1. Quantifying model evidence for yellow fever transmission routes in Africa
- Author
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Katy A. M. Gaythorpe, Laurence Cibrelus, Tini Garske, Kévin Jean, Imperial College London, Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Funding:This work was carried out as part of the Vaccine Impact Modelling Consortium (www.vaccineimpact.org),but the views expressed are those of the authors and not necessarily those of the Consortium or its funders.The funders were given the opportunity to review this paper prior to publication,but the final decision on the content of the publication was taken by the authors.We acknowledge joint Centre funding from the UK Medical Research Council and Department for International Development. The research leading to these results has received funding from the Bill & Melinda Gates foundation (OPP1117543,OPP1157270 http://www.gatesfoundation.org/)and from the Medical Research Council (MR/R015600/1https://mrc.ukri.org/)., HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), and Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)
- Subjects
0301 basic medicine ,Viral Diseases ,Epidemiology ,Force of infection ,Statics ,Pathology and Laboratory Medicine ,law.invention ,Geographical Locations ,Bayes' theorem ,0302 clinical medicine ,law ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Aedes ,Statistics ,Medicine and Health Sciences ,Public and Occupational Health ,Biology (General) ,Ecology ,Physics ,Yellow fever ,Linear model ,Classical Mechanics ,Vaccination and Immunization ,Geography ,Transmission (mechanics) ,Infectious Diseases ,Serology ,Computational Theory and Mathematics ,INFECTIONS ,Modeling and Simulation ,Physical Sciences ,Yellow fever virus ,Life Sciences & Biomedicine ,Research Article ,Generalized linear model ,Biochemistry & Molecular Biology ,Bioinformatics ,QH301-705.5 ,Immunology ,Bayesian inference ,Models, Biological ,Biochemical Research Methods ,BAYESIAN MODEL ,Infectious Disease Epidemiology ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Yellow Fever ,Genetics ,medicine ,Animals ,Humans ,Molecular Biology ,01 Mathematical Sciences ,Ecology, Evolution, Behavior and Systematics ,Estimation ,Science & Technology ,Models, Statistical ,Biology and Life Sciences ,Computational Biology ,Bayes Theorem ,06 Biological Sciences ,medicine.disease ,030104 developmental biology ,People and Places ,Africa ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Mathematical & Computational Biology ,08 Information and Computing Sciences ,Preventive Medicine ,030217 neurology & neurosurgery - Abstract
Yellow fever is a vector-borne disease endemic in tropical regions of Africa, where 90% of the global burden occurs, and Latin America. It is notoriously under-reported with uncertainty arising from a complex transmission cycle including a sylvatic reservoir and non-specific symptom set. Resulting estimates of burden, particularly in Africa, are highly uncertain. We examine two established models of yellow fever transmission within a Bayesian model averaging framework in order to assess the relative evidence for each model’s assumptions and to highlight possible data gaps. Our models assume contrasting scenarios of the yellow fever transmission cycle in Africa. The first takes the force of infection in each province to be static across the observation period; this is synonymous with a constant infection pressure from the sylvatic reservoir. The second model assumes the majority of transmission results from the urban cycle; in this case, the force of infection is dynamic and defined through a fixed value of R0 in each province. Both models are coupled to a generalised linear model of yellow fever occurrence which uses environmental covariates to allow us to estimate transmission intensity in areas where data is sparse. We compare these contrasting descriptions of transmission through a Bayesian framework and trans-dimensional Markov chain Monte Carlo sampling in order to assess each model’s evidence given the range of uncertainty in parameter values. The resulting estimates allow us to produce Bayesian model averaged predictions of yellow fever burden across the African endemic region. We find strong support for the static force of infection model which suggests a higher proportion of yellow fever transmission occurs as a result of infection from an external source such as the sylvatic reservoir. However, the model comparison highlights key data gaps in serological surveys across the African endemic region. As such, conclusions concerning the most prevalent transmission routes for yellow fever will be limited by the sparsity of data which is particularly evident in the areas with highest predicted transmission intensity. Our model and estimation approach provides a robust framework for model comparison and predicting yellow fever burden in Africa. However, key data gaps increase uncertainty surrounding estimates of model parameters and evidence. As more mathematical models are developed to address new research questions, it is increasingly important to compare them with established modelling approaches to highlight uncertainty in structures and data., Author summary Yellow fever (YF) is notoriously under reported due to non-specific symptom spectrum and the true burden is highly uncertain as a result of a complex transmission cycle. As such, estimates surrounding YF burden are highly uncertain and the mechanisms behind transmission are often unclear. We assess these mechanisms and the resulting uncertainty by estimating two existing models of YF transmission within a product space framework. This allows us to produce updated estimates of transmission intensity and to compare the relative support for each model given the data. We find strong support for a model assuming a static force of infection, approximating the constant infection pressure from the sylvatic reservoir of YF. We also highlight areas where data is sparse, often the same areas estimated to have especially high transmission intensity. This is the first robust multi-model approach to applied YF modelling and provides a framework that could be extended to other disease models.
- Published
- 2019