摘要
目的分析登革热干预措施和控制策略的成本效益关系,探讨不同场景下最具经济效益的登革热控制策略及实施方案,为登革热防控决策提供依据。方法基于登革热传播动力学模型,对宣传教育、预防性灭蚊、清理孳生地、应急性灭蚊和隔离治疗5种干预措施进行量化分析。设置登革热综合控制策略,使用粒子群算法(particle swarm optimization,PSO)在考虑成本的基础上搜索各种控制策略在不同场景下的最优参数取值,即最佳实施方案。使用成本效益比(cost-effectiveness ratio,CER)、增量成本效益比(incremental cost-effectiveness ratio,ICER)指标,衡量不同场景下各控制策略之间的成本效益关系,探索经济有效的登革热控制策略。结果在评估的干预措施中,成本效益从低到高依次是隔离治疗、宣传教育、清理孳生地、预防性灭蚊和应急性灭蚊。对于不同的干预场景,组合使用宣传教育、清理孳生地、应急性灭蚊和隔离治疗的控制策略最具成本效益。当隔离治疗的最高覆盖率为70%时,其余干预措施在干预第二年以约20%的覆盖率或作用强度实施可以在5年实现疫情的消除。结论相关部门应提前防控,提高登革热患者的隔离治疗覆盖率,同时,加强登革热防控知识的宣传教育,制定科学合理的日常防控计划,在考虑成本的情况下实施综合控制策略,以实现对登革热疫情的快速控制。
Objective To analyze the cost-effectiveness of dengue intervention measures and integrated control strategies,to explore the most cost-efficient control strategies and their implementation plans under different scenarios,providing decision-making support and guidance for dengue prevention and control efforts.Methods Based on the dengue transmission dynamics model,a quantitative analysis is conducted on five intervention measures:public education,preventive mosquito control,source reduction,emergency mosquito control,and isolation treatment.A comprehensive dengue control strategy is established,and the particle swarm optimization(PSO)algorithm is employed to search for the optimal parameter values of various control strategies under different scenarios,considering costs—i.e.,determining the best implementation plan.The cost-effectiveness ratio(CER)and incremental cost-effectiveness ratio(ICER)indicators are used to evaluate the cost-effectiveness relationships between different control strategies across various scenarios,aiming to explore economically effective dengue control strategies.Results Among the evaluated intervention measures,the cost-effectiveness from lowest to highest is as follows:isolation treatment,public education,source reduction,preventive mosquito control,and emergency mosquito control.For different intervention scenarios,the combination of public education,source reduction,emergency mosquito control,and isolation treatment proved to be the most cost-effective control strategy.When the maximum coverage rate of isolation treatment reaches 70%,implementing the other interventions at approximately 20%coverage or intensity in the second year can eliminate the outbreak within five years.Conclusion Relevant departments should implement preventive control measures in advance,increasing the coverage rate of isolation treatment for dengue fever patients.At the same time,efforts should focus on strengthening public education on dengue fever prevention,formulating scientifically sound and reasonable daily prevention plans,and implementing comprehensive intervention measures while considering costs,aiming to achieve rapid control of the dengue fever epidemic.
作者
王立颖
李伟昊
李明发
孟纬纬
杨国静
WANG Liying;LI Weihao;LI Mingfa;MENG Weiwei;YANG Guojing(School of Tropical Medicine,Hainan Medical University(Hainan Academy of Medical Sciences),NHC Key Laboratory of Tropical Disease Control,Haikou,Hainan 571199,China)
出处
《中国热带医学》
CAS
北大核心
2024年第10期1179-1186,共8页
China Tropical Medicine
基金
海南省自然科学基金项目(No.821CXTD440)
海南热带病研究中心(国家热带病研究中心海南分中心)开放课题(No.HNTDC202304)。
关键词
登革热
传播动力学模型
干预措施
策略优化
Dengue Fever
transmission dynamics model
intervention measures
strategy optimization
