Scabies in residential care homes: modelling, inference and interventions for well-connected population sub-units

Kinyanjui, Timothy, Middleton, Jo, Güttel, Stefan, Cassell, Jackie, Ross, Joshua and House, Thomas (2018) Scabies in residential care homes: modelling, inference and interventions for well-connected population sub-units. PLoS Computational Biology, 14 (3). e1006046. ISSN 1553-7358

[img] PDF - Published Version
Available under License Creative Commons Attribution.

Download (4MB)
[img] PDF (Web Published (Uncorrected Proof)) - Published Version
Available under License Creative Commons Attribution.

Download (5MB)

Abstract

In the context of an ageing population, understanding the transmission of infectious diseases such as scabies through well-connected sub-units of the population, such as residential care homes, is particularly important for the design of efficient interventions to mitigate against the effects of those diseases. Here, we present a modelling methodology based on the efficient solution of a large-scale system of linear differential equations that allows statistical calibration of individual-based random models to real data on scabies in residential care homes. In particular, we review and benchmark different numerical methods for the integration of the differential equation system, and then select the most appropriate of these methods to perform inference using Markov chain Monte Carlo. We test the goodness-of-fit of this model using posterior predictive intervals and propagate forward the resulting parameter uncertainty in a Bayesian framework to consider the economic cost of delayed interventions against scabies, quantifying the benefits of prompt action in the event of detection. We also revisit the previous methodology used to assess the safety of treatments in small population sub-units—in this context ivermectin—and demonstrate that even a very slight relaxation of the implicit assumption of homogeneous death rates significantly increases the plausibility of the hypothesis that ivermectin does not cause excess mortality based upon the data of Barkwell and Shields [1].

Item Type: Article
Keywords: Scabies, Markov-chain-based modelling framework, care homes, ivermectin
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: Q Science > QA Mathematics > QA0299 Analysis. Including analytical methods connected with physical problems
Q Science > QL Zoology > QL0360 Invertebrates > QL0434 Arthropoda
R Medicine > RL Dermatology > RL0760 Diseases due to parasites
R Medicine > RM Therapeutics. Pharmacology > RM0147 Administration of drugs and other therapeutic agents
Depositing User: Jo Middleton
Date Deposited: 10 Apr 2018 10:25
Last Modified: 23 Apr 2018 15:32
URI: http://sro.sussex.ac.uk/id/eprint/73765

View download statistics for this item

📧 Request an update