A CHOLERA METAPOPULATION MODEL INTERLINKING MIGRATION WITH INTERVENTION STRATEGIES — A CASE STUDY OF ZIMBABWE (2008–2009)

Abstract

Cholera is a water-borne disease and a major threat to human society affecting about 3–5 million people annually. A considerable number of research works have already been done to understand the disease transmission route and preventive measures in spatial or non-spatial scale. However, how the control strategies are to be linked up with the human migration in different locations in a country are not well studied. The present investigation is carried out in this direction by proposing and analyzing cholera meta-population models. The basic dynamical properties including the domain basic reproduction number are studied. Several important model parameters are estimated using cholera incidence data (2008–2009) and inter-provincial migration data from Census 2012 for the five provinces in Zimbabwe. By defining some migration index, and interlinking these indices with different cholera control strategies, namely, promotion of hand-hygiene and clean water supply and treatment, we carried out an optimal cost effectiveness analysis using optimal control theory. Our analysis suggests that there is no need to provide control measures for all the five provinces, and the control measures should be provided only to those provinces where in-migration flow is moderate. We also observe that such selective control measures which are also cost effective may reduce the overall cases and deaths.