Modeling the Effects of Helminth Infection on the Transmission Dynamics of Mycobacterium tuberculosis under Optimal Control Strategies.

Abstract

A deterministic mathematical model for the transmission and control of cointeraction of helminths and tuberculosis is presented, to examine the impact of helminth on tuberculosis and the effect of control strategies. The equilibrium point is established, and the effective reproduction number is computed. The disease-free equilibrium point is confirmed to be asymptotically stable whenever the effective reproduction number is less than the unit. The analysis of the effective reproduction number indicates that an increase in the helminth cases increases the tuberculosis cases, suggesting that the control of helminth infection has a positive impact on controlling the dynamics of tuberculosis. The possibility of bifurcation is investigated using the Center Manifold Theorem. Sensitivity analysis is performed to determine the effect of every parameter on the spread of the two diseases. The model is extended to incorporate control measures, and Pontryagin's Maximum Principle is applied to derive the necessary conditions for optimal control. The optimal control problem is solved numerically by the iterative scheme by considering vaccination of infants for Mtb, treatment of individuals with active tuberculosis, mass drug administration with regular antihelminthic drugs, and sanitation control strategies. The results show that a combination of educational campaign, treatment of individuals with active tuberculosis, mass drug administration, and sanitation is the most effective strategy to control helminth-Mtb coinfection. Thus, to effectively control the helminth-Mtb coinfection, we suggest to public health stakeholders to apply intervention strategies that are aimed at controlling helminth infection and the combination of vaccination of infants and treatment of individuals with active tuberculosis.