Project Background
Cholera remains a significant public health challenge, causing millions of cases each year. Importantly, a notable resurgence in cases, countries affected, and the case fatality rate has been increasing since 2021. Due in part to concerns about antibiotic resistance, current treatment guidelines reserve antibiotics for severely symptomatic cases, recommending treating moderately symptomatic infections with oral rehydration and supportive care alone. However, it has recently been suggested that, due to the reduction in transmissibility as a result of treatment with antibiotics, there may be certain circumstances under which treating moderately symptomatic cases with antibiotics may have population-level benefits.
To address this, we developed a compartmental model of cholera transmission in a non-endemic setting to quantify the impact of this policy change on the overall disease burden and antibiotic use. We simulated this model to show the conditions under which expanded treatment guidelines improve public health outcomes and we have solved for the threshold values where these occur.
Student Role
Building on this work, a SPUR student will solve for bifurcation points to identify critical thresholds where small changes in parameters could lead to significant shifts in disease dynamics, such as the emergence of endemic states or large outbreaks. Additionally, the student will employ Filippov models to explore the potential effects of switching treatment strategies at these bifurcation points, providing a more nuanced understanding of how expanding antibiotic treatment guidelines to include moderate infections might influence both individual outcomes and population-level disease control. This approach will allow the student to assess the stability of various intervention strategies and offer insights into optimizing public health responses to cholera outbreaks.
Student Learning Outcomes and Benefits
- Understanding of Epidemiological Modeling: The student will gain a deep understanding of compartmental models and their application in infectious disease research, particularly in modeling cholera transmission.
- Introduction to Bifurcation Theory: The student will learn about bifurcation theory and its importance in identifying critical thresholds where small changes in model parameters can lead to significant shifts in disease dynamics.
- Application of Filippov Models: The student will be introduced to Filippov models, which are used to study systems with discontinuities, and will learn how to apply these models to analyze disease intervention strategies.
- Research Communication: The student will improve their ability to communicate complex research findings, both in writing and verbally, through the preparation of reports, presentations, and possibly publications.
- Preparation for Advanced Studies: This project will provide a strong foundation for graduate studies in public health, epidemiology, or applied mathematics, positioning the student for future academic and research opportunities.
- Contribution to Public Health Knowledge: This work builds on a project that is being done in collaboration with the Global Task Force for Cholera Control and there may be opportunities to attend or present at future GTFCC meetings. The student's work could contribute to a better understanding of cholera intervention strategies, potentially influencing public health policies and making a tangible impact on disease control efforts.
Lindsay Keegan
Research Assistant Professor
Medicine
Internal Medicine
Lindsay's research answers the question of how transmission dynamics of infectious diseases impact control and elimination efforts. Her research centers on developing and applying novel statistical and dynamical methods to address questions on the ecology and evolution of infectious diseases.
Currently she is working to develop methods to understand the spread of healthcare associated infections and improve antibiotic stewardship.