Hasan Md Mehedi, Islam Md Hamidul
Department of Applied Mathematics, University of Rajshahi, Rajshahi, Bangladesh.
PLoS One. 2025 Jul 11;20(7):e0327233. doi: 10.1371/journal.pone.0327233. eCollection 2025.
Cervical cancer is a major global health concern, primarily caused by human papillomavirus (HPV), which spreads through unsafe sexual contact. Natural immunity often fails to provide full protection, permitting exogenous reinfection, which plays a key role in the persistence and transmission of HPV. This paper presents and analyzes a deterministic mathematical model of HPV transmission, incorporating exogenous re-infection. We utilized VIA test result data from 2019 to 2023 in Bangladesh to estimate key parameter values. The findings were validated through numerical simulations using MATLAB, and the analytical results demonstrated strong consistency with the numerical outputs. A critical insight is the presence of reinfection-induced backward bifurcation, indicating that targeting primary infections alone is insufficient for eradication, highlighting the need to address exogenous reinfection for effective control. We propose optimal control strategies tailored to resource-limited settings like Bangladesh, where limited vaccine access presents significant challenges, and community-driven education on safe sexual practices is crucial and continuously evolving. The results emphasize that the most effective approach combines targeted prevention with widespread community education, while precision in intervention implementation is essential to prevent reinfection surges that could prolong disease persistence and undermine control efforts. These insights provide a strong foundation for refining intervention strategies and offer valuable guidance for controlling HPV transmission through non-pharmaceutical interventions, particularly in resource-constrained settings.
宫颈癌是全球主要的健康问题,主要由人乳头瘤病毒(HPV)引起,该病毒通过不安全的性接触传播。自然免疫往往无法提供全面保护,从而导致外源性再感染,这在HPV的持续存在和传播中起着关键作用。本文提出并分析了一个纳入外源性再感染的HPV传播确定性数学模型。我们利用了孟加拉国2019年至2023年的醋酸肉眼观察(VIA)检测结果数据来估计关键参数值。通过使用MATLAB进行数值模拟对结果进行了验证,分析结果与数值输出显示出高度一致性。一个关键的见解是存在再感染诱导的反向分岔,这表明仅针对初次感染不足以根除病毒,凸显了应对外源性再感染以实现有效控制的必要性。我们针对孟加拉国这样的资源有限环境提出了最优控制策略,在这些环境中,疫苗获取有限带来了重大挑战,而社区驱动的安全性行为教育至关重要且不断发展。结果强调,最有效的方法是将有针对性的预防与广泛的社区教育相结合,同时干预措施实施的精准性对于防止可能延长疾病持续时间并破坏控制努力的再感染激增至关重要。这些见解为完善干预策略提供了坚实基础,并为通过非药物干预控制HPV传播提供了宝贵指导,特别是在资源受限的环境中。