Modelling and optimising healthcare interventions in a model with explicit within- and between-host dynamics

Area of Science:

• Mathematical modeling of infectious diseases
• Public health intervention strategies
• Epidemiology and disease control

Background:

• Endemic infectious diseases pose significant public health challenges requiring effective control strategies.
• Resource allocation for interventions is constrained by budget limitations.
• Understanding within- and between-host pathogen dynamics is crucial for designing optimal control measures.

Purpose of the Study:

• To determine optimal allocation strategies for interventions against endemic infectious diseases under varying budget constraints.
• To model the impact of isolation, supportive treatment, and specific treatment on disease dynamics.
• To identify how different objectives (e.g., reducing transmission, minimizing mortality, shortening infection duration) influence intervention choices.

Main Methods:

• Developed a mathematical model incorporating explicit within- and between-host pathogen dynamics.
• Modeled three interventions: isolation, supportive treatment, and specific treatment, analyzing their effects on transmission and mortality.
• Optimized intervention strategies by varying start/stop times and eligibility criteria for different budget levels and objectives, considering both population and individual levels.

Main Results:

• Optimal isolation strategy involves isolating individuals with higher pathogen loads, especially under lower budgets.
• Supportive treatment strategies range from isolation-like approaches to no treatment.
• Specific treatment optimization is complex, with strategies depending on pathogen load thresholds, recovery, and pathogen clearance dynamics.

Conclusions:

• The optimal infectious disease control strategy is highly context-dependent, influenced by budget, intervention type, pathogen dynamics, and desired outcomes.
• A nuanced approach is needed, balancing population-level control with individual patient management.
• Further research can refine these strategies for specific diseases and healthcare settings.