Using disease modeling to tackle global infectious epidemics

Martial Ndeffo, Assistant Professor in the Department of Integrative Veterinary Biosciences.

Texas A&M College of Veterinary Medicine & Biomedical Sciences

When an area is stricken with disease, chaos can often consume a community as it tries to organize itself amidst fear and confusion.

Martial Ndeffo, Assistant Professor at Texas A&M University College of Veterinary Medicine & Biomedical Sciences Department of Integrative Veterinary Biosciences, helps local authorities make sense of these uncertain times by delving into data to help identify the best responses to control or prevent outbreaks.

Ndeffo’s research uses transdisciplinary modeling approaches to identify and address the challenges of a range of infectious diseases. Infectious disease modeling uses mathematical analysis of data to develop quantitative representations of disease systems and their interacting variables, called models. By developing data-driven models, Ndeffo helps characterize emerging diseases in uncertain situations, identify the best disease control and prevention strategies, and analyze public health responses from a health and economic perspective. to inform public policies.

This saving search has taken him across the world, from Ebola epidemics in West and Central Africa, to the study of the epidemics of Dengue, Chikungunya and Zika in the Americas, to domestic work addressing the epidemic of HIV / AIDS and HPV in the United States.

“I have a good sense of adapting to new situations,” said Ndeffo. “I think that also comes with training as a mathematician, still having a problem-solving type of mindset, which you apply in your daily life.”

A life of numbers

Ndeffo knew he wanted to be a mathematician from a young age. Her father and older brother had math degrees and interest was rooted in her family. Although mathematics has always been a part of his life, Ndeffo was not initially drawn to the path of epidemiology.

“Initially my motivation was really to focus more on financial math, go public and find a finance job in London,” he said. “But I had more of an interest in focusing on things that were close to home, which means how could I really use my skills to solve the issues that affect my country and my home continent. This is why I started to take more interest in mathematical biology, in particular mathematical epidemiology, by studying infectious diseases.

His education began in his home country, Cameroon, a largely Francophile country, but the school took him to South Africa, an English-speaking nation, for his Masters in Mathematics. Ndeffo says his fluency in English at the time was difficult, but math was a universal language. He was able to learn both languages ​​- English and math – simultaneously in South Africa.

Strong in both language and skills, Ndeffo secured a place at the University of Cambridge for his second Masters in Applied Mathematics. He remained in Cambridge as a Gates Scholar, a prestigious scholarship funded by the Bill and Melinda Gates Foundation, while he completed his doctorate. in mathematical biology.

Ndeffo completed his postdoctoral work at Yale University, fully immersing himself in the world of infectious disease modeling and soaking up both the work and the impact it can have.

Entering into a crisis

Modeling infectious diseases is a difficult endeavor – not only does it force the researcher into a chaotic and sometimes dangerous environment, but because emerging diseases are not yet fully understood, it also forces the modeler to predict the future when the present is not fully known.

Ndeffo explains this challenge as “as uncertain as your entries are, so your exit will be.”

The nature of this research requires investigators to be flexible and adapt to new situations, both in their data collection and in their physical environment. Ndeffo explains that when epidemics strike in countries with fewer resources, the human element of this research can play an important role.

“When the 2014 Ebola outbreak started in West Africa, especially Liberia, I was part of a team from Yale University that started thinking about how we could help this crisis, ”he said. “It was really a dire situation; it was almost the world’s worst disease occurring in the poorest countries of the world. “

A member of the Ndeffo team came up with the idea of ​​providing their Liberian collaborators in the field with laptops and cellphones to use for contact tracing efforts, after learning through the Liberian ministry of Health that many members of their Ebola response teams had collected data using pen and paper and traveled long distances to deliver this data by hand to public health authorities for analysis.

“There may be a lag of a week between when the data was collected and when public health authorities are able to review it and make a decision. By the time the cases were identified, the situation had completely changed, ”he said. “One thing that made a big difference was a very simple mobile phone app where you can observe something in the field and just enter those observations. The people of Monrovia, the capital, could access real-time data, they could make a decision, and you could act in real time on the ground.

Recently, he has devoted his energy to working on neglected tropical diseases. Ndeffo says that because they are overlooked there is little existing research and he sees a window to make important contributions where others may not think of looking.

“There is certainly an opportunity there, an opening to contribute and for your outcome to be directly taken into account by public health decision makers,” he said. “You can really make a tangible impact in these situations, so that’s why I devoted a little more time to neglected tropical diseases.”

A pandemic is coming home

Recently, Ndeffo diverted its research efforts to studying the development of the global COVID-19 pandemic. His COVID-19 modeling work is reminiscent of previous research he has conducted on emerging diseases, and its adaptive nature is a force in meeting the challenges of studying a disease that is not yet fully characterized.

“Like any emerging disease, it is difficult to study because there are a lot of unknown factors,” he said. “Having the experience of working on Ebola in 2014, I know a bit about these types of developing situations, but there is always a problem in that you will have a lot of things that you don’t know about the disease itself. .

“I think whether we like it or not, we have to learn something. A lot of things will have to change, ”he said. “In order for the company to truly settle in this place, we need a more multidisciplinary view or analysis of what happened and how to prepare for what might happen. It is very important for us not to do it in isolation but to really bring together many disciplines, because of the multifaceted approach to these situations.

While he has hope for the future, Ndeffo warns that the effects of COVID-19 could be more profound than what we are initially seeing.

The strain this virus places on our healthcare system can lead to overwhelmed healthcare facilities, delayed care, reduced access, reduced use of essential services and other effects for people with unhealthy conditions. linked to COVID.

“When you think of these emerging diseases, you have to think of what I call the indirect impact. It is becoming increasingly clear that the indirect impact of COVID is very large and no one knows it – it could even be worse than the direct impact of COVID, ”he said. “This brings us to this place where we design our response measures and our preparedness strategy; we really have to think beyond the direct impact of the disease. We have to consider how we maintain the right balance between public health in a holistic way rather than as a single problem that we are trying to solve. “

Ndeffo sees the need to continue studying COVID-19 as the pandemic develops and is eager to lend a hand where he can. He is also continuing his research on neglected tropical diseases, in the hope that his modeling will inform an elimination strategy.

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