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

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.

Mathematical Model for Optimal Control of Soil-Transmitted Helminth Infection.

In this paper, we study the dynamics of soil-transmitted helminth infection. We formulate and analyse a deterministic compartmental model using nonlinear differential equations. The basic reproduction number is obtained and both disease-free and endemic equilibrium points are shown to be asymptotically stable under given threshold conditions. The model may exhibit backward bifurcation for some parameter values, and the sensitivity indices of the basic reproduction number with respect to the parameters are determined. We extend the model to include control measures for eradication of the infection from the community. Pontryagian's maximum principle is used to formulate the optimal control problem using three control strategies, namely, health education through provision of educational materials, educational messages to improve the awareness of the susceptible population, and treatment by mass drug administration that target the entire population(preschool- and school-aged children) and sanitation through provision of clean water and personal hygiene. Numerical simulations were done using MATLAB and graphical results are displayed. The cost effectiveness of the control measures were done using incremental cost-effective ratio, and results reveal that the combination of health education and sanitation is the best strategy to combat the helminth infection. Therefore, in order to completely eradicate soil-transmitted helminths, we advise investment efforts on health education and sanitation controls.

Optimal control problems of epidemic systems with parameter uncertainties: application to a malaria two-age-classes transmission model with asymptomatic carriers.

The main scope of this paper is to study the optimal control practices of malaria, by discussing the implementation of a catalog of optimal control strategies in presence of parameter uncertainties, which is typical of infectious diseases data. In this study we focus on a deterministic mathematical model for the transmission of malaria, including in particular asymptomatic carriers and two age classes in the human population. A partial qualitative analysis of the relevant ODE system has been carried out, leading to a realistic threshold parameter. For the deterministic model under consideration, four possible control strategies have been analyzed: the use of Long-lasting treated mosquito nets, indoor residual spraying, screening and treatment of symptomatic and asymptomatic individuals. The numerical results show that using optimal control the disease can be brought to a stable disease free equilibrium when all four controls are used. The Incremental Cost-Effectiveness Ratio (ICER) for all possible combinations of the disease-control measures is determined. The numerical simulations of the optimal control in the presence of parameter uncertainty demonstrate the robustness of the optimal control: the main conclusions of the optimal control remain unchanged, even if inevitable variability remains in the control profiles. The results provide a promising framework for the designing of cost-effective strategies for disease controls with multiple interventions, even under considerable uncertainty of model parameters.