tetano
Editor, Senior Moderator
BMC Public Health. 2014 Dec 29;14(1):1328. [Epub ahead of print]
[h=1]Design of non-pharmaceutical intervention strategies for pandemic influenza outbreaks.[/h] Martinez DL, Das TK.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] As seen during past pandemic influenza outbreaks, pharmaceutical interventions (PHIs) withvaccines and antivirals are the most effective methods of mitigation. However, availability of PHIs isunlikely to be adequate during the early stages of a pandemic. Hence, for early mitigation andpossible containment, non-pharmaceutical interventions (NPIs) offer a viable alternative. Also, NPIsmay be the only available interventions for most underdeveloped countries. In this paper we presenta comprehensive methodology for design of effective NPI strategies.
[h=4]METHODS:[/h] We develop a statistical ANOVA-based design approach that uses a detailed agent-based simulationas an underlying model. The design approach obtains the marginal effect of the characteristicparameters of NPIs, social behavior, and their interactions on various pandemic outcome measuresincluding total number of contacts, infections, and deaths. We use the marginal effects to establishregression equations for the outcome measures, which are optimized to obtain NPI strategies.Efficacy of the NPI strategies designed using our methodology is demonstrated using simulatedpandemic influenza outbreaks with different levels of virus transmissibility.
[h=4]RESULTS:[/h] Our methodology was able to design effective NPI strategies, which were able to contain outbreaksby reducing infection attack rates (IAR) to below 10% in low and medium virus transmissibilityscenarios with 33% and 50% IAR, respectively. The level of reduction in the high transmissibilityscenario (with 65% IAR) was also significant. As noted in the published literature, we also foundschool closure to be the single most effective intervention among all NPIs.
[h=4]CONCLUSIONS:[/h] If harnessed effectively, NPIs offer a significant potential for mitigation of pandemic influenzaoutbreaks. The methodology presented here fills a gap in the literature, which, though replete withmodels on NPI strategy evaluation, lacks a treatise on optimal strategy design.
PMID: 25547377 [PubMed - as supplied by publisher] Free full text
[h=1]Design of non-pharmaceutical intervention strategies for pandemic influenza outbreaks.[/h] Martinez DL, Das TK.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] As seen during past pandemic influenza outbreaks, pharmaceutical interventions (PHIs) withvaccines and antivirals are the most effective methods of mitigation. However, availability of PHIs isunlikely to be adequate during the early stages of a pandemic. Hence, for early mitigation andpossible containment, non-pharmaceutical interventions (NPIs) offer a viable alternative. Also, NPIsmay be the only available interventions for most underdeveloped countries. In this paper we presenta comprehensive methodology for design of effective NPI strategies.
[h=4]METHODS:[/h] We develop a statistical ANOVA-based design approach that uses a detailed agent-based simulationas an underlying model. The design approach obtains the marginal effect of the characteristicparameters of NPIs, social behavior, and their interactions on various pandemic outcome measuresincluding total number of contacts, infections, and deaths. We use the marginal effects to establishregression equations for the outcome measures, which are optimized to obtain NPI strategies.Efficacy of the NPI strategies designed using our methodology is demonstrated using simulatedpandemic influenza outbreaks with different levels of virus transmissibility.
[h=4]RESULTS:[/h] Our methodology was able to design effective NPI strategies, which were able to contain outbreaksby reducing infection attack rates (IAR) to below 10% in low and medium virus transmissibilityscenarios with 33% and 50% IAR, respectively. The level of reduction in the high transmissibilityscenario (with 65% IAR) was also significant. As noted in the published literature, we also foundschool closure to be the single most effective intervention among all NPIs.
[h=4]CONCLUSIONS:[/h] If harnessed effectively, NPIs offer a significant potential for mitigation of pandemic influenzaoutbreaks. The methodology presented here fills a gap in the literature, which, though replete withmodels on NPI strategy evaluation, lacks a treatise on optimal strategy design.
PMID: 25547377 [PubMed - as supplied by publisher] Free full text