Optimal control of diseases in prison populations through screening policies of new inmates

Abstract

In this paper, we study an optimal control problem of a communicable disease in a prison population. In order to control the spread of the disease inside a prison, we consider an active case-finding strategy, consisting on screening a proportion of new inmates at the entry point, followed by a treatment depending on the results of this procedure. The control variable consists then in the coverage of the screening applied to new inmates. The disease dynamics is modeled by a SIS (susceptible-infected-susceptible) model, typically used to represent diseases that do not confer immunity after infection. We determine the optimal strategy that minimizes a combination between the cost of the screening/treatment at the entrance and the cost of maintaining infected individuals inside the prison, in a given time horizon. Using the Pontryagin Maximum Principle and Hamilton-Jacobi-Bellman equation, among other tools, we provide the complete synthesis of an optimal feedback control, consisting in a bangbang strategy with at most two switching times and no singular arc trajectory, characterizing different profiles depending on model parameters.