Dataset Information

Optimal control and cost-effective analysis of the 2017 meningitis outbreak in Nigeria.

ABSTRACT: This paper presents a deterministic model for Neisseria meningitidis, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two controls avert more infections at low costs. Furthermore, a reciprocal relationship exists between the use of facial masks and vaccine. That is, when the use of facial masks is high, the use of vaccine is low and vice versa. Cost-effective analysis was applied to investigate the most cost-effective strategy from various combination of control strategies. The results show that strategy combining all the control variables is the most cost-effective strategy followed by the strategy involving both personal-protection, the vaccination-only strategy was the least cost-effective. Although vaccination strategy is not cost-effective in this study, it is as effective in curtailing the infection as the other two control strategies. The study suggests that governments of communities with limited resources should consider complementing the use of vaccine with the use of facial mask particularly in hard-to-reach places in their communities.

SUBMITTER: Agusto FB

PROVIDER: S-EPMC6545339 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Optimal control and cost-effective analysis of the 2017 meningitis outbreak in Nigeria.

Agusto F B FB Leite M C A MCA

Infectious Disease Modelling 20190517

This paper presents a deterministic model for <i>Neisseria meningitidis</i>, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two ...[more]

PMID: 31193915

Similar Datasets

Project description:BackgroundIn September 2017, Nigeria experienced a large outbreak of human monkeypox (HMPX). In this study, we report the outbreak experience and response in the Niger Delta University Teaching Hospital (NDUTH), Bayelsa state, where the index case and majority of suspected cases were reported.MethodsIn a cross-sectional study between September 25th and 31st December 2017, we reviewed the clinical and laboratory characteristics of all suspected and confirmed cases of HMPX seen at the NDUTH and appraised the plans, activities and challenges of the hospital in response to the outbreak based on documented observations of the hospital's infection control committee (IPC). Monkeypox cases were defined using the interim national guidelines as provided by the Nigerian Centre for Disease Control (NCDC).ResultsOf 38 suspected cases of HMPX, 18(47.4%) were laboratory confirmed, 3(7.9%) were probable, while 17 (18.4%) did not fit the case definition for HMPX. Majority of the confirmed/probable cases were adults (80.9%) and males (80.9%). There was concomitant chicken pox, syphilis and HIV-1 infections in two confirmed cases and a case of nosocomial infection in one healthcare worker (HCW). The hospital established a make-shift isolation ward for case management, constituted a HMPX response team and provided IPC resources. At the outset, some HCWs were reluctant to participate in the outbreak and others avoided suspected patients. Some patients and their family members experienced stigma and discrimination and there were cases of refusal of isolation. Repeated trainings and collaborative efforts by all stakeholders addressed some of these challenges and eventually led to successful containment of the outbreak.ConclusionWhile the 2017 outbreak of human monkeypox in Nigeria was contained, our report reveals gaps in outbreak response that could serve as lessons to other hospitals to strengthen epidemic preparedness and response activities in the hospital setting.

Project description:BACKGROUND:Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria. METHODS:Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak. RESULTS:There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states. CONCLUSION:There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.

Dataset Information

Optimal control and cost-effective analysis of the 2017 meningitis outbreak in Nigeria.

Publications

Optimal control and cost-effective analysis of the 2017 meningitis outbreak in Nigeria.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure