It has been shown that the inclusion of an isolated class in the classical SIR model for childhood diseases can be responsible for self-sustained oscillations. Hence, the recurrent outbreaks of such diseases can be caused by autonomous, deterministic factors. We extend the model to include a latent class (i.e. individuals who are infected with the disease, but are not yet able to pass the disease to others) and study the resulting dynamics. The existence of Hopf bifurcations is shown for the model, as well as a homoclinic bifurcation for a perturbation to the model. For historical data on scarlet fever in England, our model agrees with the epidemiological data much more closely than the model without the latent class. For other childhood diseases, our model suggests that isolation is unlikely to be a major factor in sustained oscillations.
Antiretroviral-based pre-exposure HIV interventions may soon be rolled out in resource-constrained Sub-Saharan African countries, but rollout plans have yet to be designed. Here we use geospatial modeling and optimization techniques to compare two rollout plans for ARV-based microbicides in South Africa: a utilitarian plan that minimizes incidence by using geographic targeting, and an egalitarian plan that maximizes geographic equity in access to interventions. We find significant geographic variation in the efficiency of interventions in reducing HIV transmission, and that efficiency increases disproportionately with increasing incidence. The utilitarian plan would result in considerable geographic inequity in access to interventions, but (by exploiting geographic variation in incidence) could prevent ~40% more infections than the egalitarian plan. Our results show that the geographic resource allocation decisions made at the beginning of a rollout, and the location where the rollout is initiated, will be crucial in determining the success of interventions in reducing HIV epidemics.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.