We present a compartmental mathematical model of (SITR) to investigate the effect of saturation treatment in the dynamical spread of diarrhea in the community. The mathematical analysis shows that the disease free and the endemic equilibrium points of the model exist. The disease-free equilibrium is locally and globally asymptotically stable when \(R_{0}<1\) and unstable otherwise \(R_{0}>1\). Numerical simulation results, show the effect of saturation treatment function on the spread of diarrhea. Efficacy of treatment shows a great impact in the total eradication of diarrhea epidemic.
Diarrhea is the frequent passage of loose, watery, soft stools with or without abdominal bloating, pressure, and cramps commonly referred to as gas or flatulence. It is the second leading cause of death in children under five years old [1]. Diarrhea is responsible for killing around 76,000 children globally, there are nearly 1.7 billion cases of diarrhea disease yearly. In developing countries, the annual incidence rate of diarrhea disease episodes in children less than five years old is 3.2 episodes per child. It kills more young children than HIV/AIDS, malaria and measles combined. It causes more than 1.5 million deaths annually, thereby making it a worse health threat than cancer or AIDS in terms of death toll.
Sub-Sahara / Africa is the most vulnerable region of infectious disease [2], this is due to the fact that the region is greatly affected by climate change which makes it more vulnerable to outbreaks that are associated with periods of rainfall and runoff when subsequent turbidity compromises the efficiency of the drinking water treatment plants [3]. Auld et al. [4] found out that heavy rainfall increases diarrhea outbreak due to water contaminated distribution. Many waterborne disease outbreaks occur following a period of intense rainfall [5]. Diarrhea could be acute which lasts for 2 weeks and chronic which lasts for more than 2 weeks [3]. It is one of the most common diseases that is transferred through contaminated food and water [6,7]. There are two types of diarrhea which are infectious and non-infectious diarrhea.
Infectious diarrhea is caused by a virus, parasite or bacterium, which could be campylobacteria, shiga toxin producing E. Coli, giardiasis, salmonellosis, shigellosis, Rotavirus, yersinia, cryptosphoridiosis etc. Noninfectious is caused by toxins (e.g. food poisoning). This type of diarrhea does not spread from person to person [8, 9]. The immunity after infection is temporary and the infection tends to be less severe than the original infection [8]. However, diarrhea is preventable and can be treated.
Adewale et al. [1] worked on Mathematical analysis of diarrhea in the presence of vaccine. They computed \(R_{0}\). In cases where \(R_{0}>1\), the disease became endemic, meaning the disease remained in the population at a consistent rate, as one infected individual transmits the disease to one susceptible.
Chaturvedi et al. [10] did a study on shigella outbreaks. It was established that as long as \(R_{0}< 1\), there would be no epidemic. Upon simulation using assumed parameter values, the results produced, comprehended the epidemic theory and practical situations. The system was proven stable using the Routh-Hurwitz criterion and parameter estimation was successfully completed.
Jose et al. [11] also worked on Epidemiological model of diarrhea diseases and its application in prevention and control. The model was able to mimic the observed epidemiological patterns of infantile diarrhea diseases associated mainly with enterotoxigenic Escherichia coli or with rotavirus. The proposed mathematical model predicted a plausible pattern of the serological profile of an enteric infection. According to their computer simulation experiments (CSE) with this model, it was not necessary to develop an enteric vaccine conferring total and long-lasting immunity in order to achieve protection from diarrhea diseases in young children. Given a protective efficacy and a finite duration of vaccine-induced protection, the optimal immunization policy must be sought. Oral rehydration therapy (ORT) intervention had a clear effect in diminishing the number of individuals dying from diarrhea illness. The CSE also predict an apparent reduction in age-prevalence of diarrhea diseases by use of ORT.
Ardkaew et al. [12] identified the patterns of diarrhea incidence in children under age five in Northeastern provinces of Thailand along the border with Lao PDR. They based their research on the individual hospital case records of patients with diarrhea from 1999 to 2004. Linear regression models containing the District, seasons, and year as factors were fitted to the log-transformed disease incidences, with generalized estimated equations used to account for spatial correlation between districts. The others observed a higher seasonal trend from January to March and April to June. Their analyses suggested that using a thematic map to show the level of diarrhea incidence by district can help provide practicable information that health authorities can use to work effectively and initiate health policies to eradicate the disease.
Cherry et al. [5] worked on Evaluation of bovine viral diarrhea virus control using a mathematical model of infection dynamics. The model architecture was a development of the traditional model framework using susceptible, infectious and removed animals (the SIR model). The model predicted 1:2% persistent infection (within the range of field estimates) and was fairly insensitive to alterations of structure or parameter values. This model drew important conclusions regarding the control of BVD, particularly with respect to the importance of persistently infected (PI) animals in maintaining BVD as an endemic entity in the herd.
Diarrhea modeling has increasingly attracted the attention of mathematical modelers and several works in that regards have been considered on this disease [13]. However, most of these works have focused on vaccination. Thus, often vaccination of diarrhea is considered for children and adults in susceptible class and the exposed periods. Being motivated by the work done in [14], we included saturation treatment function to get its effect. The aim of this work is to construct a mathematical model to study the transmission dynamics of diarrhea infections within the population.
Parameters | Description |
---|---|
\(S\) | Susceptible |
\(I\) | Infective |
\(T\) | Treated class |
\(R\) | Recovered class |
\(\Lambda \) | Recruitment rate |
\(\beta _{1} \) | Effective contact rate |
\(\beta _{2} \) | Saturation treatment rate |
\(\eta \) | Enhancement factor |
\(P\) | Proportion of infected individuals joining either the class R or T |
\(\gamma \) | Rate of treated individuals from infection |
\(\sigma \) | Rate at which treated individuals move to recovered class |
\(\omega \) | Rate at which recovered individuals move to susceptible class |
\(\mu \) | The natural death rate in all compartments |
\(\kappa \) | Educational adjustment |
Lemma 1. If \(\left\{S(0),I(0),T(0),R(0)\right\}\) and all associated parameters of the system are positive, then solutions \(S(t),I(t),T(t),R(t)\) are all positive \(\forall t>0\).
Proof.
Let
\[t_{1} =\sup \left\{t>0:S(t)\ge 0,I(t)\ge 0,T(t)\ge 0,R(t)\ge 0\right\}\]
From the first equation of (1), we have
\[\frac{dS}{dt} =\Lambda +\omega R-\mu S-\left(\beta _{1} \frac{I}{1+\kappa I} +\beta _{2} \frac{\eta T}{1+\kappa T} \right)S.\]
Since \(\left(\Lambda +\omega R\right)\ge 0\), then \(\frac{dS}{dt} \ge -\left(\mu +\phi \right)S,\)
where \(\phi =\left(\beta _{1} \frac{I}{1+\kappa I} +\beta _{2} \frac{\eta T}{1+\kappa T} \right)\).
Integrating both sides gives
\[\int _{0}^{t_{1} }\frac{dS}{dt} \ge -\int _{0}^{t_{1} }\left(\mu +\phi \right)dt ,\]
\[\left. \left(\ln \left|S(t)\right|\right)\right|_{0}^{t_{1} } \ge -\left(\mu +\phi \right)t_{1} ,\]
\[\left. S(t)\right|_{0}^{t_{1} } \ge e^{-\left(\mu +\phi \right)t_{1} } ,\]
\[S(t)\ge S(0)+e^{-\left(\mu +\phi \right)t_{1} } >0.\]
Next, we want to prove that \(I(t)>0\). From the second equation of (1), we have
Lemma 2. The closed set \(\Omega =\left\{\left(S,I,T,R\right)\in {R}_{+}^{4} :0\le \left(S+I+T+R\right)\le \frac{\Lambda }{\mu } \right\}\) is positively invariant.
Proof. Assume that \(\left\{S(t),I(t),T(t).R(t)\right\}\in {R}_{+}^{4} \forall t>0\). The equation (3) can be written as \[\frac{dN}{\Lambda -\mu N} =dt\] \[\int _{o}^{t}\frac{dN}{\Lambda -\mu N} =\int _{0}^{t}dt \] \[N(t)=N(0)e^{-\mu t} +\frac{\Lambda }{\mu } \left(1-e^{-\mu t} \right)\] \[{\mathop{\lim }\limits_{t\to \infty }} N(t)=\frac{\Lambda }{\mu } \] if \(N(0)\le \frac{\Lambda }{\mu }\), then we have \(N(t)\le \frac{\Lambda }{\mu } ,\forall t>0\). Moreover, if \(N(0)> \frac{\Lambda }{\mu }\), then the solution \(\left(S(t),I(t),T(t),R(t)\right)\) enter the closed set \(\Omega \) which affirms that \(\Omega \) is positively invariant. So, the region \(\Omega\) contains all solutions in \({R}_{+}^{4}\). Hence, it is sufficient to study the disease transmission dynamics under the dynamical system (1) in \(\Omega\).
Theorem 3. The disease-free equilibrium is locally asymptotically stable if \(R_{0} < 1\). \[J=\left[\begin{array}{cccc} {-\left(\mu +\phi \right)} & {-\beta _{1} \frac{S\left(1+kI\right)-ISk}{\left(1+kI\right)^{2} } } & {-\beta _{2} \frac{\eta S\left(1+kT\right)-\eta TSk}{\left(1+kT\right)^{2} } } & {\omega } \\ {\phi } & {-\beta _{1} \frac{S\left(1+kI\right)-ISk}{\left(1+kI\right)^{2} } -\left(\mu +\gamma \right)} & {-\beta _{2} \frac{\eta S\left(1+kT\right)-\eta TSk}{\left(1+kT\right)^{2} } } & {0} \\ {0} & {P\gamma } & {-\left(\mu +\sigma \right)} & {0} \\ {0} & {\left(1-P\right)\gamma } & {\sigma } & {-\left(\mu +\omega \right)} \end{array}\right],\] where \(\phi =\left(-\beta _{1} \frac{I}{\left(1+kI\right)} +-\beta _{1} \frac{\eta T}{\left(1+kI\right)} \right)\).
Evaluating the Jacobian at \(E_{0}\). Hence, we obtain \[J_{E^{0} } =\left[\begin{array}{cccc} {-\mu } & {-\beta _{1} \frac{\Lambda }{\mu } } & {-\beta _{2} \frac{\eta \Lambda }{\mu } } & {\omega } \\ {\phi } & {\beta _{1} \frac{\Lambda }{\mu } -\left(\mu +\gamma \right)} & {\beta _{2} \frac{\eta \Lambda }{\mu } } & {0} \\ {0} & {P\gamma } & {-\left(\mu +\sigma \right)} & {0} \\ {0} & {\left(1-P\right)\gamma } & {\sigma } & {-\left(\mu +\omega \right)} \end{array}\right].\] Here, we evaluate the Jacobian at \(E^{0}\) and identity matrix to get the eigenvalues, that is, \[\left|J_{E^{0} } -\lambda I\right|=\left|\begin{array}{cccc} {-\mu -\lambda } & {-\beta _{1} \frac{\Lambda }{\mu } } & {-\beta _{2} \frac{\eta \Lambda }{\mu } } & {\omega } \\ {\phi } & {\beta _{1} \frac{\Lambda }{\mu } -\left(\mu +\gamma \right)-\lambda } & {\beta _{2} \frac{\eta \Lambda }{\mu } } & {0} \\ {0} & {P\gamma } & {-\left(\mu +\sigma \right)-\lambda } & {0} \\ {0} & {\left(1-P\right)\gamma } & {\sigma } & {-\left(\mu +\omega \right)-\lambda } \end{array}\right|=0.\] Then \(\lambda _{1} =-\mu < 0\) and \(\lambda _{2} =-\left(\mu +\omega \right)< 0\).The remaining eigenvalues can be obtained by solving \[H=\left|\begin{array}{cc} {\beta _{1} \frac{\Lambda }{\mu } -\left(\mu +\gamma \right)-\lambda } & {\beta _{2} \frac{\eta \Lambda }{\mu } } \\ {P\gamma } & {-\left(\mu +\sigma \right)-\lambda } \end{array}\right|=0.\] Then we get the following characteristic equation \[\lambda ^{2} +\left(2\mu +\gamma +\sigma -\beta _{1} \frac{\Lambda }{\mu } \right)\lambda +\mu ^{2} +\left(\sigma +\gamma -\beta _{1} \frac{\Lambda }{\mu } \right)\mu +\left(\gamma -\beta _{1} \frac{\Lambda }{\mu } \right)-\beta _{2} \frac{P\gamma \eta \Lambda }{\mu } =0.\] We have a form of quadratic equation, that is, \[P\left(\lambda \right)=\lambda ^{2} +a_{1} \lambda +a_{2} =o,\] where \(a_{1} =\left(\mu +\gamma \right)+\left(\mu +\sigma \right)-\beta _{1} \frac{\Lambda }{\mu }\) and \(a_{2} =\left(\mu +\sigma \right)\left(\mu +\gamma \right)\left[1-R_{0} \right]\). If \(R_{0} 0\) and if \(R_{0} < 1\), then \(\beta _{1} \frac{\Lambda }{\mu \left(\mu +\gamma \right)} 0\). Hence the disease-free equilibrium is locally asymptotically stable if \(R_{0} < 1\).Theorem 4. The disease free equilibrium is globally stable in \(\Omega\) if \(R_{0} < 1\), where \(\Omega\) is a feasible region of Equation (1) and contains all solutions in \({R}_{+}^{4}\) as shown in the previous proof. Again, we prove that the disease-free equilibrium is globally asymptotically stable, using the approach of Castillo – Chavez [13].
Proof. We group Equation (1) into two compartments, that is, uninfected and infected individuals, given by \[\left. \begin{array}{l} {a_{1} :\frac{dX}{dt} =F(X,Z)} \\ {a_{2} :\frac{dZ}{dt} =G(X,Z),G(X,0)=0} \end{array}\right\}. \] Where \(X=(S,R),Z=(I,T)\) with \(X\in {R}_{+}^{2}\) representing the uninfected individuals and \(Z\in {R}_{+}^{2}\) representing infected individuals including the latent and infectious. Let us denote the disease-free equilibrium point by
Theorem 5. The endemic equilibrium \(E^{1}\) is locally asymptotically stable if \(R_{0} >1\). Now, evaluating the Jacobian at \(E^{1}\), we obtain \[J_{E^{1} } =\left[\begin{array}{cccc} {-\left(\mu +A\right)} & {-B} & {-C} & {\omega } \\ {A} & {B-D} & {C} & {0} \\ {0} & {P\gamma } & {-F} & {0} \\ {0} & {\left(1-P\right)\gamma } & {\sigma } & {-U} \end{array}\right],\] Where \(A=\left(\beta _{1} \frac{I^{*} }{1+kI^{*} } +\beta _{2} \frac{\eta T^{*} }{1+kT^{*} } \right),\) \[B=\beta _{1} \frac{S^{*} \left(1+kI^{*} \right)-IS^{*} k}{\left(1+kI^{*} \right)^{2} } ,\] \[C=\beta _{2} \frac{\eta S^{*} \left(1+kT^{*} \right)-\eta T^{*} S^{*} k}{\left(1+kT^{*} \right)^{2} } ,\] \[D=\left(\mu +\gamma \right),\] \[F=\left(\mu +\sigma \right),\] \[U=\left(\mu +\omega \right).\] The eigenvalues of the Jacobian matrix above are, \[\left|J_{E^{1} } -\lambda I\right|=\left|\begin{array}{cccc} {-\left(\mu +A\right)-\lambda } & {-B} & {-C} & {\omega } \\ {A} & {B-D-\lambda } & {C} & {0} \\ {0} & {P\gamma } & {-F-\lambda } & {0} \\ {0} & {\left(1-P\right)\gamma } & {\sigma } & {-U-\lambda } \end{array}\right|=0\] This has the following form of characteristic equation \[-\left(\left(\mu +A\right)+\lambda \right)\left[-\left(U+\lambda \right)\right]\left(\lambda ^{2} +a_{1} \lambda +a_{2} \right)=0.\] Where \begin{eqnarray*} a_{1} &=&-k\mu \left(\gamma +\mu \right)\left(\mu +\sigma \right)\left(P\gamma +\mu +\sigma \right)\left(\mu +\omega \right)-\left(\mu +\sigma \right)\left(\mu \left(\gamma +\mu \right)\left(\mu +\sigma \right)\right)\\ &&+\left(\mu \left(\mu +\sigma \right)+\gamma \left(2\mu -P\mu +2\sigma \right)\right)\omega -kP\gamma \Lambda \left(\mu +\omega \right)\beta _{1}\\ &&+P\gamma \eta \left(-\gamma \mu \left(\mu +\sigma \right)+\gamma \left(\left(-2+P\right)\mu -2\sigma \right)\omega +\left(k\Lambda -\mu \right)\left(\mu +\sigma \right)\left(\mu +\omega \right)\right)\beta _{2} \end{eqnarray*} and \[a_{2} =-\left(\mu +\sigma \right)\left(\mu +\omega \right)\left[1-R_{0} \right].\]
We can see that \(\lambda _{1} =-U,\lambda _{2} =-\left(\mu +A\right),\left(a_{1} ,a_{2} \right)>0\). Then, all roots of the characteristic equation above have negative real part. Therefore, the endemic equilibrium of Equation (1) is locally asymptotically stable if \(R_{0} >1\).Parameters | Description | Value/days | Source |
---|---|---|---|
\(\Lambda \) | Recruitment rate | 45 | Estimated |
\(\beta _{1} \) | Effective contact rate | 0.00093 | [4] |
\(\beta _{2}\) | Saturation treatment rate | 0.0031 | [5] |
\(\eta \) | Enhancement factor | 0.2 | Assumed |
\(P\) | Proportion of infected individuals joining either the class R or T | 0.04 | [5] |
\(\gamma \) | Rate of treated individuals from infection | 0.7 | [15] |
\(\sigma \) | Rate at which treated individuals move to recovered class | 0.9 | [7] |
\(\omega \) | Rate at which recovered individuals move to susceptible class | 0.8 | Assumed |
\(\mu \) | The natural death rate in all compartments | 0.063 | [13] |
\(\kappa \) | Educational adjustment | 0.012 | [4] |