Optimal control and cost-effectiveness analysis of a three age-structured transmission dynamics of chikungunya virus

Abstract

Chikungunya is an RNA viral disease, transmitted to humans by infected Aedes aegypti or Aedes albopictus mosquitoes. In this paper, an age-structured deterministic model for the transmission dynamics of Chikungunya virus is presented. The model is locally and globally asymptotically stable when the reproduction number is less than unity. A global sensitivity analysis using the reproduction number indicates that the mosquito biting rate, the transmission probability per contact of mosquitoes and of humans, mosquito recruitment rate and the death rate of the mosquitoes are the parameters with the most influence on Chikungunya transmission dynamics. Optimal control theory was then applied, using the results from the sensitivity analysis, to minimize the number infected humans, with time dependent control variables (impacting mosquito biting rate, transmission probability, death rate and recovery rates in humans). The numerical simulations indicate that Chikungunya can be reduced by the application of these controls. The benefits associated with these health interventions are evaluated using cost-effectiveness analysis and these shows that using mono-control strategy involving treatment of infected individuals is the most cost-effective strategy of this category. With pairs of control, the pairs involving treatment of infected individuals and mosquitoes adulticiding, is the most cost-effective strategy of this category and is more cost-effective than using the triple control strategy involving personal protection, treatment of infected humans and mosquitoes adulticiding.