Comments on "A Mathematical Study to Control Visceral Leishmaniasis: An Application to South Sudan"

Mathematical modeling of the impact of temperature variations and immigration on malaria prevalence in Nigeria

The study examines the population-level impact of temperature variability and immigration on malaria prevalence in Nigeria, using a novel deterministic model. The model incorporates disease transmission by immigrants into the community. In the absence of immigration, the model is shown to exhibit the phenomenon of backward bifurcation. The disease-free equilibrium of the autonomous version of the model was found to be locally asymptotically stable in the absence of infective immigrants. However, the model exhibits an endemic equilibrium point when the immigration parameter is greater than zero. The endemic equilibrium point is seen to be globally asymptotically stable in the absence of disease-induced mortality. Uncertainty and sensitivity analysis of the model, using parameter values and ranges relevant to malaria transmission dynamics in Nigeria, shows that the top three parameters that drive malaria prevalence (with respect to [Formula: see text]) are the mosquito natural death rate ([Formula: see text]), mosquito biting rate ([Formula: see text]) and the transmission rates between humans and mosquitoes ([Formula: see text]). Numerical simulations of the model show that in Nigeria, malaria burden increases with increasing mean monthly temperature in the range of 22–28[Formula: see text]. Thus, this study suggests that control strategies for malaria should be intensified during this period. It is further shown that the proportion of infective immigrants has marginal effect on the transmission dynamics of the disease. Therefore, the simulations suggest that a reduction in the fraction of infective immigrants, either exposed or infectious, would significantly reduce the malaria incidence in a population.

Long-lasting insecticidal nets and the quest for malaria eradication: a mathematical modeling approach

Recent dramatic declines in global malaria burden and mortality can be largely attributed to the large-scale deployment of insecticidal-based measures, namely long-lasting insecticidal nets (LLINs) and indoor residual spraying. However, the sustainability of these gains, and the feasibility of global malaria eradication by 2040, may be affected by increasing insecticide resistance among the Anopheles malaria vector. We employ a new differential-equations based mathematical model, which incorporates the full, weather-dependent mosquito lifecycle, to assess the population-level impact of the large-scale use of LLINs, under different levels of Anopheles pyrethroid insecticide resistance, on malaria transmission dynamics and control in a community. Moreover, we describe the bednet-mosquito interaction using parameters that can be estimated from the large experimental hut trial literature under varying levels of effective pyrethroid resistance. An expression for the basic reproduction number, [Formula: see text], as a function of population-level bednet coverage, is derived. It is shown, owing to the phenomenon of backward bifurcation, that [Formula: see text] must be pushed appreciably below 1 to eliminate malaria in endemic areas, potentially complicating eradication efforts. Numerical simulations of the model suggest that, when the baseline [Formula: see text] is high (corresponding roughly to holoendemic malaria), very high bednet coverage with highly effective nets is necessary to approach conditions for malaria elimination. Further, while >50% bednet coverage is likely sufficient to strongly control or eliminate malaria from areas with a mesoendemic malaria baseline, pyrethroid resistance could undermine control and elimination efforts even in this setting. Our simulations show that pyrethroid resistance in mosquitoes appreciably reduces bednet effectiveness across parameter space. This modeling study also suggests that increasing pre-bloodmeal deterrence of mosquitoes (deterring them from entry into protected homes) actually hampers elimination efforts, as it may focus mosquito biting onto a smaller unprotected host subpopulation. Finally, we observe that temperature affects malaria potential independently of bednet coverage and pyrethroid-resistance levels, with both climate change and pyrethroid resistance posing future threats to malaria control.

Mathematical assessment of the role of Dengvaxia vaccine on the transmission dynamics of dengue serotypes

A new mathematical model is designed and used to assess the impact of the newly-released Dengvaxia vaccine on the transmission dynamics of two co-circulating dengue strains (where strain 1 consists of dengue serotypes 1, 3 and 4; and strain 2 consists of dengue serotype 2). It is shown that the model exhibits the phenomenon of backward bifurcation when the disease-induced mortality in the host population exceeds a certain threshold value or if the vaccine does not provide perfect protection against infection with the two strains. In the absence of backward bifurcation, the disease-free equilibrium of the model is shown to be globally-asymptotically stable whenever the associated reproduction number is less than unity. It is shown that the community-wide use of the vaccine could induce positive, negative or no population-level impact, depending on the sign of a certain epidemiological threshold quantity (known as the vaccine impact factor). Simulations of the model, using data from Oaxaca, Mexico, show that, although the community-wide use of the vaccine will significantly reduce dengue burden in the community, it is unable to lead to the elimination of the two dengue strains. It is further shown that the use of Dengvaxia vaccine in dengue-naive populations may induce increased risk of severe disease in these populations.