No description available.

No description available.

Thesis. 1979. M.S.--Massachusetts Institute of Technology. Alfred P. Sloan School of Management. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND DEWEY. / Includes bibliographical references. / M.S.

The main goal of my studies has been to search for the optimal control strategy of controlling epidemics when taking into account both economical and social costs of the disease. Three control scenarios emerge with treating the whole population (global strategy, GS), treating a small number of individuals in a well-defined neighbourhood of a detected case (local strategy, LS) and allowing the disease to spread unchecked (null strategy, NS). The choice of the optimal strategy is governed mainly by a relative cost of palliative and preventive treatments. Although the properties of the pathogen might not be known in advance for emerging diseases, the prediction of the optimal strategy can be made based on economic analysis only. The details of the local strategy and in particular the size of the optimal treatment neighbourhood weakly depends on disease infectivity but strongly depends on other epidemiological factors (rate of occurring the symptoms, spontaneously recovery). The required extent of prevention is proportional to the size of the infection neighbourhood, but this relationship depends on time till detection and time till treatment in a non-nonlinear (power) law. The spontaneous recovery also affects the choice of the control strategy. I have extended my results to two contrasting and yet complementary models, in which individuals that have been through the disease can either be treated or not. Whether the removed individuals (i.e., those who have been through the disease but then spontaneously recover or die) are part of the treatment plan depends on the type of the disease agent. The key factor in choosing the right model is whether it is possible - and desirable - to distinguish such individuals from those who are susceptible. If the removed class is identified with dead individuals, the distinction is very clear. However, if the removal means recovery and immunity, it might not be possible to identify those who are immune. The models are similar in their epidemiological part, but differ in how the removed/recovered individuals are treated. The differences in models affect choice of the strategy only for very cheap treatment and slow spreading disease. However for the combinations of parameters that are important from the epidemiological perspective (high infectiousness and expensive treatment) the models give similar results. Moreover, even where the choice of the strategy is different, the total cost spent on controlling the epidemic is very similar for both models. Although regular and small-world networks capture some aspects of the structure of real networks of contacts between people, animals or plants, they do not include the effect of clustering noted in many real-life applications. The use of random clustered networks in epidemiological modelling takes an impor- tant step towards application of the modelling framework to realistic systems. Network topology and in particular clustering also affects the applicability of the control strategy.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Not available / text