Towards Effective and Economical Helminth Control: A Case Study in Amhara, Ethiopia

Introduction: Soil transmitted helminth (STH) infection in human population occurs in marginalized low-income, and resource-constrained regions of the world with more than one and half billion people in developing sub-Saharan Africa, Asia and America. Objective: In this paper a deterministic mathematical model for Soil transmitted helminth (STH) infection with an optimal control model was developed and analyzed to examine the best cost-effective integrated strategy in control and eliminate the disease from the community. Methodology: An optimal control SEIAR deterministic model of helminth infection transmission dynamics with cost-effectiveness analysis. An optimal control model with three control variables (namely sanitation and personal hygiene (SPH) ( u1 ); Health education (HE) ( u2 ) and Mass drug administration (MDA) ( u3 ) ) is formulated. The pontryagin’s maximum principle is used to derive the Hamiltonian, the adjoint variables, the characterization of the controls and the optimality system. An Incremental Cost-Effectiveness Ratio (ICER) is used to investigate cost-effective integrated intervention method to reduce the disease in the community. Numerical simulations were performed using Forwardbackward sweep iterative method. Results: We obtained the Hamiltonian, the adjoint variables, the characterization of the controls and the optimality system. From numerical simulations an integrated strategy prevention and uprooting was found to be a best cost-effective strategy to combat STH infection. From the numerical results we obtained that strategy A (combination of SPH and HE) is most cost effective of all strategies for fighting against STH infection in the community. Therefore, attention should be given for the integrated strategy by stakeholders and policymakers to control STH.