Transmission and control of XXXX : a mathematical modelling study.

@entity1 @entity5434 @entity281 @entity311 @entity31365
INTRODUCTION: @entity31365 is now recognised as a leading cause of @entity311 in Malaysia. As @entity1 come into increasing contact with the reservoir host ( @entity5434 ) as a consequence of deforestation, assessing the potential for a shift from zoonotic to sustained @entity31365 transmission between @entity1 is critical. METHODS: A multi-host, multi-site transmission model was developed, taking into account the three areas (forest, farm, and village) where transmission is thought to occur. Latin hypercube sampling of model parameters was used to identify parameter sets consistent with possible prevalence in macaques and @entity1 inferred from observed data. We then explore the consequences of increasing @entity1 -macaque contact in the farm, the likely impact of rapid treatment, and the use of long-lasting insecticide-treated nets (LLINs) in preventing wider spread of this @entity281 . RESULTS: Identified model parameters were consistent with transmission being sustained by the macaques with spill over infections into the @entity1 population and with high overall basic reproduction numbers (up to 2267). The extent to which macaques forage in the farms had a non-linear relationship with @entity1 @entity281 prevalence, the highest prevalence occurring when macaques forage in the farms but return frequently to the forest where they experience higher contact with vectors and hence sustain transmission. Only one of 1,046 parameter sets was consistent with sustained @entity1 -to- @entity1 transmission in the absence of macaques, although with a low @entity1 reproduction number (R(0H) = 1.04). Simulations showed LLINs and rapid treatment provide personal protection to @entity1 with maximal estimated reductions in @entity1 prevalence of 42% and 95%, respectively. CONCLUSION: This model simulates conditions where @entity31365 transmission may occur and the potential impact of control measures. Predictions suggest that conventional control measures are sufficient at reducing the risk of @entity281 in @entity1 , but they must be actively implemented if @entity31365 is to be controlled.
