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Title
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Population dynamics and household structures in infectious disease modelling : a demographic perspective
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Author
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Abstract
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| Some population groups are more likely to acquire an infection or to experience a severe outcome in case of disease due to risk factors that may not be randomly distributed in the population. Some of these factors are related to demographic characteristics and structures (e.g. age, sex, household composition), which typically are incorporated in the host population in models of infectious disease transmission, though often in a highly simplified manner. Demographic structures, however, result from complex demographic processes that tend to change over time. In the context of infectious disease epidemiology, it is not well understood how these underlying processes shape current and future population structures with relevance for the transmission and burden of infectious diseases. For that reason, the aim of this dissertation was to explore and improve infectious disease models with dynamic host populations with the purpose of investigating the impact of demographic structures and changes on the transmission and burden of infectious diseases transmitted through close contact. With the advantages and limitations of the existing literature in mind, we developed a demographic microsimulation for an age- and household-structured population, tailored for applications in infectious disease modelling. We specifically simulated the Belgian population and considered the demographic processes of fertility, mortality, migration and household transitions. The microsimulation was extended by a disease transmission model for emerging infectious diseases. The age and household structures had an impact on the disease transmission dynamics, but the magnitude of the relationship depended on epidemiological heterogeneity in the population. Moreover, the size and composition of households were crucial for explaining how the infection spread at the individual, household and population level. In a second application of the microsimulation, we investigated how population ageing affects the mortality burden of respiratory infections. The disease transmission model was modified to resemble the spread of SARS-CoV-2 and novel influenza A virus. We focused on the living arrangements in the older adult population, as the COVID-19 pandemic, for example, has had a disproportionate impact on those living in LTCFs. Similarly, we found that this relatively small population group, which is often disregarded in infectious disease modelling, faced a markedly higher risk of infection in our simulations and accounted for a substantial share of the burden of mortality associated with the respiratory infections. The burden of future epidemics increased with the ageing of the population, but the magnitude of this relationship depended on the living arrangements and general health in the older adult population. |
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Language
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English
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Publication
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Hasselt
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UHasselt & UAntwerpen
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2023
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Volume/pages
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xvi, 228 p.
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Note
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Hens, Niel [Supervisor]
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Neels, Karel [Supervisor]
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Full text (open access)
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