Department of Mathematics, Konkuk University, Seoul, Republic of Korea.
Institute of Mathematics, University of the Philippines, Diliman, Quezon City, Philippines.
PLoS One. 2020 Apr 9;15(4):e0230964. doi: 10.1371/journal.pone.0230964. eCollection 2020.
Tuberculosis (TB) is one of the top 10 causes of death globally and the leading cause of death by a single infectious pathogen. The World Health Organization (WHO) has declared the End TB Strategy, which targets a 90% reduction in the incidence rate by the year 2035 compared to the level in the year 2015. In this work, a TB model is considered to understand the transmission dynamics in the top three TB burden countries-India, China, and Indonesia. Country-specific epidemiological parameters were identified using data reported by the WHO. If India and Indonesia succeed in enhancing their treatment protocols and increase treatment and treatment success rate to that of China, the incidence rate could be reduced by 65.99% and 68.49%, respectively, by the end of 2035. Evidently, complementary interventions are essential to achieve the WHO target. Our analytical approach utilizes optimal control theory to obtain time-dependent nonpharmaceutical and latent case finding controls. The objective functional of the optimal control problem includes a payoff term reflecting the goal set by WHO. Appropriate combinations of control strategies are investigated. Based on the results, gradual enhancement and continuous implementation of intervention measures are recommended in each country.
结核病(TB)是全球十大死因之一,也是单一传染病病原体导致的主要死因。世界卫生组织(WHO)发布了《终结结核病战略》,目标是到 2035 年,与 2015 年相比,发病率降低 90%。在这项工作中,我们考虑了一个结核病模型,以了解印度、中国和印度尼西亚这三个结核病负担最重的国家的传播动态。使用世界卫生组织报告的数据确定了特定国家的流行病学参数。如果印度和印度尼西亚成功地加强了它们的治疗方案,并将治疗和治疗成功率提高到中国的水平,那么到 2035 年底,发病率将分别降低 65.99%和 68.49%。显然,补充干预措施对于实现世卫组织的目标至关重要。我们的分析方法利用最优控制理论来获得时变的非药物和潜伏病例发现控制。最优控制问题的目标函数包括一个反映世卫组织目标的报酬项。我们研究了适当的控制策略组合。根据结果,建议在每个国家逐步加强和持续实施干预措施。
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