PeerJ
Volume 2018, Issue 4, 2018

Uncertainty and sensitivity analysis of the basic reproduction number of diphtheria: A case study of a Rohingya refugee camp in Bangladesh, November-December 2017 (Article) (Open Access)

Matsuyama R. , Akhmetzhanov A.R. , Endo A. , Lee H. , Yamaguchi T. , Tsuzuki S. , Nishiura H.*
  • a Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan
  • b Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan
  • c Graduate School of Medicine, Hokkaido University, Sapporo, Japan, London School of Hygiene and oTropical Medicine, University of London, London, United Kingdom
  • d Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan
  • e Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan
  • f Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan
  • g Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Saitama, Japan

Abstract

Background: A Rohingya refugee camp in Cox's Bazar, Bangladesh experienced a large-scale diphtheria epidemic in 2017. The background information of previously immune fraction among refugees cannot be explicitly estimated, and thus we conducted an uncertainty analysis of the basic reproduction number, R 0 . Methods: A renewal process model was devised to estimate the R 0 and ascertainment rate of cases, and loss of susceptible individuals was modeled as one minus the sum of initially immune fraction and the fraction naturally infected during the epidemic. To account for the uncertainty of initially immune fraction, we employed a Latin Hypercube sampling (LHS) method. Results: R 0 ranged from 4.7 to 14.8 with the median estimate at 7.2. R 0 was positively correlated with ascertainment rates. Sensitivity analysis indicated that R 0 would become smaller with greater variance of the generation time. Discussion: Estimated R 0 was broadly consistent with published estimate from endemic data, indicating that the vaccination coverage of 86% has to be satisfied to prevent the epidemic by means of mass vaccination. LHS was particularly useful in the setting of a refugee camp in which the background health status is poorly quantified. © 2018 Matsuyama et al.

Author Keywords

Basic Reproduction Number outbreak Vaccination Mathematical model Epidemiology Bangladesh Statistical estimation Corynebacterium diphtheriae Diphtheria Refugee

Index Keywords

DNA polymorphism laryngitis upper respiratory tract congestion human health status acute disease sensitivity analysis nonhuman refugee camp Article disease transmission Corynebacterium diphtheriae uncertainty mass immunization world health organization Bangladesh vaccination Basic Reproduction Number diphtheria
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044714419&doi=10.7717%2fpeerj.4583&partnerID=40&md5=50c0068dab3a2f4fc6f17f92078f93dd
DOI: 10.7717/peerj.4583
ISSN: 21678359
Cited by: 4
Original Language: English