Optimal control and cost-effective analysis of the 2017 meningitis outbreak in Nigeria

This paper presents a deterministic model for Neisseria meningitidis, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two controls avert more infections at low costs. Furthermore, a reciprocal relationship exists between the use of facial masks and vaccine. That is, when the use of facial masks is high, the use of vaccine is low and vice versa. Cost-effective analysis was applied to investigate the most cost-effective strategy from various combination of control strategies. The results show that strategy combining all the control variables is the most cost-effective strategy followed by the strategy involving both personal-protection, the vaccination-only strategy was the least cost-effective. Although vaccination strategy is not cost-effective in this study, it is as effective in curtailing the infection as the other two control strategies. The study suggests that governments of communities with limited resources should consider complementing the use of vaccine with the use of facial mask particularly in hard-to-reach places in their communities.