Cost-effectiveness analysis of optimal control strategies on the transmission dynamics of HIV and Varicella-Zoster co-infection

Abstract

HIV and Varicella-Zoster co-infection has been threatens the lives and livelihood of millions of individuals all over the world. In various nations of the world the co-infection disease is presently a major health problem. Although, various researchers carried out studies related with HIV and Zoster single infections, no one has carried out a study on the co-infection disease. Therefore, investigating the HIV and Varicella-Zoster co-infection transmission dynamics using mathematical modeling approach is relatively necessary. The main objective of this study is to investigate the cost-effective analysis of the proposed optimal control strategies on the transmission dynamics of HIV and Varicella-Zoster co-infection in the community using compartmental modeling approach. Qualitatively, we have computed the model equilibrium points and analyze their local stabilities using Routh-Hurwitz stability criteria, the effective reproduction numbers by using the next generator matrix operator method, we re-formulated the optimal control problem of the complete co-infection model by implementing five time dependent optimal control strategies, analyzed the optimal control problem by applying the Pontryagin's Maximum/Minimum principle. Sensitivity analysis and numerical simulations have been carried out using the forward sensitivity index formula and the fourth order Runge-Kutta numerical methods respectively and verified the analytic results. Finally, we have performed the cost effective analysis for the proposed controlling strategies and from the result we have observed that implementing strategy four (treatment of Varicella-Zoster infected individuals to increase their recovery rate and recovery period) is the most cost effective-strategy as compared with other alternatives.