Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas Gerais state Brazil. Parasitological, socioeconomic, demographic, and water contact information were surveyed in 506 S. mansoni-infected individuals, aged 6 to 15 years, resident in these endemic areas. Eligible individuals were treated with PZQ until they were determined to be negative by the absence of S. mansoni eggs in the feces on two consecutive days of Kato-Katz fecal thick smear. These individuals were surveyed again 12 months from the date of successful treatment with PZQ. A classification and regression tree modeling (CART) was then used to explore the relationship between socioeconomic, demographic, and epidemiological variables and their reinfection status. The most important risk factor identified for S. mansoni reinfection was their “heavy” infection at baseline. Additional analyses, excluding heavy infection status, showed that lower socioeconomic status and a lower level of education of the household head were also most important risk factors for S. mansoni reinfection. Our results provide an important contribution toward the control and possible elimination of schistosomiasis by identifying three major risk factors that can be used for targeted treatment and monitoring of reinfection. We suggest that control measures that target heavily infected children in the most economically disadvantaged households would be most beneficial to maintain the success of mass chemotherapy campaigns.
E-news readers have increasingly at their disposal a broad set of news articles to read. Online newspaper sites use recommender systems to predict and to offer relevant articles to their users. Typically, these recommender systems do not leverage users’ reading behavior. If we know how the topics-reads change in a reading session, we may lead to fine-tuned recommendations, for example, after reading a certain number of sports items, it may be counter-productive to keep recommending other sports news. The motivation for this article is the assumption that understanding user behavior when reading successive online news articles can help in developing better recommender systems. We propose five categories of stochastic models to describe this behavior depending on how the previous reading history affects the future choices of topics. We instantiated these five classes with many different stochastic processes covering short-term memory, revealed-preference, cumulative advantage, and geometric sojourn models. Our empirical study is based on large datasets of E-news from two online newspapers. We collected data from more than 13 million users who generated more than 23 million reading sessions, each one composed by the successive clicks of the users on the posted news. We reduce each user session to the sequence of reading news topics. The models were fitted and compared using the Akaike Information Criterion and the Brier Score. We found that the best models are those in which the user moves through topics influenced only by their most recent readings. Our models were also better to predict the next reading than the recommender systems currently used in these journals showing that our models can improve user satisfaction.
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