Evaluation of Influenza Intervention Strategies in Turkey with Fuzzy Ahp-Vikor
(Funda Samanlıoğlu)

In this study, a fuzzy AHP-VIKOR method is presented to help decision makers (DMs), especially physicians, evaluate and rank intervention strategies for influenza. Selecting the best intervention strategy is a sophisticated multiple criteria decision-making (MCDM) problem with potentially competing criteria. Two fuzzy MCDM methods, fuzzy analytic hierarchy process (F-AHP) and fuzzy VIsekriterijumska optimizacija i KOmpromisno Resenje (F-VIKOR), are integrated to evaluate and rank influenza intervention strategies. In fuzzy AHP-VIKOR, F-AHP is used to determine the fuzzy criteria weights and F-VIKOR is implemented to rank the strategies with respect to the presented criteria. A case study is given where a professor of infectious diseases and clinical microbiology, an internal medicine physician, an ENT physician, a family physician, and a cardiologist in Turkey act as DMs in the process.

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Determination of Epidemic Parameters from Early Phase Fatality Data: A case study of the 2009 A(H1N1) pandemic in Europe
(Ayşe Hümeyra Bilge, Funda Samanlıoğlu)

This paper demonstrates that the susceptible-infected-removed (SIR) model applied to the early phase of an epidemic can be used to determine epidemic parameters reliably. As a case study, the SIR model is applied to the fatality data of the 2009 fall wave cycle of the A(H1N1) pandemic in 12 European countries. It is observed that the best estimates of the basic reproduction number R0 and the mean duration of the infection period 1/η lie on a curve in the scatterplots, indicating the existence of a nearly-invariant quantity which corresponds to the duration of the epidemic. Spline interpolation applied to the early phase of the epidemic, an approximately 10-week period, together with a future control point in the stabilization region, is sufficient to estimate model parameters. The SIR model is run over a wide range of parameters and estimates of R0 in the range 1.2–2.0 match the values in the literature. The duration of the infection period, 1/η is estimated to be in the range 2.0–7.0 days. Longer infection periods are tied to spatial characteristics of the spread of the epidemic.

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An Overview of the 2009 A(H1N1) Pandemic in Europe: Efficiency of the Vaccination and Healthcare Strategies
(Funda Samanlıoğlu, Ayşe Hümeyra Bilge)

2009 A(H1N1) data for 13 European countries obtained from the weekly influenza surveillance overview (WISO) reports of European Centre for Disease Prevention and Control (ECDC) in the form of weekly cumulative fatalities are analyzed. The variability of relative fatalities is explained by the health index of analyzed countries. Vaccination and healthcare practices as reported in the literature are used to explain the departures from this model. The timing of the vaccination with respect to the peak of the epidemic and its role in the efficiency of the vaccination is discussed. Simulations are used to show that on-time vaccination reduces considerably the final value of R(t), R f, but it has little effect on the shape of normalized curve R(t)/R f.

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