White Peter J, Ward Helen, Cassell Jackie A, Mercer Catherine H, Garnett Geoff P
Department of Infectious Disease Epidemiology, Imperial College Faculty of Medicine, London, United Kingdom.
J Infect Dis. 2005 Sep 1;192(5):824-36. doi: 10.1086/432004. Epub 2005 Jul 21.
Prompt treatment of infectious diseases plays an important role in infection control. In the face of the increasing incidence of sexually transmitted infection, the ability of genitourinary medicine services to provide appropriate and timely care is reduced. To explore the relationship between capacity and demand for care, we developed and analyzed a mathematical model of gonorrhea transmission, incorporating patient flow through treatment services and heterogeneity in sexual risk behavior. Two equilibrium levels of infection incidence--"high" and "low"--exist for the same parameter values, and which of them occurs depends on starting conditions. At the high-incidence equilibrium, there is a "vicious circle" in which inadequate treatment capacity leads to many untreated infections, generating further high incidence and high demand and thus maintaining the inadequacy of services. A substantial increase in capacity is needed to interrupt this process and enter a "virtuous circle," in which adequate service provision keeps demand low, offering cost savings as well as improvements in health.
及时治疗传染病在感染控制中起着重要作用。面对性传播感染发病率的不断上升，泌尿生殖医学服务机构提供适当及时护理的能力却有所下降。为了探究护理能力与需求之间的关系，我们构建并分析了一个淋病传播的数学模型，该模型纳入了患者在治疗服务流程中的流动情况以及性风险行为的异质性。对于相同的参数值，存在两种感染发病率的平衡水平——“高”和“低”——具体出现哪种情况取决于起始条件。在高发病率平衡状态下，存在一个“恶性循环”，即治疗能力不足导致许多感染未得到治疗，进而引发更高的发病率和更高的需求，从而维持服务的不足。需要大幅提高能力来中断这一过程并进入“良性循环”，在良性循环中，充足的服务提供使需求保持在低水平，既能节省成本又能改善健康状况。
