scholarly journals Cost-effective G-CSF therapy strategies for cyclical neutropenia: Mathematical modelling based hypotheses

2006 ◽  
Vol 238 (4) ◽  
pp. 754-763 ◽  
Author(s):  
Catherine Foley ◽  
Samuel Bernard ◽  
Michael C. Mackey
Keyword(s):  
Mathematical Modelling ◽  
Cost Effective ◽  
Cyclical Neutropenia ◽  
Therapy Strategies

scholarly journals OC 8405 IDENTIFICATION OF AN MTB-SPECIFIC SOLUBLE HOST SIGNATURE FOR RISK OF DEVELOPMENT OF ACTIVE TB IN HIV-POSITIVE MTB-EXPOSED CONTACTS

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A5.1-A5
Author(s):  
Joseph Mendy ◽  
Novel N Chegou ◽  
Harriet Mayanja-Kizza ◽  
Kim Stanley ◽  
Bonnie Thiel ◽  
...  
Keyword(s):  
At Risk ◽  
Cost Effective ◽  
Interventional Therapy ◽  
Hiv Positive ◽  
African Countries ◽  
Makerere University ◽  
Cost Effective Approach ◽  
Specific Antigens ◽  
Therapy Strategies ◽  
Active Disease

BackgroundWith 2 billion people infected with Mycobacterium tuberculosis (Mtb) worldwide, identification of those most at-risk of progressing to active disease would provide a targeted, cost-effective approach for preventative therapy strategies. The GC6–74 project recruited Mtb-exposed HIV-positive (HIV+) contacts from 5 African countries with the aim of identifying molecular and protein signatures for identification of ‘at-risk’ subjects by comparing those who progressed to active disease (progressors) to those who remained asymptomatic (controls).MethodsFor this arm of the project, we analysed longitudinal samples from 12 HIV +progressors and 28 HIV +matched controls from Uganda (Makerere University, MAK) and South Africa (Stellenbosch University, SUN). Diluted whole blood was stimulated for 7 days with 7 Mtb-specific antigens plus controls. Supernatant was collected and a 38-plex multiplex assay performed following identification of confirmed progressors and controls.ResultsThe median time to progression to active disease was 510 days for SUN and 425 days for MAK participants. Baseline CD4 counts were 163 cells/µl for progressors and 154 cells/µl for controls. Baseline responses showed significantly lower IL-4 production in progressors following ESAT-6/CFP-10 (EC) stimulation (p=0.0309) and significantly higher macrophage-derived chemokine (MDC) following both Rv3019 and TB10.4 stimulation. For the time-point closest to progression, IL-10 production following EC stimulation and IFN-γ production following Rv3019 stimulation were significantly higher in progressors than controls (p=0.0024 and p=0.0028 respectively). A combination of 12 analytes following EC and TB10.4 stimulation gave 84.4% and 91.1% correct classification respectively.ConclusionWe have defined a soluble signature for detecting likely progression to active TB in HIV +subjects 1 year prior to progression. Following validation in other cohorts, this could be exploited for development of a field-friendly test for targeted interventional therapy.

scholarly journals Modelling Cost-Effectiveness of Syphilis Detection Strategies In Prisoners: Exploratory Exercise In A Chilean Male Prison

2020 ◽  
Author(s):  
Carla Castillo-Laborde ◽  
Pedro Gajardo ◽  
Manuel Nájera-De Ferrari ◽  
Isabel Matute ◽  
Macarena Hirmas-Adauy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mathematical Modelling ◽  
Rapid Test ◽  
Cost Effective ◽  
Current Situation ◽  
Case Detection ◽  
Active Case ◽  
Passive Case Detection ◽  
Rapid Tests ◽  
Detection Strategies

Abstract BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows to simulate the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different test and detection strategies might be a powerful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and to perform active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.

scholarly journals Modelling Cost-Effectiveness Of Syphilis Detection Strategies In Prisoners: Exploratory Exercise In A Chilean Male Prison

2020 ◽  
Author(s):  
Carla Castillo-Laborde ◽  
Pedro Gajardo ◽  
Manuel Nájera-De Ferrari ◽  
Isabel Matute ◽  
Macarena Hirmas-Adauy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mathematical Modelling ◽  
Rapid Test ◽  
Cost Effective ◽  
Current Situation ◽  
Case Detection ◽  
Active Case ◽  
Passive Case Detection ◽  
Rapid Tests ◽  
Detection Strategies

Abstract BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different test and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.

scholarly journals Modelling Cost-Effectiveness of Syphilis Detection Strategies in Prisoners: Exploratory Exercise in a Chilean Male Prison

2021 ◽  
Author(s):  
Carla Castillo-Laborde ◽  
Pedro Gajardo ◽  
Manuel Nájera-De Ferrari ◽  
Isabel Matute ◽  
Macarena Hirmas-Adauy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mathematical Modelling ◽  
Rapid Test ◽  
Cost Effective ◽  
Current Situation ◽  
Case Detection ◽  
Active Case ◽  
Passive Case Detection ◽  
Rapid Tests ◽  
Detection Strategies

Abstract BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from controlled. People deprived of liberty are a vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.

scholarly journals Mathematical modelling and optimal cost-effective control of COVID-19 transmission dynamics

2020 ◽  
Vol 135 (11) ◽  
Author(s):  
S. Olaniyi ◽  
O. S. Obabiyi ◽  
K. O. Okosun ◽  
A. T. Oladipo ◽  
S. O. Adewale
Keyword(s):  
Mathematical Modelling ◽  
Cost Effective ◽  
Transmission Dynamics ◽  
Effective Control ◽  
Optimal Cost

The impact of microbiological tools on mathematical modelling of biological wastewater treatment

1997 ◽  
Vol 36 (10) ◽  
pp. 97-108
Author(s):  
P. C. Pollard ◽  
E. v. Münch ◽  
P. A. Lant ◽  
P. F. Greenfield
Keyword(s):  
Wastewater Treatment ◽  
Mathematical Modelling ◽  
Waste Treatment ◽  
Control Strategies ◽  
Cost Effective ◽  
Design Guidelines ◽  
Biological Behaviour ◽  
Cost Effective Treatment ◽  
The Impact ◽  
Biological Waste Treatment

Biological systems are being used to treat an increasing range of complex wastes; domestic and industrial wastewaters containing nutrients and refractory organic compounds, soil sites and groundwater contaminated by organics, and organic solid residues. These treatment processes rely on micro-organisms and, more than ever before, must deliver higher quality outcomes at higher levels of reliability to protect the environment. At the same time, pressures to deliver cost-effective treatment have increased. The challenge for these biological treatment technologies and the associated engineering is to achieve the environmental and economic goals simultaneously. Mathematical modelling is an essential component in developing a detailed understanding of such processes, as well as design guidelines and suitable operating and control strategies. This paper provides a brief summary of the development of mathematical models for biological waste treatment systems, why they have become increasingly complex and how certain microbiological tools can provide the experimental means to validate more complex segregated and structured models of biological behaviour. With a number of specific modelling examples in the field of wastewater treatment, we illustrate the potential of these modern microbiological tools and their implications for gaining an improved understanding of biological waste treatment.

scholarly journals Insights from quantitative and mathematical modelling on the proposed 2030 goal for gambiense human African trypanosomiasis (gHAT)

2019 ◽  
Vol 3 ◽  
pp. 1553
Author(s):  
Keyword(s):  
Mathematical Modelling ◽  
Human African Trypanosomiasis ◽  
Stochastic Dynamics ◽  
Spatial Scales ◽  
Central Africa ◽  
Cost Effective ◽  
Predictive Modelling ◽  
World Health ◽  
African Trypanosomiasis ◽  
Health Organization

Gambiense human African trypanosomiasis (gHAT) is a parasitic, vector-borne neglected tropical disease that has historically affected populations across West and Central Africa and can result in death if untreated. Following from the success of recent intervention programmes against gHAT, the World Health Organization (WHO) has defined a 2030 goal of global elimination of transmission (EOT). The key proposed indicator to measure achievement of the goal is to have zero reported cases. Results of previous mathematical modelling and quantitative analyses are brought together to explore both the implications of the proposed indicator and the feasibility of achieving the WHO goal. Whilst the indicator of zero case reporting is clear and measurable, it is an imperfect proxy for EOT and could arise either before or after EOT is achieved. Lagging reporting of infection and imperfect diagnostic specificity could result in case reporting after EOT, whereas the converse could be true due to underreporting, lack of coverage, and cryptic human and animal reservoirs. At the village-scale, the WHO recommendation of continuing active screening until there are three years of zero cases yields a high probability of local EOT, but extrapolating this result to larger spatial scales is complex. Predictive modelling of gHAT has consistently found that EOT by 2030 is unlikely across key endemic regions if current medical-only strategies are not bolstered by improved coverage, reduced time to detection and/or complementary vector control.  Unfortunately, projected costs for strategies expected to meet EOT are high in the short term and strategies that are cost-effective in reducing burden are unlikely to result in EOT by 2030. Future modelling work should aim to provide predictions while taking into account uncertainties in stochastic dynamics and infection reservoirs, as well as assessment of multiple spatial scales, reactive strategies, and measurable proxies of EOT.

Cold rolling of flat metal products: Contribution of mathematical modelling

1998 ◽  
Vol 212 (1) ◽  
pp. 73-86 ◽  
Author(s):  
S A Domanti ◽  
D L S McElwain
Keyword(s):  
Cold Rolling ◽  
Mathematical Modelling ◽  
Asymptotic Approximation ◽  
Significant Contribution ◽  
Cost Effective ◽  
Finite Element Approach ◽  
Large Memory ◽  
Element Approach ◽  
Metal Products ◽  
Quality Improvement Tool

The significant contribution of mathematical modelling both to the understanding and improvement of the cold rolling of flat metal products is indisputable. This survey documents this contribution and claims that mathematical modelling will continue to provide a cost effective quality improvement tool with the finite element approach on fast large-memory computers and the use of the asymptotic approximation offering the best prospects for further major advances.

scholarly journals Modelling Cost-Effectiveness of Syphilis Detection Strategies in Prisoners: Exploratory Exercise in a Chilean Male Prison

2020 ◽  
Author(s):  
Carla Castillo-Laborde ◽  
Pedro Gajardo ◽  
Manuel Nájera-De Ferrari ◽  
Isabel Matute ◽  
Macarena Hirmas-Adauy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mathematical Modelling ◽  
Rapid Test ◽  
Cost Effective ◽  
Current Situation ◽  
Case Detection ◽  
Active Case ◽  
Passive Case Detection ◽  
Rapid Tests ◽  
Detection Strategies

Abstract BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.

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