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Computational and Mathematical Methods in Medicine
An Interdisciplinary Journal of Mathematical, Theoretical and Clinical Aspects of Medicine
Volume 11, 2010 - Issue 4
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Original Articles

Optimal control of vertically transmitted disease: an integrated approach

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Pages 369-387 | Received 16 Oct 2009, Accepted 03 Jul 2010, Published online: 05 Nov 2010
 

Abstract

We study the dynamics of a disease under administration of a vaccine and antiviral drug, where the disease transmits directly from the parents to the offspring (vertical transmission) and also through contact with infective individuals (horizontal transmission). While vaccination to those susceptible reduces the horizontal transmission, administration of the antiviral drug to infected individuals lessens the chance of vertical transmission. Thus the vaccine and antiviral drug play different roles in controlling the disease, which has both vertical and horizontal transmission. We develop a 3D model with Susceptible–Infected–Recovered under vaccination to the susceptible and antiviral treatment to the infected and consider a control theoretic approach using the Pontryagin maximum principle to analyse the cost-effectiveness of the control process. Our results demonstrate that a mixed intervention strategy of vaccination and antiviral drug in a proper ratio is the most effective way to control the disease. We show that cost-effectiveness of both intervention strategies intimately depends on disease-related parameters, such as force of infection, probability of being infected to offspring from infected mothers, loss of immunity or reinfection and also on cost of treatment.

AMS Subject Classification::

Acknowledgements

We would like to thank Dr Chris Bauch, University of Guelph, for helpful discussions on the manuscript. We are also grateful to two anonymous reviewers for their valuable comments and suggestions to improve the manuscript.

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