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. 2014 Feb 12;11(1):1.
doi: 10.1186/1742-7622年11月1日.

Cholera transmission dynamic models for public health practitioners

Affiliations

Cholera transmission dynamic models for public health practitioners

Isaac Chun-Hai Fung. Emerg Themes Epidemiol. .

Abstract

Great progress has been made in mathematical models of cholera transmission dynamics in recent years. However, little impact, if any, has been made by models upon public health decision-making and day-to-day routine of epidemiologists. This paper provides a brief introduction to the basics of ordinary differential equation models of cholera transmission dynamics. We discuss a basic model adapted from Codeço (2001), and how it can be modified to incorporate different hypotheses, including the importance of asymptomatic or inapparent infections, and hyperinfectious V. cholerae and human-to-human transmission. We highlight three important challenges of cholera models: (1) model misspecification and parameter uncertainty, (2) modeling the impact of water, sanitation and hygiene interventions and (3) model structure. We use published models, especially those related to the 2010 Haitian outbreak as examples. We emphasize that the choice of models should be dictated by the research questions in mind. More collaboration is needed between policy-makers, epidemiologists and modelers in public health.

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Figures

Figure 1
Figure 1
Schematic of a basic model of cholera transmission dynamics (model adapted from Codeço [19]).
Figure 2
Figure 2
Vaccine and waning immunity (Model 1).
Figure 3
Figure 3
Vaccine and waning immunity (Model 2).
Figure 4
Figure 4
Water, sanitation and hygiene interventions.
Figure 5
Figure 5
Hyperinfectious bacteria and asymptomatic infection (adapted from Andrews and Basu, 2011 [11]) note: The "Vaccinated" compartment refers to successfully vaccinated individuals who become immune.
Figure 6
Figure 6
"Human-to-human" infection incorporated into the basic model.

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