title: Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.
abstract: Visceral leishmaniasis (VL) is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.
authors.affiliation: Department of Mathematics, Adamas University, Barasat, Kolkata, India.
authors.forename: Santanu
authors.initials: S
authors.lastname: Biswas
authors.affiliation: Chemical Engineering and Process Development, CSIR-National Chemical Laboratory, Dr. Homi Bhabha Road, Pune, 411008, India.|Academy of Scientific & Innovative Research (AcSIR), CSIR-NCL Campus, Pune - 411008, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Subramanian
authors.affiliation: Department of Mathematics and Statistics, College of Science - Sultan Qaboos University, P.O. box - 36, Muscat, Oman.
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: ELMojtaba
authors.affiliation: Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata, 700108, India.
authors.forename: Joydev
authors.initials: J
authors.lastname: Chattopadhyay
authors.affiliation: Chemical Engineering and Process Development, CSIR-National Chemical Laboratory, Dr. Homi Bhabha Road, Pune, 411008, India.|Academy of Scientific & Innovative Research (AcSIR), CSIR-NCL Campus, Pune - 411008, India.
authors.forename: Ram Rup
authors.initials: RR
authors.lastname: Sarkar
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000191:economics / Q000627:therapeutic use; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D004197:Disease Reservoirs; D016527:Drug Costs; D006801:Humans; D007194:India / Q000453:epidemiology; D007299:Insect Bites and Stings / Q000453:epidemiology / Q000469:parasitology; D007300:Insect Control / Q000191:economics / Q000379:methods*; D007303:Insect Vectors / Q000469:parasitology*; D057148:Insecticide-Treated Bednets / Q000191:economics; D007306:Insecticides / Q000191:economics; D007891:Leishmania; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000453:epidemiology; D007898:Leishmaniasis, Visceral / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008962:Models, Theoretical; D011576:Psychodidae / Q000469:parasitology*; D012621:Seasons
chemical_list: D000981:Antiprotozoal Agents; D007306:Insecticides