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A Multiagent-Based Model for Epidemic Disease Monitoring in DR Congo

ABSTRACT: Any infectious diseases have been reported in sub-Saharan countries over the past decade due to the inefficiency of health structures to anticipate outbreaks. In a poorly-infrastructure country such as the Democratic Republic of Congo (DRC), with inadequate health staff and laboratories, it is difficult to respond rapidly to an epidemic, especially in rural areas. As the DRC’s health system has three levels (peripheral, regional and national), from the production of health data at the peripheral level to the national level that makes the decision, meantime the disease can spread to many people. Lack of communication between health centres of the same health zone and Health zones of the same Health Provincial Division does not contribute to the regional response. This article, an extended version of [1], proposes a well elaborated solution track to deal with this problem by using an agent-centric approach to study by simulation how to improve the process. A new experiment is described by arranging twenty-eight health zones of Kinshasa to show how their collaboration can provide unique health data source for all stakeholders and help reducing disease propagation. It concerns also 47 health centres, 1 medical laboratory, 1 Provincial Health Division and 4 Rapid Riposte Teams. The simulation data, provided by Provincial Health Division of Kinshasa, concerned cholera outbreak from January to December 2017. The interaction between these agents demonstrated that Health Zone Agent can automatically alert his neighbours whenever he encountered a confirmed case of an outbreak. This action can reduce disease propagation as population will be provided with prevention measures. These interactions between agents have provided models to propose to the current system in order to find out the best that can help reducing decision time.

SUBMITTER: Cliquet Jr. A

PROVIDER: S-EPMC7120616 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Project description:The etiology of kwashiorkor remains enigmatic and longitudinal studies examining potential causes of kwashiorkor are scarce. Using historical, longitudinal study data from the rural area of Bwamanda, Democratic Republic of Congo, we investigated the potential causal association between diet and the development of kwashiorkor in 5?657 preschool children followed 3-monthly during 15 months. We compared dietary risk factors for kwashiorkor with those of marasmus. Kwashiorkor was diagnosed as pitting oedema of the ankles; marasmus as abnormal visibility of skeletal structures and palpable wasting of the gluteus muscle. A 24-h recall was administered 3-monthly to record the consumption of the 41 locally most frequent food items. We specified Hanley-Miettinen smooth-in-time risk models containing potential causal factors, including food items, special meals prepared for the child, breastfeeding, disease status, nutritional status, birth rank, age, season and number of meals. Bayesian Information Criteria identified the most plausible causal model of why some children developed kwashiorkor. In a descriptive analysis of the diet at the last dietary assessment prior to development of kwashiorkor, the diet of children who developed kwashiorkor was characterized by low consumption of sweet potatoes, papaya and "other vegetables" [0.0% , 2.3% (95% CI [0.4, 12.1]) and 2.3% (95% CI [0.4, 12.1])] in comparison with children who did not develop kwashiorkor [6.8% (95% CI [6.4, 7.2]), 15.5% (95% CI [15, 16.1]) and 15.1% (95% CI [14.6, 15.7])] or children who developed marasmus [4.5% (95% CI [2.6, 7.5]) 11.8% (95% CI [8.5, 16.0]) and 17.6% (95% CI [13.7, 22.5])]. Sweet potatoes and papayas have high ?-carotene content and so may some of "the other vegetables". We found that a risk model containing an age function, length/height-for age Z-score, consumption of sweet potatoes, papaya or other vegetables, duration of this consumption and its interaction term, was the most plausible model. Among children aged 10-42 months, the risk of developing kwashiorkor increased with longer non-consumption of these foods. The analysis was repeated with only children who developed marasmus as the reference series, yielding similar results. Our study supports that ?-carotene may play an important role in the protection against kwashiorkor development.

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A Multiagent-Based Model for Epidemic Disease Monitoring in DR Congo

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