Controlling rabies epidemics in Nepal with limited resources: optimal control theory approach

Abstract

In many developing countries, including Nepal, rabies epidemics constitute a serious public health concern, partly because of limited resources for proper implementation of control measures. In this study, we develop an extended model by incorporating various controls into the transmission dynamics model with both dog and jackal vectors. We apply the optimal control theory on the developed model system to identify optimal control strategy for mitigating rabies burden in Nepal with limited resources. Among the potential control strategies, human vaccination, dog vaccination, dog culling, dog sterilization, and jackal vaccination, considered in this study, our results show that a combination of dog vaccination and dog culling is the most effective strategy to control rabies in Nepal. Our optimal control solutions provide the strategy for optimal implementation of these controls to suppress rabies prevalence among dogs and jackals of Nepal using a minimum cost associated with controls. We found that given limited resources, implementing controls in a time-dependent manner with a higher level at the beginning of the outbreaks and reducing them during later part of the epidemics can provide maximum benefits.