The antimicrobial resistance (AMR) strain of bacteria is the major problem in the nosocomial infection, this cause the adverse outcome of the hospitalization patients such as prolonged LOS or increase mortality. The one of the invervention of the AMR nosocomial infection is the effective AMR surveillance in the hospital. The AMR surveillance can stop the spreading of the AMR bacteria in the hospital and this will reduce the NI rate in the hospital.

The features of the effective AMR surveillance system
1. real time monitoring
2. can be identified the location that occur AMR culture positive, ward and bed.
3. multi-level infection control to eliminated the AMR prevalence.

The model is proper to evaluated the cost-utility of the AMR surveillance system.

Costs
1. Antibiotics cost (AMR bacteria must use high cost antibiotic for treatment)
2. ICU admission cost (Longer admission)
3. Ventilator time cost (Longer ventilator used time)

Perspectives
1. Societal: Time spent by family members
2. Patients: Can not work in the admission period
3. Payers: Medical cost includes labor, equipment, capital
4. Healthcare provider

Reference

1. Ferri M, Ranucci E, Romagnoli P, Giaccone V. Antimicrobial resistance: A global emerging threat to public health systems. Crit Rev Food Sci Nutr. 2017 Sep 2;57(13):2857-2876. doi: 10.1080/10408398.2015.1077192. PMID: 26464037.
2. Fernando SA, Gray TJ, Gottlieb T. Healthcare-acquired infections: prevention strategies. Intern Med J. 2017 Dec;47(12):1341-1351. doi: 10.1111/imj.13642. PMID: 29224205.

I would like to suggest High School Student Stress Monitoring System.

Background: Currently, we’re amidst a pandemic COVID-19 outbreak, which change our current socio-economic status quo to the new normal. Our traditional education system did not construct to support the newer methods of learning, the government has embarked on fully distance learning such as studying from home, lecturing by video conference, or giving assignments through the social networks. While these measures might be our best strategy, it still has an inevitable mental side effect toward children especially high-school students who are undergoing rigorous study for higher education admission. Create mental monitoring system for students might be beneficial to screening and prevent stress that can lead to mental illness.

Coverage: The high school students aged range from 14 to 18 years old, studying in education institutes.

Method: Using a set of survey questionnaire screening periodically. The results will be analyzed and reports, the potential high-stress students will be referred to the school guidance teacher and psychologist for consultation.

Cost: Direct cost – Computers, Servers, and Internet Service. Indirect cost – Productivity loss (as students , psychologists and teachers have to spent some time using the system)

Outcome: DALYs averted

Reference:
Pieh, C., et al. (2021). “Assessment of Mental Health of High School Students During Social Distancing and Remote Schooling During the COVID-19 Pandemic in Austria.” JAMA Netw Open 4(6): e2114866.
Williams, M. L., et al. (2021). “Addressing Stress in High School Students During the COVID-19 Pandemic.” NASN Sch Nurse 36(4): 226-232.

– The intervention I would like to consider in my modelling is oral rabies vaccine. The model will compared between non-oral rabies vaccine situation and oral rabies vaccine implemented situation.

– According to my modelling about the rabies last week, I followed the model structure from Laager M. (2018). The model consist of 4 compartment including susceptible population (S), vaccination population (V), exposure population (E), and infected population (I) that link between compartments with 7 parameters. The oral rabies vaccine doesn’t change the model structure but change the value of some parameters.

– The characteristic of the intervention including percent of vaccine coverage, vaccine efficiency, and rate of loss of vaccine efficacy.

What intervention(s) you are considering in your modelling?
I chose Ebola as my study case. I would like to study the early response or intervention for Ebola. In August 2014 the WHO published the Roadmap for response, outlining three phases of response initiatives to combat the outbreak. In October 2014, during the first phase, the UN Mission for Ebola Emergency Response (UNMEER) was launched. UNMEER had several aims: that 70 percent of cases would be isolated and that 70 percent of the burials would be conducted in a safe manner. Approximately 2 months after the UNMEER initiated interventions were implemented, the national weekly case counts decreased

How it will be added to the model structure?
I would like to explore the potential benefits of the intervention by looking at the time of implementation by moving the time of interventions in the transmission model.

What are the characteristics of the intervention(s)?
The characteristics of the intervention include the transmission parameter and also the hospitalization rate and the case fatality rates for those hospitalized.

What intervention(s) you are considering in your modelling?

– I chose the lockdown intervention. It is the intervention that most governments around the world chose to deal with the Covid-19 pandemic and is not difficult to understand for a simple model one.

How it will be added to the model structure?
– by the different beta for the SIRD model, I pick the base number from Luangwilai et al. (2020), they have beta = 0.2169, then I assume that lockdown has 20 and 25 per cent efficiency in the same situation. so beta will decrease with 20 and 25 per cent.

What are the characteristics of the intervention(s)?
– lockdown is the intervention that targets to decrease beta.

What intervention(s) you are considering in your modelling?

– Social distancing & Lockdown includes avoiding large gatherings, physical contact, and other efforts to mitigate the spread of infectious disease. According to my model, this is going to impact or decrease of transmission rate or beta.

– Case identification & isolation; Vaccine & antiviral drugs for increase recovery rate or gamma.

How it will be added to the model structure?

– According of my model from last week, I would like to modified the equations by adding some parameters to the equations to make the mathematical model more complete.

What are the characteristics of the intervention(s)?

– Both of interventions have more impact to increase and decrease some parameters of the structure of SEIR COVID-19 model by the current pandemic. The characteristics of this intervention will help me predict the COVID situation more effectively.

What intervention(s) you are considering in your modeling?

– The intervention I would like to implement in my modeling about Leptospirosis is animal vaccination. According to U. Narkkul’s study [1] about “Human, animal, water source interactions and leptospirosis in Thailand”, there are different Human-Animal Contact Patterns and different Animal-Environment Contact Patterns in different area. With this knowledge, we can apply vaccination to proper animal type to help reducing rate of transmission of Leptospirosis. Although, efficiency of Leptospirosis has been questioned, there are some vaccine that are efficiency (according to Rafael Bazaglia Sonada’s study [2]). This intervention might start in specific for specific animals involved with water source, for example, giving vaccine to dogs in Nakhon Sri Thammarat area that was found that it is high contact pattern between dogs-environment and dog-human.

How it will be added to model structure ?

– Most mathematical model study for Leptospirosis use SIR model[3] and few use SEIR model. This intervention might interrupt transmission by reduce risk of spreading from infected animals to environment and human. I will imply effect of the intervention in to some parameter, such as reduce in beta.

What are the characteristics of the intervention(s)?

– Giving vaccine to animals involved in transmission process is the intervention that aim to reduce infected vector and reduce transmission rate that might be helpful and might be measured by cost-utility economic evaluation or cost effectiveness economic evaluation.

[1] Narkkul, U., Thaipadungpanit, J., Srisawat, N. et al. Human, animal, water source interactions and leptospirosis in Thailand. Sci Rep 11, 3215 (2021). https://doi.org/10.1038/s41598-021-82290-5
[2] Sonada RB, Azevedo SS, Soto FRM, Costa DFD, Morais ZM, Souza GO, Gonçales AP, Miraglia F, Vasconcellos SA. Efficacy of leptospiral commercial vaccines on the protection against an autochtonous strain recovered in Brazil. Braz J Microbiol. 2018 Apr-Jun;49(2):347-350. doi: 10.1016/j.bjm.2017.06.008. Epub 2017 Oct 12. PMID: 29122476; PMCID: PMC5913823.
[3] Paisanwarakiat, R., & Thamchai, R. (2021). Optimal Control of a Leptospirosis Epidemic Model. Science & Technology Asia, 26(1), 9-17. Retrieved from https://ph02.tci-thaijo.org/index.php/SciTechAsia/article/view/214606

What intervention(s) you are considering in your modeling?

School closure and lockdown will be one of the interventions that decrease the transmission rate
Vaccination also be an intervention that reduce susceptible

How it will be added to the model structure?

The intervention will interrupt the model by reducing the transmission rate. I’ll add the parameter and complete the algorithm

What are the characteristics of the intervention(s)?

These will reduce the transmission rate and make this model much more precise.