinants

2020 ◽  
Author(s):  
Jie Zhu ◽  
Blanca Gallego
Keyword(s):  
Public Health ◽  
Disease Transmission ◽  
Reproduction Number ◽  
Transmission Rate ◽  
Region Of Interest ◽  
Health Interventions ◽  
Transmission Model ◽  
Public Health Interventions ◽  
Containment Measures ◽  
The Impact

Abstract To date, many studies have argued the potential impact of public health interventions on flattening the epidemic curve of SARS-CoV-2. Most of them have focused on simulating the impact of interventions in a region of interest by manipulating contact patterns and key transmission parameters to reflect different scenarios. Our study looks into the evolution of the daily effective reproduction number during the epidemic via a stochastic transmission model. We found this measure (although model-dependent) provides an early signal of the efficacy of containment measures. This epidemiological parameter when updated in real-time can also provide better predictions of future outbreaks. Our results found a substantial variation in the effect of public health interventions on the dynamic of SARS-CoV-2 transmission over time and across countries, that could not be explained solely by the timing and number of the adopted interventions. This suggests that further knowledge about the idiosyncrasy of their implementation and effectiveness is required. Although sustained containment measures have successfully lowered growth in disease transmission, more than half of the 101 studied countries failed to maintain the effective reproduction number close to or below 1. This resulted in continued growth in reported cases. Finally, we were able to predict with reasonable accuracy which countries would experience outbreaks in the next 30 days.

scholarly journals Investigating the Impact of Social Awareness and Rapid Test on A COVID-19 Transmission Model

2021 ◽  
Vol 4 (1) ◽  
pp. 46-64
Author(s):  
Muhammad Afief Balya ◽  
Bunga Oktaviani Dewi ◽  
Faza Indah Lestari ◽  
Gayatri Ratu ◽  
Hanna Rosuliyana ◽  
...  
Keyword(s):  
Basic Reproduction Number ◽  
Reproduction Number ◽  
Equilibrium Points ◽  
Rapid Test ◽  
Social Awareness ◽  
Transmission Model ◽  
Media Campaign ◽  
Single Intervention ◽  
The Impact ◽  
The Basic Reproduction Number

In this article, we propose and analyze a mathematical model of COVID-19 transmission among a closed population, with social awareness and rapid test intervention as the control variables. For this, we have constructed the model using a compartmental system of the ordinary differential equations. Dynamical analysis regarding the existence and local stability of equilibrium points is conducted rigorously. Our analysis shows that COVID-19 will disappear from the population if the basic reproduction number is less than one, and persist if the basic reproduction number is greater than one. In addition, we have shown a trans-critical bifurcation phenomenon based on our proposed model when the basic reproduction number equals one. From the elasticity analysis, we have observed that rapid testing is more promising in reducing the basic reproduction number as compared to a media campaign to improve social awareness on COVID-19. Using the Pontryagin Maximum Principle (PMP), the characterization of our optimal control problem is derived analytically and solved numerically using the forward-backward iterative algorithm. Our cost-effectiveness analysis shows that using rapid test and media campaigns partially are the best intervention strategy to reduce the number of infected humans with the minimum cost of intervention. If the intervention is to be implemented as a single intervention, then using solely the rapid test is a more promising and low-cost option in reducing the number of infected individuals vis-a-vis a media campaign to increase social awareness as a single intervention.

scholarly journals Vaccination is Australia's most important COVID-19 public health action, even though herd immunity is unlikely

2021 ◽  
Author(s):  
Emma S McBryde ◽  
Michael T Meehan ◽  
Jamie Sziklay ◽  
Adeshina Adekunle ◽  
Abdul Kuddus ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Control Strategies ◽  
Severe Disease ◽  
Herd Immunity ◽  
Public Health Action ◽  
Herd Protection ◽  
Health Action ◽  
The Impact ◽  
Indirect Protection ◽  
Better Than

The Australian National Cabinet four-step plan to transition to post-pandemic re-opening begins with vaccination to achieve herd protection and protection of the health system against a surge in COVID-19 cases. Assuming a pre-vaccination reproduction number for the Delta variant of 5, we show that for the current Mixed program of vaccinating over 60s with AstraZeneca and 16-60s with Pfizer we would not achieve herd immunity. We would need to cover 85% of the population (including many 5-16 year-olds to achieve herd immunity). At lower reproduction number of 3 and our current Mixed strategy, we can achieve herd immunity without vaccinating 5-15 year olds. This will be achieved at a 60% coverage pursuing a strategy targetting high transmitters or 70% coverage using a strategy targetting the vulnerable first. A reproduction number of 7 precludes achieving herd immunity, however vaccination is able to prevent 75% of deaths compared with no vaccination. We also examine the impact of vaccination on death in the event that herd immunity is not achieved. Direct effects of vaccination on reducing death are very good for both Pfizer and AstraZeneca vaccines. However we estimate that the Mixed or Pfizer program performs better than the AstraZeneca program. Furthermore, vaccination levels below the herd immunity threshold can lead to substantial (albeit incomplete) indirect protection for both vaccinated and unvaccinated populations. Given the potential for not reaching herd immunity, we need to consider what level of severe disease and death is acceptable, balanced against the consequences of ongoing aggressive control strategies.

scholarly journals Implications of the COVID-19 pandemic on eliminating trachoma as a public health problem

2020 ◽  
Author(s):  
Seth Blumberg ◽  
Anna Borlase ◽  
Joaquin M Prada ◽  
Anthony W Solomon ◽  
Paul Emerson ◽  
...  
Keyword(s):  
Public Health ◽  
Basic Reproduction Number ◽  
Health Problem ◽  
Reproduction Number ◽  
Control Strategies ◽  
Public Health Problem ◽  
New Paradigm ◽  
Specific Implementation ◽  
The Impact ◽  
The Basic Reproduction Number

AbstractBackgroundProgress towards elimination of trachoma as a public health problem has been substantial, but the COVID-19 pandemic has disrupted community-based control efforts.MethodsWe use a susceptible-infected model to estimate the impact of delayed distribution of azithromycin treatment on the prevalence of active trachoma.ResultsWe identify three distinct scenarios for geographic districts depending on whether the basic reproduction number and the treatment-associated reproduction number are above or below a value of one. We find that when the basic reproduction number is below one, no significant delays in disease control will be caused. However, when the basic reproduction number is above one, significant delays can occur. In most districts a year of COVID-related delay can be mitigated by a single extra round of mass drug administration. However, supercritical districts require a new paradigm of infection control because the current strategies will not eliminate disease.ConclusionIf the pandemic can motivate judicious, community-specific implementation of control strategies, global elimination of trachoma as a public health problem could be accelerated.

scholarly journals Mitigating COVID-19 outbreaks in workplaces and schools by hybrid telecommuting

2021 ◽  
Vol 17 (8) ◽  
pp. e1009264
Author(s):  
Simon Mauras ◽  
Vincent Cohen-Addad ◽  
Guillaume Duboc ◽  
Max Dupré la Tour ◽  
Paolo Frasca ◽  
...  
Keyword(s):  
High School ◽  
Primary School ◽  
Primary Schools ◽  
Reproduction Number ◽  
Real Life ◽  
Transmission Model ◽  
Image Position ◽  
Local Reproduction ◽  
The Impact ◽  
Day By Day

The COVID-19 epidemic has forced most countries to impose contact-limiting restrictions at workplaces, universities, schools, and more broadly in our societies. Yet, the effectiveness of these unprecedented interventions in containing the virus spread remain largely unquantified. Here, we develop a simulation study to analyze COVID-19 outbreaks on three real-life contact networks stemming from a workplace, a primary school and a high school in France. Our study provides a fine-grained analysis of the impact of contact-limiting strategies at workplaces, schools and high schools, including: (1) Rotating strategies, in which workers are evenly split into two shifts that alternate on a daily or weekly basis; and (2) On-Off strategies, where the whole group alternates periods of normal work interactions with complete telecommuting. We model epidemics spread in these different setups using a stochastic discrete-time agent-based transmission model that includes the coronavirus most salient features: super-spreaders, infectious asymptomatic individuals, and pre-symptomatic infectious periods. Our study yields clear results: the ranking of the strategies, based on their ability to mitigate epidemic propagation in the network from a first index case, is the same for all network topologies (workplace, primary school and high school). Namely, from best to worst: Rotating week-by-week, Rotating day-by-day, On-Off week-by-week, and On-Off day-by-day. Moreover, our results show that below a certain threshold for the original local reproduction number R 0 l o c a l within the network (< 1.52 for primary schools, < 1.30 for the workplace, < 1.38 for the high school, and < 1.55 for the random graph), all four strategies efficiently control outbreak by decreasing effective local reproduction number to R 0 l o c a l < 1. These results can provide guidance for public health decisions related to telecommuting.

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