动力学模型在预防控制手足口病中的应用研究

The project concentrates on the study of the dynamics model and prevention and control of hand, foot and mouth disease (HFMD). HFMD is an infectious disease caused by enterovirus, which mostly occurs in children under 5 years old. The prevalence of hand, foot and mouth disease is not optimistic, and the number of cases remains high every year. In the past five years, HFMD has become the infectious disease with the largest number of cases, even exceeding the number of cases of hepatitis B or tuberculosis. At present, most of the studies on the transmission dynamics of HFMD remain at the level of describing the epidemic regularity of HFMD and the regularity of its development into an outbreak. Based on the epidemiological characteristics and epidemiological status of HFMD, the following dynamic models will be established by considering climate, meteorological, environmental factors, summer and winter vacations, school closures and vaccination in the study area: (1) Heterogeneous models of HFMD infection in different areas; (2) Non-smooth models of kindergartens and other nursery in response to outbreaks of HFMD; (3) A multi-stage model of the effect of vaccines on the epidemic of HFMD. According to the actual statistical data, we will fit the parameters of the model and analysis the risk factors of outbreaks of HFMD. Combining with the living consumption level of residents, medical expenses, designing the optimal control strategy and considering the cost-effectiveness, we will put forward the most cost-effective and feasible for prevention and control measures of HFMD and forecast the outbreak trend of HFMD in the future.

该项目致力于研究手足口病的动力学模型及预防控制。手足口病是由肠道病毒引起的传染病，多发生于5岁以下儿童。手足口病的流行现状不容乐观，每年发病人数居高不下，近5年来一跃成为发病人数最多的法定传染病，超过了乙肝、肺结核的发病人数。目前对手足口病传播动力学的研究大多停留在对其流行的规律认识及该疾病发展为暴发状态的规律认识的描述水平。本项目将依据手足口病的流行病学特点、流行现状，考虑研究地区气候气象、环境因素、寒暑假放假、封校放假及疫苗接种等，建立如下动力学模型：（1）不同地区的人群感染手足口病的异质模型；（2）幼儿园等托幼机构应对手足口病暴发的非光滑模型；（3）接种疫苗对手足口病流行影响的多阶段模型。根据实际统计数据拟合模型参数，分析手足口病暴发的危险因素；结合居民的生活消费水平、患者医疗支出，依据最优控制理论，进行成本效益分析，建立符合实际的预防控制新策略，并预测其未来暴发趋势。

动力学建模与分析是研究传染病传播与流行的重要工具。项目致力于手足口病的建模，并拓展到新冠肺炎、肺结核、种群传染病的动力学模型与数据拟合。结合传染病流行病学特征，建立了斑块模型，考虑疫苗接种的多阶段模型，考虑气候、环境与行为习惯的非自治模型，非自治脉冲随机捕食(含疾病)系统，随机扰动系统。通过模型定性分析与稳定性分析得到模型的动力学行为；通过数据拟合与参数估计得出模型的最优参数值。借助基本再生数的敏感度分析，寻找对传染病流行影响最为关键的因素。根据最优控制原理与成本效益分析方法，得出控制传染病的最优方案及最具成本效益的策略。项目的实施能够为传染病的建模与控制给出定量的决策依据。