Public Health Project Topics

Modelling on Effects of Carriers on Transmission Dynamic of Infectious Disease on Hepatitis B

Modelling on Effects of Carriers on Transmission Dynamic of Infectious Disease on Hepatitis B

Modelling on Effects of Carriers on Transmission Dynamic of Infectious Disease on Hepatitis B

CHAPTER ONE

Objective

The general objective: assess the knowledge, attitude and practices concerning hepatitis B (HBV) among rural and urban adolescents in Nigeria usingย SVEIRSย modelย .

Theย specificย objectivesย ofย theย studyย are:

  • To formulate a modified constant population SVEIRS model for hepatitis B in Nigeria
  • To determine the spread of the disease in Nigeria
  • To perform the stability analysis of the equilibrium states of the SVEIRS model
  • To identify the behavior of the
  • To compare uncontrolled and controlled state strategies on the dynamics of the
  • Perform simulations to illustrate analytical
  • Using pplane 8 we can analyze the phase portrait of the differential
  • Determine the general behavior of the disease usingย pplane8

CHAPTERย TWO

LITERATUREย REVIEW

This chapter reviews the work of other researchers related to the objectives of this thesis. Some of the related works are as follows;

Grob and Esteban (1995) stated that HBV may be transmitted horizontally and vertically. Horizontal transmission occurs during adolescence or childhood, throughout sexual exposure, needle stick (both accidental or through intravenous drug use), and blood transfusion. Therefore, any person with a bad history of sexually transmitted diseases (STDs), multiple sexual partners or an injecting drug user stands a higher chance of being infected with HBV (CDC, 2002). Exposure to blood is also means of open wounds in households and other close contacts and multiple transfusions in hemophiliacs. This view of exposure to risk was also shared who argued that most of the infections occur among adolescents and young adults due to exposure to high risk activities they engage in at this stage of life.

A vertical transmission occurs when an infected mother transmits the virus directly to the neonatal during child birth. Such transmissions are usually possible when the expectant mother suffers an acute infection of hepatitis B during pregnancy or if she is a chronic carrier during that period. The mode of this vertical transmission is not clear cut, but indications are that, infection might occur through a placenta cutting during childbirth. Majority of countries in Southeast Asia, the Western Pacific and Africa have high endemicity of HBV. In these settings the major mode of HBV transmission has been identified as vertical, where by mothers directly trans- mit virus to their infants during prenatal periods or where infected siblings, play- mates,other members of different households transmit the virus to their younger ones. A cross-sectional study clarified that without prophylaxis, an estimated num- ber of 6000 infants born to carrier mothers each year in the USA would develop chronic HBV infection as a consequence of prenatal transmission.

Unsafe blood transfusion has been a major force in the transmission of HBV glob- ally (Wang & Wong, 1960). The enactment of a law for the donation and management of blood in blood banks across the world has aggressively fought this channel of HBV transmission. This notwithstanding, current researches have showed that blood transfusion is regaining its position as one of the major risk factors for HBV transmission globally. This finding is attributed to the presence of occult HBV in- fection (OHBVI) among blood donors (Shang et al, 2007). It is also worth mention- ing that the global acceptance of the auto-disposable syringes (ADS) has consider- ably reduced the incidence of HBV infections that occur due to unsafe injections. Also, as a result of the extensive use of invasive medical procedures, iatrogenic HBV infections are no longer frequent. There have also been speculations that den- tal care operations which are capable of causing oral mucous membrane injuries is becoming a major route to HBV transmission if steps are not taken to prevent it.

Gashu Afework from Abuja University,(March, 2015) stated that Occupa- tional exposure occurs frequently among health care workers (HCWs). The most serious occupational health hazard faced by HCWs worldwide is exposure to hep- atitis B virus (HBV). Having enough Knowledge and proper attitudes toward this infection is crucial in prevention of occupational hepatitis infection. Therefore this study was conducted to assess knowledge, atti-tude and practice of HBV and its vaccination among health care professionals (HCPs) in selected public hospitals of Abuja, Nigeria. Both qualitative and quantitative methods were used. Qual- itative study involved key informants interviews whereas quantitative method was carried out by using structured self-administered questionnaire. This study revealed that HCPsโ€™ knowledge regarding occupational exposure of HBV is found to be good as majority of our par-ticipants correctly answered most of the question pertaining to it. Relatively larger proportion, 103 (44.8%) of the respondents were found to have neutral attitude score. One hundred seventy eight (77.7%) of them had been screened for and received hepatitis B Vaccine, and one hundred sixty (94.1%) of them had received full course of the vaccine. Knowledge score was significantly associated with: education level, type of profession and area of practice; whereas profession type and history of training were the only predictors of vaccination status. In conclusion, majority of the survey participants had moderate to high knowledge score, however, larger percentage of HCPs had negative or neutral attitudes on HBV and its vaccination. In spite of this, vaccination status was encouraging. The gaps identified in some areas of knowledge, attitude and practice of HBV call for concern among all stakeholders since HCPs have a high risk of being infected with HBV owing to their high frequency of exposure to infectious fluids coupled with the high infectivity of HBV.

 

CHAPTERย THREE

THEย MODEL

Introduction

Hepatitis B models are either deterministic or stochastic. Deterministic modelsย have a finite number of states, and specify rules by which individuals move fromย oneย stateย toย anotherย throughย aย seriesย ofย differentialย equations.

In this chapter, we are going to formulate our SVEIRS model based on the deterministic approach and develop expressions for the equilibrium points. Expressionsย which will be used to test for the stability of these steady states will also be devel-ย oped,ย asย wellย asย theย formulaย thatย willย beย usedย toย calculateย forย theย basicย reproductiveย numberย [4].

Model Formulationย Preliminaries

Differentialย equationsย haveย beenย developedย asย mathematicalย modelsย toย studyย theย dynamicsย ofย diseaseย transmissionย forย manyย communicableย diseases.

When a community identifies people infected with hepatitis B, new individuals get infected by coming in contact with members of the infected population. In epidemics, it is of high interest to know how the disease will spread. Thus, what we really want to know in many cases is how many infected individuals there will be in the next period. In this chapter, a mathematical model will be developed to study the epidemiology of hepatitis in the central region of Nigeria. The specific model to be developed is the Susceptible-Vaccinated-Exposed-Infected-Recovered (SVEIRS)ย model.

CHAPTERย FOUR

OPTIMALย CONTROL

Optimal control deals with the problem of finding a control law for a given systemย such that a certain optimality criterion is achieved.ย A control problem includes aย cost functional that is a function of state and control variables.ย An optimal con-ย trol is a set of differential equations describing the paths of the control variablesย that minimize the cost function.ย The optimal control can be derived using Pon-ย tryaginโ€™s maximum principle (a necessary condition also known as Pontryaginโ€™sย minimum principle or simply Pontryaginโ€™s Principle) or by solving the Hamilton-ย Jacobi-Bellmanย equationย (aย sufficientย condition)ย [25].

Introductionย toย Optimalย Control

Optimization is the process in which the best feasible solution for a problem is found. This usually entails finding either a maximum or minimum, which are called extrema, of the possible solutions. This can be done in various ways, though the most common involves using some version of the derivative of the function numerical solution of optimal control was difficult using by hand computation. Numerical mathematics is study of quantitative approximations to the solutions of mathematical problems including consideration of and bounds to the errors involved. Optimal control theory is no exception to this rule. The purpose here is to implement three different numerical algorithms in MATLAB to approximate the solution to an optimal control problem. Once the methods are developed, the concept of convergence for each method will be discussed as well as any flaws or problems with each specific method.

CHAPTERย FIVE

MODELย APPLICATION

Introduction

In this chapter, we are going to estimate parameter values that will be used for the analysis. The values will be substituted into equation obtained in chapter three to get the exact value for the basic reproductive number. Sensitivity analysis will also be carried out on the parameter values to investigate their impact on study results.

CHAPTERย SIX

CONCLUSIONย ANDย RECOMMENDATIONS

Conclusions

This model focused on HBV transmission through the deterministic approach.ย The basic reproductive number, R0ย of our SVEIRS model was calculated to beย 0.6463,ย which implies that on average,ย each infectious individual transmits virusย to 0.6463 people. The value of R0ย indicted the model is unstable or the disease dieย out. The stability analysis of the endemic equilibrium has been found to be stable;ย hence,ย theย transmissionย rateย ofย HBVย isย highย andย willย persist.

Routh-hurwitz stability criterion the best way to identify the stability of higherย powerย ฮ›ย formulatingย Hurwitzย matrix.

Theย sensitivityย analysisย thatย wasย carriedย outย bothย R0ย andย simulationย showedย thatย theย initialย infectionย rate,ย ฮฒย hasย aย veryย greatย influenceย onย theย spreadย ofย HBVย inย theย regionย thanย allย theย otherย parameters.ย Weย concludeย thatย HBVย transmissionย isย primarilyย asย aย result of the effective interaction between active HBV patients and the susceptibleย group.

Recommendations

It is highly recommended that besides the attempts being made by Minister of Health Service to fight HBV in the Nigeria, there are other effective measures that can be implemented to reduce drastically the burden of HBV on the health of the people in the region.

  • All children should get their first dose of hepatitis B vaccine at birth and should have completed the vaccine series by 6 through 18 months of
  • Children and adolescents through 18 years of age who did not get the vaccine when they were younger should also be
  • Minimize the amount of drinking
  • take drug when HBV infected recommend by doctors

References

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  • Caroline Dickens., Occult Hepatitis B Virus (HBV) Infection In The Chacma Baboon, PhD University of the Witwatersrand, Johannesburg, 2011
  • Afiba Manza-Azele Agovi,ย Hepatitisย B,ย Cย Virusย Andย HIVย CO-Infectionย Amongย Reported Female Cases In South Carolina, 2004 – 2011: An Epidemiologicalย Analysisย Ofย Pregnancyย Outcomes. Master University of South Carolina ,Columbia,2016
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  • Sacrifice Nana-Kyere, Joseph Ackora-Prah, Eric Okyere, Seth Marmah, Tuah,Afram, Hepatitis B Optimal Control Model with Vertical Transmission. Appliedย Mathematics,ย 7(1):ย 5-13,2017.
  • LenkaBubniakov, Theย Mathematicsย Ofย Infectiousย Diseases.ย Societyย forย Indus-ย trialย andย Appliedย Mathematics,ย 42(4):ย 599-653,ย 2000
  • Tigistu Demisse, Sero-Prevalence and Risk Factors Of Hepatitis B and Cย Virusesย Amongย Healthyย Adultย Bloodย Donorsย inย Wolitaย Zone,ย Nigeria.BScย The-ย Abujaย Universityย Collegeย ofย Healthย Science, Nigeria,ย 2015
  • Dongmei Chen, Bernard Moulin, Jianhong Wu, Introduction to Analyzing, Mod-eling Spatial and Temporal Dynamics of Infectious Diseases. Department of Geography Faculty of Arts and Science, Department of Computer Science and Software Engineering, Faculty of Science and Engineering, Department of Mathematics and Statistics Faculty of Science, 8:17 , 2014
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