Apenteng Ofosuhene O, Rasmussen Philip, Conrady Beate
Department of Veterinary and Animal Sciences, University of Copenhagen, Denmark.
Heliyon. 2024 Aug 8;10(16):e35896. doi: 10.1016/j.heliyon.2024.e35896. eCollection 2024 Aug 30.
This study aimed to assess the role of tourism in the spread of human immunodeficiency virus (HIV) using Malaysian epidemiological data on HIV and acquired immunodeficiency syndrome (AIDS) incidence from 1986 to 2004. A population-level mathematical model was developed with the following compartments: the population susceptible to HIV infection, the clinically confirmed HIV-positive population, the population diagnosed with AIDS, and the tourist population. Additionally, newborns infected with HIV were considered. Sensitivity analyses and variations in fixed parameter values were used to explore the effect of changes to various parameter values on HIV incidence in the model. It was determined that variations in the rate of HIV-positive inbound tourist entries and the rate of foreign tourist exits (i.e., the duration of time tourists spent in Malaysia) significantly impacted the predicted incidence of HIV and AIDS in Malaysia. The model's fit to observed HIV and AIDS incidence was evaluated, resulting in adjusted R values of 53.3% and 53.2% for HIV and AIDS, respectively. Furthermore, the reproduction number (R) was also calculated to quantify the stability of the HIV endemicity in Malaysia. The findings suggest that a steady-state level of HIV in Malaysia is achievable based on the low value of = 0.0136, and the disease-free equilibrium was stable from the negative eigenvalues obtained, which is encouraging from a public health perspective. The Partial Rank Correlation Coefficient (PRCC) values between the proportion of newborns born HIV-positive, the rate of Malaysian tourist entries returning home after contracting HIV, and the rate of foreign tourist exits have a significant impact on the . The methods provide a framework for epidemiological modelling of HIV spread through transient population groups. The model results suggest that the role of tourism should not be overlooked within the set of available measures to mitigate the spread of HIV.
本研究旨在利用马来西亚1986年至2004年人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征（AIDS）发病率的流行病学数据，评估旅游业在HIV传播中的作用。开发了一个人群水平的数学模型，包含以下部分：易感染HIV的人群、临床确诊的HIV阳性人群、被诊断为AIDS的人群以及游客人群。此外，还考虑了感染HIV的新生儿。通过敏感性分析和固定参数值的变化，探讨了各种参数值的变化对模型中HIV发病率的影响。研究确定，HIV阳性入境游客的入境率和外国游客的出境率（即游客在马来西亚停留的时间）显著影响了马来西亚HIV和AIDS的预测发病率。评估了该模型与观察到的HIV和AIDS发病率的拟合情况，HIV和AIDS的调整R值分别为53.3%和53.2%。此外，还计算了繁殖数（R）以量化马来西亚HIV地方流行的稳定性。研究结果表明，基于 = 0.0136的低值，马来西亚的HIV稳态水平是可以实现的，并且从得到的负特征值来看，无病平衡是稳定的，这从公共卫生角度来看是令人鼓舞的。HIV阳性新生儿的比例、感染HIV后回国的马来西亚游客入境率以及外国游客出境率之间的偏秩相关系数（PRCC）值对 有显著影响。这些方法为通过流动人口群体传播HIV的流行病学建模提供了一个框架。模型结果表明，在减轻HIV传播的一系列可用措施中，不应忽视旅游业的作用。
