Modelling heterogeneity and the impact of chemotherapy and vaccination against human hookworm
Authored by L Sabatelli, A C Ghani, L C Rodrigues, P J Hotez, S Brooker
Date Published: 2008
DOI: 10.1098/rsif.2007.1255
Sponsors:
Wellcome Trust
Platforms:
No platforms listed
Model Documentation:
Other Narrative
Mathematical description
Model Code URLs:
Model code not found
Abstract
There is a growing emphasis on the development of vaccines against
helminths (worms), and mathematical models provide a useful tool to
assess the impact of new vaccines under a range of scenarios. The
present study describes a stochastic individual-based model to assess
the relative impact of chemotherapy and vaccination against human
hookworm infection and investigates the implications of potential
correlations between risk of infection and vaccine efficacy. Vaccination
is simulated as a reduction in susceptibility to infection and the model
includes population heterogeneities and dynamical waning of protection.
To help identify appropriate measures of vaccine impact, we present a
novel framework to quantify the vaccine impact on the
infection-associated morbidity and introduce a measure of symmetry to
study the correspondence between reduction in intensity and reduction in
morbidity. Our modelling shows that, in high-transmission settings, the
greatest impact of vaccination will be attained when vaccine efficacy is
the greatest among individuals harbouring the heaviest worm burdens, and
that the decline of morbidity primarily depends on the level of
protection attained in the most at risk 8 12\% of the population. We
also demonstrate that if risk of infection and vaccine protection are
correlated, there is not always a direct correspondence between the
reduction in worm burden and in morbidity, with the precise relationship
varying according to transmission setting.
Tags
Mathematical-model
Population-dynamics
Plasmodium-falciparum
Density-dependence
Cost-effectiveness analysis
Human helminth infections
Papua-new-guinea
Schistosomiasis vaccine
Nematode infection
Immune-responses