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Monitoring the Path to the Elimination of Infectious Diseases

During the endgame of elimination programs, parasite populations may exhibit dynamical phenomena not typical of endemic disease. Particularly, monitoring programs for tracking infection prevalence may be hampered by overall rarity, the sporadic and unpredictable timing and location of outbreaks, and...

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Autores principales: Drake, John M., Hay, Simon I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082106/
https://www.ncbi.nlm.nih.gov/pubmed/30270879
http://dx.doi.org/10.3390/tropicalmed2030020
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author Drake, John M.
Hay, Simon I.
author_facet Drake, John M.
Hay, Simon I.
author_sort Drake, John M.
collection PubMed
description During the endgame of elimination programs, parasite populations may exhibit dynamical phenomena not typical of endemic disease. Particularly, monitoring programs for tracking infection prevalence may be hampered by overall rarity, the sporadic and unpredictable timing and location of outbreaks, and under-reporting. A particularly important problem for monitoring is determining the distance that must be covered to achieve the elimination threshold at an effective reproduction number less than one. In this perspective, we suggest that this problem may be overcome by measuring critical slowing down. Critical slowing down is a phenomenon exhibited by nonlinear dynamical systems in the vicinity of a critical threshold. In infectious disease dynamics, critical slowing down is expressed as an increase in the coefficient of variation and other properties of the fluctuations in the number of cases. In simulations, we show the coefficient of variation to be insensitive to under-reporting error and therefore a robust measurement of the approach to elimination. Additionally, we show that there is an inevitable delay between the time at which the effective reproduction number is reduced to below one and complete elimination is achieved. We urge that monitoring programs include dynamical properties such as critical slowing down in their metrics for measuring achievement and avoid withdrawing control activities prematurely.
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spelling pubmed-60821062018-09-24 Monitoring the Path to the Elimination of Infectious Diseases Drake, John M. Hay, Simon I. Trop Med Infect Dis Perspective During the endgame of elimination programs, parasite populations may exhibit dynamical phenomena not typical of endemic disease. Particularly, monitoring programs for tracking infection prevalence may be hampered by overall rarity, the sporadic and unpredictable timing and location of outbreaks, and under-reporting. A particularly important problem for monitoring is determining the distance that must be covered to achieve the elimination threshold at an effective reproduction number less than one. In this perspective, we suggest that this problem may be overcome by measuring critical slowing down. Critical slowing down is a phenomenon exhibited by nonlinear dynamical systems in the vicinity of a critical threshold. In infectious disease dynamics, critical slowing down is expressed as an increase in the coefficient of variation and other properties of the fluctuations in the number of cases. In simulations, we show the coefficient of variation to be insensitive to under-reporting error and therefore a robust measurement of the approach to elimination. Additionally, we show that there is an inevitable delay between the time at which the effective reproduction number is reduced to below one and complete elimination is achieved. We urge that monitoring programs include dynamical properties such as critical slowing down in their metrics for measuring achievement and avoid withdrawing control activities prematurely. MDPI 2017-06-26 /pmc/articles/PMC6082106/ /pubmed/30270879 http://dx.doi.org/10.3390/tropicalmed2030020 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Perspective
Drake, John M.
Hay, Simon I.
Monitoring the Path to the Elimination of Infectious Diseases
title Monitoring the Path to the Elimination of Infectious Diseases
title_full Monitoring the Path to the Elimination of Infectious Diseases
title_fullStr Monitoring the Path to the Elimination of Infectious Diseases
title_full_unstemmed Monitoring the Path to the Elimination of Infectious Diseases
title_short Monitoring the Path to the Elimination of Infectious Diseases
title_sort monitoring the path to the elimination of infectious diseases
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082106/
https://www.ncbi.nlm.nih.gov/pubmed/30270879
http://dx.doi.org/10.3390/tropicalmed2030020
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