论文标题
通过疾病发病时间序列的离散时间建模来估计麻疹补充免疫活性的功效
Estimating efficacy of measles supplementary immunization activities via discrete-time modeling of disease incidence time series
论文作者
论文摘要
麻疹是全球疾病负担和儿童死亡率的重要来源。由于医疗保健基础设施不良和通道,通过常规免疫(RI)计划通过常规免疫(RI)计划进行疫苗接种。因此,以疫苗接种运动形式进行补充免疫活动(SIA),以通过减少易感人群的规模来防止麻疹暴发。 SIA功效定义为SIA免疫的易感人群的比例,是评估竞选有效性的关键指标。我们提出了一个离散时间隐藏的马尔可夫模型,用于使用报告的麻疹发病率数据来估计SIA功效并预测未来的发病率趋势。我们的方法通过添加模型成分来捕获SIAS对易感人群的影响,扩展了易感感染的(TSIR)框架的时间序列。它还通过不确定性传播的两阶段估计程序来解释不足的报道及其相关的不确定性。提出的模型可用于估计潜在的易感人群动态,评估有多少易感人士被过去的SIA免疫,并在各种假设的SIA场景下预测未来的发病率趋势。我们通过模拟在各个级别的报告下通过模拟检查模型性能,并将该模型从2012年到2018年分析贝宁的每月报道的麻疹发病率。
Measles is a significant source of global disease burden and child mortality. Measles vaccination through routine immunization (RI) programs in high-burden settings remains a challenge due to poor health care infrastructure and access. Supplementary immunization activities (SIA) in the form of vaccination campaigns are therefore implemented to prevent measles outbreaks by reducing the size of the susceptible population. The SIA efficacy, defined as the fraction of susceptible population immunized by an SIA, is a critical metric for assessing campaign effectiveness. We propose a discrete-time hidden Markov model for estimating SIA efficacy and forecasting future incidence trends using reported measles incidence data. Our approach extends the time-series susceptible-infected-recovered (TSIR) framework by adding a model component to capture the impact of SIAs on the susceptible population. It also accounts for under-reporting and its associated uncertainty via a two-stage estimation procedure with uncertainty propagation. The proposed model can be used to estimate the underlying susceptible population dynamics, assess how many susceptible people were immunized by past SIAs, and forecast incidence trends in the future under various hypothetical SIA scenarios. We examine model performance via simulations under various levels of under-reporting, and apply the model to analyze monthly reported measles incidence in Benin from 2012 to 2018.