RESUMO
Rabies is a fatal disease that has been a serious health concern, especially in developing countries. Although rabies is preventable by vaccination, the spread still occurs sporadically in many countries, including Thailand. Geographical structures, habitats, and behaviors of host populations are essential factors that may result in an enormous impact on the mechanism of propagation and persistence of the disease. To investigate the role of geographical structures on the transmission dynamics of canine rabies, we developed a stochastic individual-based model that integrates the exact configuration of buildings and roads. In our model, the spatial distribution of dogs was estimated based on the distribution of buildings, with roads considered to facilitate dog movement. Two contrasting areas with high- and low-risk of rabies transmission in Thailand, namely, Hatyai and Tepha districts, were chosen as study sites. Our modeling results indicated that the distinct geographical structures of buildings and roads in Hatyai and Tepha could contribute to the difference in the rabies transmission dynamics in these two areas. The high density of buildings and roads in Hatyai could facilitate more rabies transmission. We also investigated the impacts of rabies intervention, including reducing the dog population, restricting owned dog movement, and dog vaccination on the spread of canine rabies in these two areas. We found that reducing the dog population alone might not be sufficient for preventing rabies transmission in the high-risk area. Owned dog confinement could reduce more the likelihood of rabies transmission. Finally, a higher vaccination coverage may be required for controlling rabies transmission in the high-risk area compared to the low-risk area.
Assuntos
Doenças do Cão , Vacina Antirrábica , Raiva , Animais , Doenças do Cão/epidemiologia , Doenças do Cão/prevenção & controle , Cães , Geografia , Humanos , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/veterinária , Vacinação/veterinária , Cobertura VacinalRESUMO
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a major threat to global public health. Epidemiological and infection controls associated with CRKP are challenging because of several potential elements involved in a complicated cycle of transmission. Here, we proposed a comprehensive mathematical model to investigate the transmission dynamics of CRKP, determine factors affecting the prevalence, and evaluate the impact of interventions on transmission. The model includes the essential compartments, which are uncolonized, asymptomatic colonized, symptomatic colonized, and relapsed patients. Additionally, symptomatic colonized and relapsed patients were further classified into subpopulations according to their number of treatment failures or relapses. We found that the admission of colonized patients and use of antibiotics significantly impacted the endemic transmission in health care units. Thus, we introduced the treatment efficacy, defined by combining the treatment duration and probability of successful treatment, to characterize and describe the effects of antibiotic treatment on transmission. We showed that a high antibiotic treatment efficacy results in a significantly reduced likelihood of patient readmission in the health care unit. Additionally, our findings demonstrate that CRKP transmission with different epidemiological characteristics must be controlled using distinct interventions.
Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Klebsiella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Farmacorresistência Bacteriana , Hospitais , Humanos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniaeRESUMO
Human mobility plays a crucial role in the temporal and spatial spreading of infectious diseases. During the past few decades, researchers have been extensively investigating how human mobility affects the propagation of diseases. However, the mechanism of human mobility shaping the spread of epidemics is still elusive. Here we examined the impact of human mobility on the infectious disease spread by developing the individual-based SEIR model that incorporates a model of human mobility. We considered the spread of human influenza in two contrasting countries, namely, Belgium and Martinique, as case studies, to assess the specific roles of human mobility on infection propagation. We found that our model can provide a geo-temporal spreading pattern of the epidemics that cannot be captured by a traditional homogenous epidemic model. The disease has a tendency to jump to high populated urban areas before spreading to more rural areas and then subsequently spread to all neighboring locations. This heterogeneous spread of the infection can be captured by the time of the first arrival of the infection [Formula: see text], which relates to the landscape of the human mobility characterized by the relative attractiveness. These findings can provide insights to better understand and forecast the disease spreading.
Assuntos
Doenças Transmissíveis/transmissão , Influenza Humana/transmissão , Densidade Demográfica , Dinâmica Populacional , Bélgica , Epidemias , Humanos , Martinica , Modelos Biológicos , Análise Espaço-Temporal , População UrbanaRESUMO
Resistance to antimalarial drugs is currently a growing public health problem, resulting in more cases with treatment failure. Although previous studies suggested that a concentration gradient facilitates the antibiotic resistance evolution in bacteria, no attempt has been made to investigate the roles of a concentration gradient in malaria drug resistance. Unlike the person-to-person mode of transmission of bacteria, the malaria parasites need to switch back and forth between the human and mosquito hosts to complete the life cycle and to spread the resistant alleles. Here we developed a stochastic combined within- and between-hosts evolutionary dynamics model specific to malaria parasites in order to investigate the influence of an antimalarial concentration gradient on the evolutionary dynamics of malaria drug resistance. Every stage of malaria development in both human and mosquito hosts are individually modelled using the tau-leaping algorithm. We found that the concentration gradient can accelerate antimalarial resistance evolution. The gain in resistance evolution was improved by the increase in the parasite mutation rate and the mosquito biting rate. In addition, even though the rate of resistance evolution is not sensitive to the changes in parasite reduction ratios (PRRs) of antimalarial drugs, the probability of finding the antimalarial drug resistant parasites decreases when the PRR increases.