Community-based Immunization Strategies for Epidemic Control

Understanding the epidemic dynamics, and finding out efficient techniques to control it, is a challenging issue. A lot of research has been done on targeted immunization strategies, exploiting various global network topological properties. However, in practice, information about the global structure of the contact network may not be available. Therefore, immunization strategies that can deal with a limited knowledge of the network structure are required. In this paper, we propose targeted immunization strategies that require information only at the community level. Results of our investigations on the SIR epidemiological model, using a realistic synthetic benchmark with controlled community structure, show that the community structure plays an important role in the epidemic dynamics. An extensive comparative evaluation demonstrates that the proposed strategies are as efficient as the most influential global centrality based immunization strategies, despite the fact that they use a limited amount of information. Furthermore, they outperform alternative local strategies, which are agnostic about the network structure, and make decisions based on random walks.Comment: 6 pages, 7 figure

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

With reports of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) continuing to increase and therapeutic options decrease, infection control methods are of increasing importance. Here we investigate the relationship between surveillance and infection control. Surveillance plays two roles with respect to control: it allows detection of infected/colonized individuals necessary for their removal from the general population, and it allows quantification of control success. We develop a stochastic model of MRSA transmission dynamics exploring the effects of two screening strategies in an epidemic setting: random and on admission. We consider both hospital and community populations and include control and surveillance in a single framework. Random screening was more efficient at hospital surveillance and allowed nosocomial control, which also prevented epidemic behaviour in the community. Therefore, random screening was the more effective control strategy for both the hospital and community populations in this setting. Surveillance strategies have significant impact on both ascertainment of infection prevalence and its control

Assessing Feasibility and Readiness to Address Obesity through Policy in American Indian Reservations

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy strategies within their communities. We assessed general community readiness to address obesity using 18 questions from the Community Readiness Handbook. Means and standard deviations were evaluated and scores ranged from 1 (no readiness) to 9 (high readiness). We then assessed stakeholder attitudes regarding the feasibility of implementing specific strategies given tribal culture, infrastructure, leadership, and funding support. Average scores were calculated and mean values ranked from highest (best strategy) to lowest. Despite significant differences in their geographic and sociodemographic characteristics, both communities identified increasing the availability of healthy foods in tribal venues as the most feasible strategy and scored in the “preplanning” readiness stage. The survey design, implementation process, and findings generated significant community interest and discussion. Health planners in one of the communities used the survey findings to provide tribal decision-makers with measurable information to prioritize appropriate strategies for implementation

Community mobilization for water hyacinth control strategies: experiences from Kainji Lake area, Nigeria

(12 page document

IPMSM torque control strategies based on LUTs and VCT feedback for robust control under machine parameter variations

In recent years, Interior Permanent Magnet Synchronous Machines (IPMSMs) have attracted a considerable attention in the scientific community and industry for Electric and Hybrid Electric Vehicle (HEV) propulsion systems. Lookup Table (LUT) based Field Oriented Control (FOC) strategies are widely used for IPMSM torque control. However, LUTs strongly depend on machine parameters. Deviations of these parameters due to machine ageing, temperature or manufacturing inaccuracies can lead to control instabilities in the field weakening region. In this paper, two novel hybrid IPMSM control strategies combining the usage of LUTs and Voltage Constraint Tracking (VCT) feedbacks are proposed in order to overcome the aforementioned controllability issues. Simulation results that demonstrate the validity of the proposed approaches are presented.Postprint (author's final draft

Integrating Community-Based Interventions to Reverse the Convergent TB/HIV Epidemics in Rural South Africa.

The WHO recommends integrating interventions to address the devastating TB/HIV co-epidemics in South Africa, yet integration has been poorly implemented and TB/HIV control efforts need strengthening. Identifying infected individuals is particularly difficult in rural settings. We used mathematical modeling to predict the impact of community-based, integrated TB/HIV case finding and additional control strategies on South Africa's TB/HIV epidemics. We developed a model incorporating TB and HIV transmission to evaluate the effectiveness of integrating TB and HIV interventions in rural South Africa over 10 years. We modeled the impact of a novel screening program that integrates case finding for TB and HIV in the community, comparing it to status quo and recommended TB/HIV control strategies, including GeneXpert, MDR-TB treatment decentralization, improved first-line TB treatment cure rate, isoniazid preventive therapy, and expanded ART. Combining recommended interventions averted 27% of expected TB cases (95% CI 18-40%) 18% HIV (95% CI 13-24%), 60% MDR-TB (95% CI 34-83%), 69% XDR-TB (95% CI 34-90%), and 16% TB/HIV deaths (95% CI 12-29). Supplementing these interventions with annual community-based TB/HIV case finding averted a further 17% of TB cases (44% total; 95% CI 31-56%), 5% HIV (23% total; 95% CI 17-29%), 8% MDR-TB (68% total; 95% CI 40-88%), 4% XDR-TB (73% total; 95% CI 38-91%), and 8% TB/HIV deaths (24% total; 95% CI 16-39%). In addition to increasing screening frequency, we found that improving TB symptom questionnaire sensitivity, second-line TB treatment delays, default before initiating TB treatment or ART, and second-line TB drug efficacy were significantly associated with even greater reductions in TB and HIV cases. TB/HIV epidemics in South Africa were most effectively curtailed by simultaneously implementing interventions that integrated community-based TB/HIV control strategies and targeted drug-resistant TB. Strengthening existing TB and HIV treatment programs is needed to further reduce disease incidence

Human behaviors: a threat for mosquito control?

Community involvement and the preventive behavior of households are considered to be at the heart of vector-control strategies. In this work, we consider a simple theoretical model that enables us to take into account human behaviors that may interfere with vector control. The model reflects the trade-off between perceived costs and observed efficacy. Our theoretical results emphasize that households may reduce their protective behavior in response to mechanical elimination techniques piloted by a public agent, leading to an increase of the total number of mosquitoes in the surrounding environment and generating a barrier for vector-borne diseases control. Our study is sufficiently generic to be applied to different arboviral diseases. It also shows that vector-control models and strategies have to take into account human behaviors.Comment: 27 pages, 7 figure

Efficient community-based control strategies in adaptive networks

Most researches on adaptive networks mainly concentrate on the properties of steady state, but neglect transient dynamics. In this study, we pay attention to the emergence of community structures in transient process and the effects of community-based control strategies on epidemic spreading. First, by normalizing modularity $Q$, we investigate the evolution of community structures during the transient process, and find that very strong community structures are induced by rewiring mechanism in the early stage of epidemic spreading, which remarkably delays the outbreaks of epidemic. Then we study the effects of control strategies started from different stages on the prevalence. Both immunization and quarantine strategies indicate that it is not "the earlier, the better" for the implementing of control measures. And the optimal control effect is obtained if control measures can be efficiently implemented in the period of strong community structure. For immunization strategy, immunizing the S nodes on SI links and immunizing S nodes randomly have similar control effects. Yet for quarantine strategy, quarantining the I nodes on SI links can yield far better effects than quarantining I nodes randomly. More significantly, community-based quarantine strategy plays more efficient performance than community-based immunization strategy. This study may shed new lights on the forecast and the prevention of epidemic among human population.Comment: 5 pages, 5 figure

On the Origins and Control of Community Types in the Human Microbiome

Microbiome-based stratification of healthy individuals into compositional categories, referred to as "community types", holds promise for drastically improving personalized medicine. Despite this potential, the existence of community types and the degree of their distinctness have been highly debated. Here we adopted a dynamic systems approach and found that heterogeneity in the interspecific interactions or the presence of strongly interacting species is sufficient to explain community types, independent of the topology of the underlying ecological network. By controlling the presence or absence of these strongly interacting species we can steer the microbial ecosystem to any desired community type. This open-loop control strategy still holds even when the community types are not distinct but appear as dense regions within a continuous gradient. This finding can be used to develop viable therapeutic strategies for shifting the microbial composition to a healthy configurationComment: Main Text, Figures, Methods, Supplementary Figures, and Supplementary Tex