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PubMed1990

Statistical modelling of the AIDS epidemic for forecasting health care needs.

The objective of this paper is to develop statistical methods for estimating current and future numbers of individuals in different stages of the natural history of the human immunodeficiency (AIDS) virus infection and to evaluate the impact of therapeutic advances on these numbers. The approach is to extend the method of back-calculation to allow for a multistage model of natural history and to permit the hazard functions of progression from one stage to the next to depend on calendar time. Quasi-likelihood estimates of key quantities for evaluating health care needs can be obtained through iteratively reweighted least squares under weakly parametric models for the infection rate. An approach is proposed for incorporating into the analysis independent estimates of human immunodeficiency virus (HIV) prevalence obtained from epidemiologic surveys. The methods are applied to the AIDS epidemic in the United States. Short-term projections are given of both AIDS incidence and the numbers of HIV-infected AIDS-free individuals with CD4 cell depletion. The impact of therapeutic advances on these numbers is evaluated using a change-point hazard model. A number of important sources of uncertainty must be considered when interpreting the results, including uncertainties in the specified hazard functions of disease progression, in the parametric model for the infection rate, in the AIDS incidence data, in the efficacy of treatment, and in the proportions of HIV-infected individuals receiving treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Study on forecasting local rubella outbreaks in Hangzhou city proper by serologic method].

Rubella outbreaks were proved by the rubazyme M test (Abbott) and rubella haemagglutination inhibition test in Hangzhou city in 1987. On the basis of these and previous immune surveillance in human population, we predict that epidemic of rubella will also occur in recent two years. Rubella IgM antibody was detected by enzyme immunoassay using commercially available Rubazyme-M Diagnostic Kit (Abbott Laboratories). It was detected within 0-66 days after eruption and detection rate was the highest between 5th and 14th day of onset. The coincidence rate of enzyme immunoassay and HAI tests for rubella diagnosis was 90.3%, and false negative rate of enzyme immunoassay was 9.7%. Besides, the importance of differentiating measles from rubella and diagnostic criteria of HAI test for rubella were discussed.

China↗
PubMed1989

[Forecasting strategies of hepatitis B vaccination based on decision tree model].

The strategies of hepatitis B vaccination was studied based on the decision tree model. The results showed that the young, especially newborn should be given the highest priority for vaccination and the best strategy to the neonate is vaccination without screening for HBsAg to their mothers. The results also showed that the population groups who can take positive benefits (BCR greater than 1) after being vaccinated can be enlarged if decreasing the costs of the vaccination and tests for hepatitis B virus markers, and increasing the protect rates and years of vaccination. It told us that we should not only pay attention to the study for the more effective and cheaper vaccine, but manage scientifically and use reasonably as well.

Adolescent↗