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人兽共患内脏利什曼病动态的数学建模:考虑更新参数和巴西人类通报数据的新分析

Mathematical modelling for Zoonotic Visceral Leishmaniasis dynamics: A new analysis considering updated parameters and notified human Brazilian data.

作者信息

Shimozako Helio Junji, Wu Jianhong, Massad Eduardo

机构信息

Faculty of Medicine, University of São Paulo and LIM 01-HCFMUSP, Avenida Dr. Arnaldo 455, 01246-903, São Paulo, SP, Brazil.

Centre for Disease Modelling, York Institute for Health Research, York University, 4700, Keele Street, Toronto, ON, M3J 1P3, Canada.

出版信息

Infect Dis Model. 2017 Mar 18;2(2):143-160. doi: 10.1016/j.idm.2017.03.002. eCollection 2017 May.

Abstract

Brazil is one of the highest endemic countries for Zoonotic Visceral Leishmaniasis: according to the Brazilian Ministry of Health, the annual number of new human cases and deaths due to this disease has been increasing for the last 20 years. In addition, regarding the Americas, the specific relationship between canine and human for Visceral Leishmaniasis dynamics is still not well understood. In this work we propose a new model for Zoonotic Visceral Leishmaniasis, based on the models previously published by Burattini et al. (1998) and Ribas et al. (2013). Herein, we modeled the disease dynamics using a modified set of differential equations from those two authors, considering the same assumptions (inclusion of human, dog and sandfly populations, all constants over time). From this set of equations we were able to calculate the basic reproduction number and to analyze the stability and sensitivity of the system to the parameters variability. As main result, when the stability of the system is reached, the normalized reporting human cases rate is estimated in day. This estimation is very close to the 2015 report from Araçatuba city, /day. We also observed from stability and sensitivity analysis that the activity of sandfly population is critical to introduction and maintenance of Zoonotic Visceral Leishmaniasis in the population. In addition, the importance of dog as source of infection concentrates on latent dog, since it does not show clinical symptoms and signs and, therefore, has a great contribution to disease dissemination. As conclusion, considering the presently ethical issues regarding to elimination of positive dog in Brazil and the highly sensitivity of disease dynamics on sandfly population, we recommend that the sandfly population control should be prioritized.

摘要

巴西是动物源性内脏利什曼病的高流行国家之一

根据巴西卫生部的数据,在过去20年中,该疾病导致的新发病例和死亡人数逐年增加。此外,在美洲地区,犬类与人类在内脏利什曼病传播动态中的具体关系仍未得到充分了解。在这项研究中,我们基于Burattini等人(1998年)和Ribas等人(2013年)先前发表的模型,提出了一种新的动物源性内脏利什曼病模型。在此,我们使用这两位作者修改后的一组微分方程对疾病动态进行建模,考虑相同的假设(纳入人类、犬类和白蛉种群,所有参数随时间恒定)。通过这组方程,我们能够计算基本再生数,并分析系统对参数变化的稳定性和敏感性。主要结果是,当系统达到稳定状态时,估计每日标准化报告的人类病例率。这一估计值与阿拉萨图巴市2015年的报告非常接近,为 /天。我们还从稳定性和敏感性分析中观察到,白蛉种群的活动对于动物源性内脏利什曼病在人群中的传播和维持至关重要。此外,犬类作为感染源的重要性主要集中在潜伏感染的犬类身上,因为它们没有表现出临床症状和体征,因此对疾病传播有很大贡献。总之,考虑到巴西目前关于扑杀阳性犬类的伦理问题以及疾病动态对白蛉种群的高度敏感性,我们建议优先控制白蛉种群。

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