Department of Mathematics, Fitchburg State University, Fitchburg, MA, United States of America.
Department of Mathematics, Rochester Institute of Technology, Rochester, NY, United States of America.
PLoS One. 2024 Oct 4;19(10):e0311314. doi: 10.1371/journal.pone.0311314. eCollection 2024.
Visceral Leishmaniasis (VL) is a deadly, vector-borne, parasitic, neglected tropical disease, particularly prevalent on the Indian subcontinent. Sleeping under the long-lasting insecticide-treated nets (ITNs) was considered an effective VL prevention and control measures, until KalaNet, a large trial in Nepal and India, did not show enough supporting evidence. In this paper, we adapt a biologically accurate, yet relatively simple compartmental ordinary differential equations (ODE) model of VL transmission and explicitly model the use of ITNs and their role in VL prevention and elimination. We also include a game-theoretic analysis in order to determine an optimal use of ITNs from the individuals' perspective. In agreement with the previous more detailed and complex model, we show that the ITNs coverage amongst the susceptible population has to be unrealistically high (over 96%) in order for VL to be eliminated. However, we also show that if the whole population, including symptomatic and asymptomatic VL cases adopt about 90% ITN usage, then VL can be eliminated. Our model also suggests that ITN usage should be accompanied with other interventions such as vector control.
内脏利什曼病（VL）是一种致命的、经媒介传播的、寄生虫性的、被忽视的热带病，尤其在印度次大陆流行。在长时效杀虫剂处理蚊帐（ITN）下睡觉被认为是一种有效的内脏利什曼病预防和控制措施，直到在尼泊尔和印度进行的大型 KalaNet 试验没有提供足够的支持证据。在本文中，我们采用了一种具有生物学准确性但相对简单的内脏利什曼病传播的房室微分方程（ODE）模型，并明确地对 ITN 的使用及其在 VL 预防和消除中的作用进行了建模。我们还进行了博弈论分析，以便从个人角度确定 ITN 的最佳使用方法。与之前更详细和复杂的模型一致，我们表明，为了消除 VL，易感人群中的 ITN 覆盖率必须高得不切实际（超过 96%）。然而，我们也表明，如果包括有症状和无症状 VL 病例的整个人群采用约 90%的 ITN 使用，那么 VL 就可以被消除。我们的模型还表明，ITN 的使用应该伴随着其他干预措施，如病媒控制。
