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Utilizing general human movement models to predict the spread of emerging infectious diseases in resource poor settings.

ABSTRACT: Human mobility is an important driver of geographic spread of infectious pathogens. Detailed information about human movements during outbreaks are, however, difficult to obtain and may not be available during future epidemics. The Ebola virus disease (EVD) outbreak in West Africa between 2014-16 demonstrated how quickly pathogens can spread to large urban centers following one cross-species transmission event. Here we describe a flexible transmission model to test the utility of generalised human movement models in estimating EVD cases and spatial spread over the course of the outbreak. A transmission model that includes a general model of human mobility significantly improves prediction of EVD's incidence compared to models without this component. Human movement plays an important role not only to ignite the epidemic in locations previously disease free, but over the course of the entire epidemic. We also demonstrate important differences between countries in population mixing and the improved prediction attributable to movement metrics. Given their relative rareness, locally derived mobility data are unlikely to exist in advance of future epidemics or pandemics. Our findings show that transmission patterns derived from general human movement models can improve forecasts of spatio-temporal transmission patterns in places where local mobility data is unavailable.

SUBMITTER: Kraemer MUG

PROVIDER: S-EPMC6435716 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Utilizing general human movement models to predict the spread of emerging infectious diseases in resource poor settings.

Kraemer M U G MUG Golding N N Bisanzio D D Bhatt S S Pigott D M DM Ray S E SE Brady O J OJ Brownstein J S JS Faria N R NR Faria N R NR Cummings D A T DAT Pybus O G OG Smith D L DL Tatem A J AJ Hay S I SI Reiner R C RC

Scientific reports 20190326 1

Human mobility is an important driver of geographic spread of infectious pathogens. Detailed information about human movements during outbreaks are, however, difficult to obtain and may not be available during future epidemics. The Ebola virus disease (EVD) outbreak in West Africa between 2014-16 demonstrated how quickly pathogens can spread to large urban centers following one cross-species transmission event. Here we describe a flexible transmission model to test the utility of generalised hum ...[more]

PMID: 30914669

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Project description:BackgroundThe anticipated scale-up of antiretroviral therapy (ART) in high-prevalence, resource-constrained settings requires operational research to guide policy on the design of treatment programmes. Mathematical models can explore the potential impacts of various treatment strategies, including timing of treatment initiation and provision of laboratory monitoring facilities, to complement evidence from pilot programmes.Methods and findingsA deterministic model of HIV transmission incorporating ART and stratifying infection progression into stages was constructed. The impact of ART was evaluated for various scenarios and treatment strategies, with different levels of coverage, patient eligibility, and other parameter values. These strategies included the provision of laboratory facilities that perform CD4 counts and viral load testing, and the timing of the stage of infection at which treatment is initiated. In our analysis, unlimited ART provision initiated at late-stage infection (AIDS) increased prevalence of HIV infection. The effect of additionally treating pre-AIDS patients depended on the behaviour change of treated patients. Different coverage levels for ART do not affect benefits such as life-years gained per person-year of treatment and have minimal effect on infections averted when treating AIDS patients only. Scaling up treatment of pre-AIDS patients resulted in more infections being averted per person-year of treatment, but the absolute number of infections averted remained small. As coverage increased in the models, the emergence and risk of spread of drug resistance increased. Withdrawal of failing treatment (clinical resurgence of symptoms), immunologic (CD4 count decline), or virologic failure (viral rebound) increased the number of infected individuals who could benefit from ART, but effectiveness per person is compromised. Only withdrawal at a very early stage of treatment failure, soon after viral rebound, would have a substantial impact on emergence of drug resistance.ConclusionsOur analysis found that ART cannot be seen as a direct transmission prevention measure, regardless of the degree of coverage. Counselling of patients to promote safe sexual practices is essential and must aim to effect long-term change. The chief aims of an ART programme, such as maximised number of patients treated or optimised treatment per patient, will determine which treatment strategy is most effective.

Project description:Animals share a variety of common resources, which can be a major driver of conspecific encounter rates. In this work, we implement a spatially explicit mathematical model for resource visitation behaviour in order to examine how changes in resource availability can influence the rate of encounters among consumers. Using simulations and asymptotic analysis, we demonstrate that, under a reasonable set of assumptions, the relationship between resource availability and consumer conspecific encounters is not monotonic. We characterize how the maximum encounter rate and associated critical resource density depend on system parameters like consumer density and the maximum distance from which consumers can detect and respond to resources. The assumptions underlying our theoretical model and analysis are motivated by observations of large aggregations of black-backed jackals at carcasses generated by seasonal outbreaks of anthrax among herbivores in Etosha National Park, Namibia. As non-obligate scavengers, black-backed jackals use carcasses as a supplemental food resource when they are available. While jackals do not appear to acquire disease from ingesting anthrax carcasses, changes in their movement patterns in response to changes in carcass abundance do alter jackals' conspecific encounter rate in ways that may affect the transmission dynamics of other diseases, such as rabies. Our theoretical results provide a method to quantify and analyse the hypothesis that the outbreak of a fatal disease among herbivores can potentially facilitate outbreaks of an entirely different disease among jackals. By analysing carcass visitation data, we find support for our model's prediction that the number of conspecific encounters at resource sites decreases with additional increases in resource availability. Whether or not this site-dependent effect translates to an overall decrease in encounters depends, unexpectedly, on the relationship between the maximum distance of detection and the resource density.

Project description:BackgroundInformation needs and resource preferences of office-based general pediatricians have not been well characterized.MethodsData collected from a sample of twenty office-based urban/suburban general pediatricians consisted of: (a) a demographic survey about participants' practice and computer use, (b) semi-structured interviews on their use of different types of information resources and (c) semi-structured interviews on perceptions of information needs and resource preferences in response to clinical vignettes representing cases in Genetics and Infectious Diseases. Content analysis of interviews provided participants' perceived use of resources and their perceived questions and preferred resources in response to vignettes.ResultsParticipants' average time in practice was 15.4 years (2-28 years). All had in-office online access. Participants identified specialist/generalist colleagues, general/specialty pediatric texts, drug formularies, federal government/professional organization Websites and medical portals (when available) as preferred information sources. They did not identify decision-making texts, evidence-based reviews, journal abstracts, medical librarians or consumer health information for routine office use.In response to clinical vignettes in Genetics and Infectious Diseases, participants identified Question Types about patient-specific (diagnosis, history and findings) and general medical (diagnostic, therapeutic and referral guidelines) information. They identified specialists and specialty textbooks, history and physical examination, colleagues and general pediatric textbooks, and federal and professional organizational Websites as information sources. Participants with access to portals identified them as information resources in lieu of texts. For Genetics vignettes, participants identified questions about prenatal history, disease etiology and treatment guidelines. For Genetics vignettes, they identified patient history, specialists, general pediatric texts, Web search engines and colleagues as information sources. For Infectious Diseases (ID) vignettes, participants identified questions about patients' clinical status at presentation and questions about disease classification, diagnosis/therapy/referral guidelines and sources of patient education. For ID vignettes, they identified history, laboratory results, colleagues, specialists and personal experience as information sources.ConclusionContent analysis of office-based general pediatricians' responses to clinical vignettes provided a qualitative description of their perceptions of information needs and preferences for information resource for cases in Genetics and Infectious Diseases. This approach may provide complementary information for discovering practitioner's information needs and resource preferences in different contexts.

Dataset Information

Utilizing general human movement models to predict the spread of emerging infectious diseases in resource poor settings.

Publications

Utilizing general human movement models to predict the spread of emerging infectious diseases in resource poor settings.

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