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[This corrects the article DOI: 10.3389/fpubh.2023.1252357.].
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This study analyzes the impact of COVID-19 variants on cost-effectiveness across age groups, considering vaccination efforts and nonpharmaceutical interventions in Republic of Korea. We aim to assess the costs needed to reduce COVID-19 cases and deaths using age-structured model. The proposed age-structured model analyzes COVID-19 transmission dynamics, evaluates vaccination effectiveness, and assesses the impact of the Delta and Omicron variants. The model is fitted using data from the Republic of Korea between February 2021 and November 2022. The cost-effectiveness of interventions, medical costs, and the cost of death for different age groups are evaluated through analysis. The impact of different variants on cases and deaths is also analyzed, with the Omicron variant increasing transmission rates and decreasing case-fatality rates compared to the Delta variant. The cost of interventions and deaths is higher for older age groups during both outbreaks, with the Omicron outbreak resulting in a higher overall cost due to increased medical costs and interventions. This analysis shows that the daily cost per person for both the Delta and Omicron variants falls within a similar range of approximately $10-$35. This highlights the importance of conducting cost-effect analyses when evaluating the impact of COVID-19 variants.
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COVID-19 , Análisis de Costo-Efectividad , Humanos , Anciano , SARS-CoV-2 , COVID-19/epidemiología , Costos y Análisis de CostoRESUMEN
Background: The coronavirus disease (COVID-19) pandemic has spread rapidly across the world, creating an urgent need for predictive models that can help healthcare providers prepare and respond to outbreaks more quickly and effectively, and ultimately improve patient care. Early detection and warning systems are crucial for preventing and controlling epidemic spread. Objective: In this study, we aimed to propose a machine learning-based method to predict the transmission trend of COVID-19 and a new approach to detect the start time of new outbreaks by analyzing epidemiological data. Methods: We developed a risk index to measure the change in the transmission trend. We applied machine learning (ML) techniques to predict COVID-19 transmission trends, categorized into three labels: decrease (L0), maintain (L1), and increase (L2). We used Support Vector Machine (SVM), Random Forest (RF), and XGBoost (XGB) as ML models. We employed grid search methods to determine the optimal hyperparameters for these three models. We proposed a new method to detect the start time of new outbreaks based on label 2, which was sustained for at least 14 days (i.e., the duration of maintenance). We compared the performance of different ML models to identify the most accurate approach for outbreak detection. We conducted sensitivity analysis for the duration of maintenance between 7 days and 28 days. Results: ML methods demonstrated high accuracy (over 94%) in estimating the classification of the transmission trends. Our proposed method successfully predicted the start time of new outbreaks, enabling us to detect a total of seven estimated outbreaks, while there were five reported outbreaks between March 2020 and October 2022 in Korea. It means that our method could detect minor outbreaks. Among the ML models, the RF and XGB classifiers exhibited the highest accuracy in outbreak detection. Conclusion: The study highlights the strength of our method in accurately predicting the timing of an outbreak using an interpretable and explainable approach. It could provide a standard for predicting the start time of new outbreaks and detecting future transmission trends. This method can contribute to the development of targeted prevention and control measures and enhance resource management during the pandemic.
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COVID-19 , Humanos , COVID-19/epidemiología , Brotes de Enfermedades/prevención & control , Pandemias/prevención & control , Personal de Salud , Aprendizaje AutomáticoRESUMEN
BACKGROUND: The norovirus is a major cause of acute gastroenteritis at all ages but particularly has a high chance of affecting children under the age of five. Given that the outbreak of norovirus in Korea is seasonal, it is important to try and predict the start and end of norovirus outbreaks. METHODS: We predicted weekly norovirus warnings using six machine learning algorithms using test data from 2017 to 2018 and training data from 2009 to 2016. In addition, we proposed a novel method for the early detection of norovirus using a calculated norovirus risk index. Further, feature importance was calculated to evaluate the contribution of the estimated weekly norovirus warnings. RESULTS: The long short-term memory machine learning (LSTM) algorithm proved to be the best algorithm for predicting weekly norovirus warnings, with 97.2% and 92.5% accuracy in the training and test data, respectively. The LSTM algorithm predicted the observed start and end weeks of the early detection of norovirus within a 3-week range. CONCLUSIONS: The results of this study show that early detection can provide important insights for the preparation and control of norovirus outbreaks by the government. Our method provides indicators of high-risk weeks. In particular, last norovirus detection rate, minimum temperature, and day length, play critical roles in estimating weekly norovirus warnings.
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Infecciones por Caliciviridae , Gastroenteritis , Norovirus , Niño , Humanos , Infecciones por Caliciviridae/diagnóstico , Infecciones por Caliciviridae/epidemiología , Gastroenteritis/diagnóstico , Gastroenteritis/epidemiología , Brotes de Enfermedades , Aprendizaje AutomáticoRESUMEN
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease in China, Japan, and Korea. This study aimed to estimate the monthly SFTS occurrence and the monthly number of SFTS cases in the geographical area in Korea using epidemiological data including demographic, geographic, and meteorological factors. Important features were chosen through univariate feature selection. Two models using machine learning methods were analyzed: the classification model in machine learning (CMML) and regression model in machine learning (RMML). We developed a novel model incorporating the CMML results into RMML, defined as modified-RMML. Feature importance was computed to assess the contribution of estimating the number of SFTS cases using modified-RMML. Aspect to the accuracy of the novel model, the performance of modified-RMML was improved by reducing the MSE for the test data as 12.6-52.2%, compared to the RMML using five machine learning methods. During the period of increasing the SFTS cases from May to October, the modified-RMML could give more accurate estimation. Computing the feature importance, it is clearly observed that climate factors such as average maximum temperature, precipitation as well as mountain visitors, and the estimation of SFTS occurrence obtained from CMML had high Gini importance. The novel model incorporating CMML and RMML models improves the accuracy of the estimation of SFTS cases. Using the model, climate factors, including temperature, relative humidity, and mountain visitors play important roles in transmitting SFTS in Korea. Our findings highlighted that the guidelines for mountain visitors to prevent SFTS transmissions should be addressed. Moreover, it provides important insights for establishing control interventions that predict early identification of SFTS cases.
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Aprendizaje Automático , Síndrome de Trombocitopenia Febril Grave/epidemiología , Síndrome de Trombocitopenia Febril Grave/transmisión , Anciano , Clima , Simulación por Computador , Modelos Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Montañismo , Análisis de Regresión , República de Corea/epidemiología , Factores de Riesgo , Síndrome de Trombocitopenia Febril Grave/prevención & control , Enfermedad Relacionada con los ViajesRESUMEN
OBJECTIVES: A significant proportion of patients with acute minor stroke have unfavorable functional outcome due to early neurological deterioration (END). The purpose of this study was to evaluate the applicability of machine learning algorithms to predict END in patients with acute minor stroke. PATIENTS AND METHODS: We collected clinical and neuroimaging information from patients with acute minor stroke with NIHSS score of ≤ 3. Early neurological deterioration was defined as any worsening of NIHSS score within 3 days after admission. Unfavorable functional outcome was defined as a modified Rankin Scale score of ≥ 2. We also compared clinical and neuroimaging information between patients with and without END. Four machine learning algorithms, i.e., Boosted trees, Bootstrap decision forest, Deep neural network, and Logistic Regression, were selected and trained by our dataset to predict early neurological deterioration RESULTS: A total of 739 patients were included in this study. 78 patients (10.6%) experienced END. Among 78 patients with END, 61 (78.2%) had unfavorable functional outcome at 90 days after stroke onset. On multivariate analysis, the initial NIHSS score (P = 0.003), hemorrhagic transformation (P = 0.010), and stenosis (P = 0.014) or occlusion (P = 0.004) of a relevant artery were independently associated with END. Of the four machine learning algorithms, Boosted trees, Deep neural network, and Logistic Regression can be used to predict END in patients with acute minor stroke (Boosted trees: accuracy = 0.966, F1 score = 0.8 and area under the curve = 0.934, Deep neural network :0.966, 0.8, and 0. 904, and Logistic Regression : 0.966, 0.8, and 0.885). CONCLUSIONS: This study suggests that machine learning algorithms that integrate clinical and neuroimaging information can be used to predict END in patients with acute minor stroke. Further studies based on larger, multicenter datasets are needed to predict END accurately for designing treatment strategies and obtaining favorable functional outcome.
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Accidente Cerebrovascular Isquémico/complicaciones , Redes Neurales de la Computación , Anciano , Anciano de 80 o más Años , Hemorragia Cerebral/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función/fisiología , Estudios RetrospectivosRESUMEN
OBJECTIVES: On March 15, 2020, 61.3% of the confirmed cases of COVID-19 infection in South Korea are associated with the worship service that was organized on February 9 in the Shincheonji Church of Jesus in Daegu. We aim to evaluate the effects of mass infection in South Korea and assess the preventive control intervention. METHOD: Using openly available data of daily cumulative confirmed cases and deaths, the basic and effective reproduction numbers was estimated using a modified susceptible-exposed-infected-recovered-type epidemic model. RESULTS: The basic reproduction number was estimated to be R0=1.77. The effective reproduction number increased approximately 20 times after the mass infections from the 31 st patient, which was confirmed on February 9 in the Shincheonji Church of Jesus, Daegu. However, the effective reproduction number decreased to less than unity after February 28 owing to the implementation of high-level preventive control interventions in South Korea, coupled with voluntary prevention actions by citizens. CONCLUSION: Preventive action and control intervention were successfully established in South Korea.
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Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Número Básico de Reproducción , COVID-19 , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , República de Corea/epidemiología , SARS-CoV-2RESUMEN
In 2005, Lacroix et al. demonstrated that infected humans are more attractive to mosquitoes, a phenomenon known as the vector-bias effect. The aim of this study was to determine how a vector-bias effect affects the changes in the dynamics of malaria transmission, and the changes in control strategies and cost-effectiveness for optimal control considering the regional characteristics or force of infections for different transmission rates. We used a vector-bias mathematical model and considered two different incidence areas: a high transmission area and a low transmission area. Our results showed that the dynamics in the two areas differed; as bias exists and the strategy for optimal control could be changed in the different areas. Thus, this work may give that considering the vector-bias effect in different areas facilitates prediction of the future dynamics and make decisions for establishing controls. We also mention the evolution of malaria parasites in this study.
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Algoritmos , Anopheles/parasitología , Insectos Vectores/parasitología , Malaria Falciparum/parasitología , Modelos Teóricos , Plasmodium falciparum/fisiología , África/epidemiología , Animales , Brasil/epidemiología , Enfermedades Endémicas/prevención & control , Interacciones Huésped-Parásitos , Humanos , Incidencia , India/epidemiología , Indonesia/epidemiología , Malaria Falciparum/epidemiología , Malaria Falciparum/transmisión , México/epidemiología , Plasmodium falciparum/aislamiento & purificación , Arabia Saudita/epidemiologíaRESUMEN
We propose a mathematical model describing tumor-immune interactions under immune suppression. These days evidences indicate that the immune suppression related to cancer contributes to its progression. The mathematical model for tumor-immune interactions would provide a new methodology for more sophisticated treatment options of cancer. To do this we have developed a system of 11 ordinary differential equations including the movement, interaction, and activation of NK cells, CD8(+)T-cells, CD4(+)T cells, regulatory T cells, and dendritic cells under the presence of tumor and cytokines and the immune interactions. In addition, we apply two control therapies, immunotherapy and chemotherapy to the model in order to control growth of tumor. Using optimal control theory and numerical simulations, we obtain appropriate treatment strategies according to the ratio of the cost for two therapies, which suggest an optimal timing of each administration for the two types of models, without and with immunosuppressive effects. These results mean that the immune suppression can have an influence on treatment strategies for cancer.
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Inmunoterapia/métodos , Neoplasias/inmunología , Neoplasias/terapia , Animales , Linfocitos T CD4-Positivos/citología , Linfocitos T CD8-positivos/citología , Simulación por Computador , Células Dendríticas/inmunología , Humanos , Modelos Inmunológicos , Modelos TeóricosRESUMEN
Infectious disease is no longer a local problem. Modern populations are more mobile than ever before, and with this mobility comes active global mixing of infectious disease. To understand the spread of diseases such as influenza, we use a multi-city epidemic model. We extend the SEIR (susceptible-exposed-infectious-recovered) model to incorporate population migration between cities, and use this model to analyze the geographic spread of influenza. We investigate the effectiveness of travel restrictions as a control against the spread of influenza. First we obtain the basic reproduction number for the single city case, and observe two other control strategies suggested by this case: increasing the number of clinically ill individuals that are treated, and reducing the interval between infection and treatment of such individuals. We evaluate the effectiveness of the three control strategies with numerical simulations. It is shown that travel restrictions are less effective than the other two strategies. In general, travel restriction tends to delay the spread of the disease into new cities. However, it can increase the peak height of infected populations in all cities. An understanding of the epidemiological structures of related cities is strongly recommended in order to effectively apply the travel restriction strategy.