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Rafi MA, Semanta S, Shahriar T, Hasan MJ, Hossain MG. An approach to integrated management of diabetes in tuberculosis patients: Availability and readiness of the health facilities of Bangladesh. PLoS One 2024; 19:e0309372. [PMID: 39186706 PMCID: PMC11346952 DOI: 10.1371/journal.pone.0309372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 08/10/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Comorbidity of diabetes mellitus and tuberculosis (TB) is a major public health concern in low- and middle-income countries including Bangladesh. An integrated approach is required for adequate management of diabetes mellitus and TB. The objective of the present study was to investigate the availability and readiness of the TB care centers of Bangladesh toward diabetic patients' management. METHODS The present study was conducted based on existing data obtained from the Bangladesh Health Facility Survey (BHFS) 2017. Data collected from a total of 303 facilities providing TB services were retrieved. The outcome variables of the present study were availability and readiness of the TB health facilities for providing diabetes mellitus service. Readiness was measured for four domains: staff and guidelines, equipment, diagnostic facility and basic medicine. The independent variables were: facility level, management authority and location of the facility. Binary and multiple logistic regression models were constructed for both the outcome variables (availability and readiness) to find out their predictors. RESULTS Services for diabetes mellitus were available in 68% of the TB facilities while high readiness was present in 36% of the facilities. For domain-specific readiness index, readiness for the domains of staff and guidelines, equipment, diagnostic facility and basic medicine was reported in 46%, 96%, 38% and 25% facilities respectively. In the logistic regression model, availability of diabetes mellitus services was better in primary level (aOR 2.62, 95% CI 1.78-4.77) and secondary level (aOR 3.26, 95% CI 1.82-9.05) facilities than community facilities. Similarly, readiness of diabetes mellitus care was also better in these facilities (aOR 2.55, 95% CI 1.05-4.71 for primary and aOR 2.75, 95% CI 1.80-4.32 for secondary facilities). Besides, private TB facilities had better availability (aOR 2.84, 95% CI 1.75-5.89) and readiness (aOR 2.52, 95% CI 1.32-4.29) for diabetes mellitus care. CONCLUSION Availability and readiness for providing diabetes mellitus services in TB care providing facilities in Bangladesh is inadequate.
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Affiliation(s)
| | | | | | | | - Md. Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Malinzi J, Juma VO, Madubueze CE, Mwaonanji J, Nkem GN, Mwakilama E, Mupedza TV, Chiteri VN, Bakare EA, Moyo ILZ, Campillo-Funollet E, Nyabadza F, Madzvamuse A. COVID-19 transmission dynamics and the impact of vaccination: modelling, analysis and simulations. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221656. [PMID: 37501660 PMCID: PMC10369038 DOI: 10.1098/rsos.221656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
Despite the lifting of COVID-19 restrictions, the COVID-19 pandemic and its effects remain a global challenge including the sub-Saharan Africa (SSA) region. Knowledge of the COVID-19 dynamics and its potential trends amidst variations in COVID-19 vaccine coverage is therefore crucial for policy makers in the SSA region where vaccine uptake is generally lower than in high-income countries. Using a compartmental epidemiological model, this study aims to forecast the potential COVID-19 trends and determine how long a wave could be, taking into consideration the current vaccination rates. The model is calibrated using South African reported data for the first four waves of COVID-19, and the data for the fifth wave are used to test the validity of the model forecast. The model is qualitatively analysed by determining equilibria and their stability, calculating the basic reproduction number R 0 and investigating the local and global sensitivity analysis with respect to R 0 . The impact of vaccination and control interventions are investigated via a series of numerical simulations. Based on the fitted data and simulations, we observed that massive vaccination would only be beneficial (deaths averting) if a highly effective vaccine is used, particularly in combination with non-pharmaceutical interventions. Furthermore, our forecasts demonstrate that increased vaccination coverage in SSA increases population immunity leading to low daily infection numbers in potential future waves. Our findings could be helpful in guiding policy makers and governments in designing vaccination strategies and the implementation of other COVID-19 mitigation strategies.
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Affiliation(s)
- Joseph Malinzi
- Faculty of Science and Engineering, Department of Mathematics, University of Eswatini, Private Bag 4, Kwaluseni, Swaziland
- Institute of Systems Science, Durban University of Technology, Durban 4000, South Africa
| | - Victor Ogesa Juma
- Multiscale in Mechanical and Biological Engineering (M2BE), Instituto de Investigación en Ingeniería de Aragón (I3A), University of Zaragoza, 50018 Zaragoza, Spain
| | - Chinwendu Emilian Madubueze
- Department of Mathematics, Federal University of Agriculture, Makurdi, Nigeria
- Department of Mathematics and Statistics, York University, Toronto, Canada
| | - John Mwaonanji
- Department of Mathematical Sciences, Malawi University of Business and Applied Sciences, Blantyre, Malawi
| | | | - Elias Mwakilama
- Department of Pure and Applied Mathematics, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Tinashe Victor Mupedza
- Department of Mathematics & Computational Sciences, University of Zimbabwe, Box MP167 Mount Pleasant, Harare, Zimbabwe
| | | | - Emmanuel Afolabi Bakare
- International Centre for Applied Mathematical Modelling and Data Analytics, Federal University Oye-Ekiti, Ekiti State, Nigeria
- Department of Mathematics, Federal University Oye-Ekiti, Ekiti State, Nigeria
| | - Isabel Linda-Zulu Moyo
- Faculty of Science and Engineering, Department of Mathematics, University of Eswatini, Private Bag 4, Kwaluseni, Swaziland
| | | | - Farai Nyabadza
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Auckland Park 2006, South Africa
| | - Anotida Madzvamuse
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Auckland Park 2006, South Africa
- Mathematics Department, Room 121, Mathematics Building, University of British Columbia, 1984 Mathematics Road, Vancouver, BC, Canada V6T 1Z2
- School of Mathematical and Physical Sciences, Department of Mathematics, University of Sussex, Brighton BN1 9QH, UK
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Kuddus MA, Rahman A, Alam F, Mohiuddin M. Analysis of the different interventions scenario for programmatic measles control in Bangladesh: A modelling study. PLoS One 2023; 18:e0283082. [PMID: 37384663 PMCID: PMC10310053 DOI: 10.1371/journal.pone.0283082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/02/2023] [Indexed: 07/01/2023] Open
Abstract
In recent years measles has been one of the most critical public health problem in Bangladesh. Although the Ministry of Health in Bangladesh employs a broad extension of measles control policies, logistical challenges exist, and there is significant doubt regarding the disease burden. Mathematical modelling of measles is considered one of the most effective ways to understand infection transmission and estimate parameters in different countries, such as Bangladesh. In this study, a mathematical modelling framework is presented to explore the dynamics of measles in Bangladesh. We calibrated the model using cumulative measles incidence data from 2000 to 2019. Also, we performed a sensitivity analysis of the model parameters and found that the contact rate had the most significant influence on the basic reproduction number R0. Four hypothetical intervention scenarios were developed and simulated for the period from 2020 to 2035. The results show that the scenario which combines enhanced treatment for exposed and infected population, first and second doses of vaccine is the most effective at rapidly reducing the total number of measles incidence and mortality in Bangladesh. Our findings also suggest that strategies that focus on a single interventions do not dramatically affect the decline in measles incidence cases; instead, those that combine two or more interventions simultaneously are the most effective in decreasing the burden of measles incidence and mortality. In addition, we also evaluated the cost-effectiveness of varying combinations of three basic control strategies including distancing, vaccination and treatment, all within the optimal control framework. Our finding suggested that combines distancing, vaccination and treatment control strategy is the most cost-effective for reducing the burden of measles in Bangladesh. Other strategies can be comprised to measles depending on the availability of funds and policymakers' choices.
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Affiliation(s)
- Md Abdul Kuddus
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
- Department of Mathematics, University of Rajshahi, Rajshahi, Bangladesh
| | - Azizur Rahman
- School of Computing and Mathematics, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Farzana Alam
- Department of Electrical and Electronic Engineering, Rajshahi University of Engineering & Technology, Rajshahi, Bangladesh
| | - M. Mohiuddin
- Department of Mathematics, Comilla University, Cumilla, Bangladesh
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Kuddus MA, McBryde ES, Adekunle AI, White LJ, Meehan MT. Mathematical analysis of a two-strain tuberculosis model in Bangladesh. Sci Rep 2022; 12:3634. [PMID: 35256670 PMCID: PMC8901732 DOI: 10.1038/s41598-022-07536-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
Tuberculosis (TB) is an airborne infectious disease that causes millions of deaths worldwide each year (1.2 million people died in 2019). Alarmingly, several strains of the causative agent, Mycobacterium tuberculosis (MTB)—including drug-susceptible (DS) and drug-resistant (DR) variants—already circulate throughout most developing and developed countries, particularly in Bangladesh, with totally drug-resistant strains starting to emerge. In this study we develop a two-strain DS and DR TB transmission model and perform an analysis of the system properties and solutions. Both analytical and numerical results show that the prevalence of drug-resistant infection increases with an increasing drug use through amplification. Both analytic results and numerical simulations suggest that if the basic reproduction numbers of both DS (\documentclass[12pt]{minimal}
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\begin{document}$${\text{R}}_{{0{\text{s}}}}$$\end{document}R0s) and DR (\documentclass[12pt]{minimal}
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\begin{document}$${\text{R}}_{{0{\text{r}}}}$$\end{document}R0r) TB are less than one, i.e. \documentclass[12pt]{minimal}
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\begin{document}$$\max \left[ {{\text{R}}_{{0{\text{s}}}} ,{\text{ R}}_{{0{\text{r}}}} } \right] < 1,$$\end{document}maxR0s,R0r<1, the disease-free equilibrium is asymptotically stable, meaning that the disease naturally dies out. Furthermore, if \documentclass[12pt]{minimal}
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\begin{document}$${\text{R}}_{{0{\text{r}}}} > {\text{max}}\left[ {{\text{R}}_{{0{\text{s}}}} ,1} \right]$$\end{document}R0r>maxR0s,1, then DS TB dies out but DR TB persists in the population, and if \documentclass[12pt]{minimal}
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\begin{document}$${\text{R}}_{{0{\text{s}}}} > {\text{max}}\left[ {{\text{R}}_{{0{\text{r}}}} ,1} \right]$$\end{document}R0s>maxR0r,1 both DS TB and DR TB persist in the population. Further, sensitivity analysis of the model parameters found that the transmission rate of both strains had the greatest influence on DS and DR TB prevalence. We also investigated the effect of treatment rates and amplification on both DS and DR TB prevalence; results indicate that inadequate or inappropriate treatment makes co-existence more likely and increases the relative abundance of DR TB infections.
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Affiliation(s)
- Md Abdul Kuddus
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia. .,College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia. .,Department of Mathematics, University of Rajshahi, Rajshahi, 6205, Bangladesh.
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Adeshina I Adekunle
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.,Decision Sciences Program, Victoria University, Melbourne, Australia
| | - Lisa J White
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Michael T Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
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Rahman SMM, Ather MF, Nasrin R, Hoque MA, Khatun R, Rahman T, Uddin MKM, Ahmed S, Banu S. Performance of WHO-Endorsed Rapid Tests for Detection of Susceptibility to First-Line Drugs in Patients with Pulmonary Tuberculosis in Bangladesh. Diagnostics (Basel) 2022; 12:diagnostics12020410. [PMID: 35204501 PMCID: PMC8870910 DOI: 10.3390/diagnostics12020410] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/05/2022] [Accepted: 01/25/2022] [Indexed: 12/10/2022] Open
Abstract
The fast and accurate detection of susceptibility in drugs is a major challenge for a successful tuberculosis (TB) control programme. This study evaluated the performance of WHO-endorsed rapid diagnostic tools, such as BACTEC MGIT 960 SIRE (MGIT SIRE), GenoType MTBDRplus (MTBDRplus) and Xpert MTB/RIF (Xpert), for detecting susceptibility to first-line anti-TB drugs among pulmonary TB patients in Bangladesh. A total of 825 sputum samples with results from drug susceptibility testing (DST) against first-line anti-TB drugs in the MGIT SIRE, MTBDRplus and Xpert assays were evaluated and compared with the gold standard proportion susceptibility method of the Lowenstein–Jensen (LJ) medium. The overall sensitivities of MGIT SIRE were 97.6%, 90.0%, 61.3% and 44.9%, while specificities were 89.9%, 94.5%, 91.3% and 92.2% for detection of susceptibility to isoniazid (INH), rifampicin (RIF), streptomycin (STR) and ethambutol (EMB), respectively. For MTBDRplus, the sensitivities were 88.0% and 88.7%, and the specificities were 97.4% and 97.8% for the detection of susceptibility to INH and RIF, respectively. Xpert demonstrated a sensitivity and specificity of 94.8% and 99.5%, respectively, for the detection of RIF susceptibility. All tests performed significantly better in retreated TB patients compared with primary TB cases. For detection of RIF and INH susceptibility, all three assays showed almost perfect agreement with the LJ method, although MGIT SIRE exhibited low agreement for STR and EMB. Considering the high performance, shorter turnaround time and ease of use, molecular-based approaches Xpert and MTBDRplus can be widely implemented throughout the country for the rapid detection of drug-resistant TB.
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Kuddus MA, Mohiuddin M, Rahman A. Mathematical analysis of a measles transmission dynamics model in Bangladesh with double dose vaccination. Sci Rep 2021; 11:16571. [PMID: 34400667 PMCID: PMC8368032 DOI: 10.1038/s41598-021-95913-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/31/2021] [Indexed: 11/25/2022] Open
Abstract
Although the availability of the measles vaccine, it is still epidemic in many countries globally, including Bangladesh. Eradication of measles needs to keep the basic reproduction number less than one \documentclass[12pt]{minimal}
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\begin{document}$$(\mathrm{i}.\mathrm{e}. \, \, {\mathrm{R}}_{0}<1)$$\end{document}(i.e.R0<1). This paper investigates a modified (SVEIR) measles compartmental model with double dose vaccination in Bangladesh to simulate the measles prevalence. We perform a dynamical analysis of the resulting system and find that the model contains two equilibrium points: a disease-free equilibrium and an endemic equilibrium. The disease will be died out if the basic reproduction number is less than one \documentclass[12pt]{minimal}
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\begin{document}$$(\mathrm{i}.\mathrm{e}. \, \, {\mathrm{ R}}_{0}<1)$$\end{document}(i.e.R0<1), and if greater than one \documentclass[12pt]{minimal}
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\begin{document}$$(\mathrm{i}.\mathrm{e}. \, \, {\mathrm{R}}_{0}>1)$$\end{document}(i.e.R0>1) epidemic occurs. While using the Routh-Hurwitz criteria, the equilibria are found to be locally asymptotically stable under the former condition on \documentclass[12pt]{minimal}
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\begin{document}$${\mathrm{R}}_{0}$$\end{document}R0. The partial rank correlation coefficients (PRCCs), a global sensitivity analysis method is used to compute \documentclass[12pt]{minimal}
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\begin{document}$${\mathrm{R}}_{0}$$\end{document}R0 and measles prevalence \documentclass[12pt]{minimal}
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\begin{document}$$\left({\mathrm{I}}^{*}\right)$$\end{document}I∗ with respect to the estimated and fitted model parameters. We found that the transmission rate \documentclass[12pt]{minimal}
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\begin{document}$$(\upbeta )$$\end{document}(β) had the most significant influence on measles prevalence. Numerical simulations were carried out to commissions our analytical outcomes. These findings show that how progression rate, transmission rate and double dose vaccination rate affect the dynamics of measles prevalence. The information that we generate from this study may help government and public health professionals in making strategies to deal with the omissions of a measles outbreak and thus control and prevent an epidemic in Bangladesh.
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Affiliation(s)
- Md Abdul Kuddus
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia. .,Department of Mathematics, University of Rajshahi, Rajshahi, 6205, Bangladesh.
| | - M Mohiuddin
- Department of Mathematics, Comilla University, Cumilla, 3506, Bangladesh
| | - Azizur Rahman
- School of Computing and Mathematics, Charles Sturt University, Wagga Wagga, NSW, 2678, Australia
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