华支睾吸虫病预防性化疗SIS模型构建和应用  

Development and application of SIS model on C. sinensis transmission and intervention with preventive chemotherapy

作　　者：黄小红 方悦怡[2] 赖颖斯 HUANG Xiao-hong;FANG Yue-yi;LAI Ying-si(Department of Medical Statistics,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;Institute of Parasitic Diseases Control,Guangdong Provincial Center for Dis-ease Control and Prevention,Guangzhou 511430,China;Statistics Office of network data in-formation department,the First Affliliated Hospital of Guangzhou University of Traditional Chinese Medi-cine,Guangzhou 510405,China)

机构地区：[1]中山大学公共卫生学院医学统计学系,广州510080 [2]广东省疾病预防控制中心寄生虫病预防控制所,广州511430 [3]广州中医药大学第一附属医院网络数据信息科统计室,广州510405

出　　处：《中华疾病控制杂志》2020年第8期951-955,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81703320);广东省自然科学基金(2017A030313704)。

摘　　要：目的通过构建华支睾吸虫病动力学模型,评价预防性化疗措施对疾病控制的长期效果。方法构建符合华支睾吸虫病传播特征的SIS(susceptible-infected-susceptible)仓室模型。以典型流行地区为例,采用数据驱动(data-driven)的贝叶斯融合方法进行模型参数估计。利用模型模拟不同给药方式(脉冲/连续)、覆盖率、频次和时长的预防性化疗,以观察其长期动态变化和效果。结果模型具有较好的拟合和预测效果。脉冲式与连续式给药方式长期效果相似。预防性化疗对华支睾吸虫病控制的效果显著,化疗覆盖率越高、频次越多以及干预时间越长,防治效果越显著。但其效果并不持续,化疗停止后感染率出现反弹,一般强度的单纯化疗并不能达到疾病消除效果。结论应用华支睾吸虫病的传播动力学模型,可以有效模拟预防性化疗对疾病控制的长期效果。预防性化疗单独应用时效果不持续,需结合健康教育或环境改善等措施共同防治,以增强疾病控制的持续性。Objective To develop a clonorchis sinensis(C.sinensis)transmission dynamic model for the assessment of the long-term effects of preventive chemotherapy.Methods A susceptible-infected-susceptible(SIS)compartmental transmission model was developed to describe the dynamics of C.sinensis infection.The corresponding parameters were estimated through a data-driven Bayesian melding approach,based on data from a typical setting of clonorchiasis.With application of the model,we simulated the long-term effects of preventive chemotherapy under different delivery modes(pulse/continuous),coverages,frequencies and intervention durations.Results The model evaluation showed good capacities of fitting and prediction.The long-term effects of preventive chemotherapy against clonorchiasis between pulse and continuous delivery modes were similar.Preventive chemotherapy had significant control effects against clonorchiasis.Particularly,higher coverages,higher frequencies and longer duration of intervention could result in better effects.However,the effects were not sustainable,as the prevalence would rebound after intervention stopped.Conclusions The model we developed is able to assess the long-term effects of preventive chemotherapy against clonorchiasis effectively.The effects of preventive chemotherapy are not sustainable.Health education and environmental improvement should be combined to improve the sustainability for disease control.

关 键 词：华支睾吸虫 动力学模型 数据驱动 预防性化疗 长期效果 

分 类 号：R383.2[医药卫生—医学寄生虫学] R181.2[医药卫生—基础医学]