Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
PLoS One. 2024 Oct 16;19(10):e0309313. doi: 10.1371/journal.pone.0309313. eCollection 2024.
Hepatitis C Virus is endemic to many areas of Thailand, whose population structure is tending towards older age groups as birth rate and mortality decrease. With around 790,000 cases in 2019, prevalence is still relatively high, but the World Health Organisation has called for elimination of HCV by 2030.
An age structured compartmental transmission model was used to explore the effectiveness of screening strategies with respect to WHO elimination goals, as well as the effect of changing population structure on the success or failure of such strategies.
Population structure did not appear to affect the timeline of elimination targets and screening individuals over the age of 30 at a high (50% per year) coverage could bring forward achievement of the incidence elimination target by four years compared to baseline (approximately 6% per year). Achievement of mortality elimination targets was not reached until after the end of the simulation (2040), and intensive screening strategies did not appear to lead to incidence elimination by 2030.
The model suggested that with age-targeted screening programmes incidence elimination could be brought forward by several years. However, WHO elimination goals may not be met by 2030.
丙型肝炎病毒在泰国的许多地区流行,其人口结构随着出生率和死亡率的下降而趋于老龄化。2019 年约有 79 万例,患病率仍然相对较高,但世界卫生组织呼吁到 2030 年消除 HCV。
使用年龄结构的隔室传播模型来探讨针对世卫组织消除目标的筛查策略的有效性,以及人口结构变化对这些策略的成败的影响。
人口结构似乎并不影响消除目标的时间线,对 30 岁以上人群进行高覆盖率(每年 50%)的筛查,与基线相比(每年约 6%)可以提前四年实现发病率消除目标。直到模拟结束(2040 年)才达到死亡率消除目标,密集筛查策略似乎无法在 2030 年前实现发病率消除。
该模型表明,通过针对年龄的筛查计划,发病率的消除可以提前几年。然而,到 2030 年,世卫组织的消除目标可能无法实现。