Ndii Meksianis Z, Mage Ananda R, Messakh Jakobis J, Djahi Bertha S
Department of Mathematics, The University of Nusa Cendana, Kupang-NTT, Indonesia.
Department of Building Engineering Education, The University of Nusa Cendana, Kupang-NTT, Indonesia.
Heliyon. 2020 Nov 4;6(11):e05345. doi: 10.1016/j.heliyon.2020.e05345. eCollection 2020 Nov.
Dengue is a public health problem with around 390 million cases annually and is caused by four distinct serotypes. Infection by one of the serotypes provides lifelong immunity to that serotype but have a higher chance of attracting the more dangerous forms of dengue in subsequent infections. Therefore, a perfect strategy against dengue is required. Dengue vaccine with 42-80% efficacy level has been licensed for the use in reducing disease transmission. However, this may increase the likelihood of obtaining the dangerous forms of dengue. In this paper, we have developed single and two-serotype dengue mathematical models to investigate the effects of vaccination on dengue transmission dynamics. The model is validated against dengue data from Kupang city, Indonesia. We investigate the effects of vaccination on seronegative and seropositive individuals and perform a global sensitivity analysis to determine the most influential parameters of the model. A sensitivity analysis suggests that the vaccination rate, the transmission probability and the biting rate have greater effects on the reduction of the proportion of dengue cases. Interestingly, with vaccine implementation, the mosquito-related parameters do not have significant impact on the reduction in the proportion of dengue cases. If the vaccination is implemented on seronegative individuals only, it may increase the likelihood of obtaining the severe dengue. To reduce the proportion of severe dengue cases, it is better to vaccinate seropositive individuals. In the context of Kupang City where the majority of individuals have been infected by at least one dengue serotype, the implementation of vaccination strategy is possible. However, understanding the serotype-specific differences is required to optimise the delivery of the intervention.
登革热是一个公共卫生问题，每年约有3.9亿病例，由四种不同的血清型引起。感染其中一种血清型可提供对该血清型的终身免疫力，但在后续感染中感染更危险形式登革热的几率更高。因此，需要一种完美的登革热防治策略。效力水平为42%-80%的登革热疫苗已获许可用于减少疾病传播。然而，这可能会增加感染危险形式登革热的可能性。在本文中，我们建立了单血清型和双血清型登革热数学模型，以研究疫苗接种对登革热传播动态的影响。该模型根据印度尼西亚古邦市的登革热数据进行了验证。我们研究了疫苗接种对血清阴性和血清阳性个体的影响，并进行了全局敏感性分析，以确定模型中最具影响力的参数。敏感性分析表明，疫苗接种率、传播概率和叮咬率对登革热病例比例的降低有更大影响。有趣的是，随着疫苗的实施，与蚊子相关的参数对登革热病例比例的降低没有显著影响。如果仅对血清阴性个体进行疫苗接种，可能会增加感染重症登革热的可能性。为了降低重症登革热病例的比例，最好对血清阳性个体进行疫苗接种。在古邦市，大多数人至少感染过一种登革热血清型，因此实施疫苗接种策略是可行的。然而，需要了解血清型特异性差异，以优化干预措施的实施。
