Modelling the dynamics of alcohol and methamphetamine co-abuse in the Western Cape Province of South Africa

Orwa, Titus Okello (2014-12)

Thesis (MSc)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Clinical results have indicated that abuse of multiple drugs/substances has devastating health and social consequences. The combined abuse of alcohol and the highly addictive methamphetamine has worsened the drug epidemic in South Africa, especially in the Western Cape Province. Using non-linear ordinary differential equations, we formulate a deterministic mathematical model for alcohol-methamphetamine coabuse epidemic. We prove that the growth of the co-abuse epidemic is dependent on the threshold parameters of the individual substances of abuse. The substance with the maximum reproduction number dominates the epidemic. We also prove that the equilibria points of the co-abuse sub-models are locally and globally asymptotically stable when the sub-model threshold parameters are less than unity. Using parameters values derived from the sub-model fittings to data, a population estimate of co-users of alcohol and methamphetamine under treatment is estimated with a prevalence of about 1%. Although the results show of a small proportion of co-users of alcohol and methamphetamine in the province, the prevalence curve is indicative of a persistent problem. Numerical simulation results reveal that co-abuse epidemic would persists when both reproduction numbers are greater than one. Results from sensitivity analysis shows that the individual substance transmission rates between users of methamphetamine and/or alcohol and the general susceptible population are the most vital parameters in the co-abuse epidemic. This suggests the need to emphasise on preventive measures through educational campaigns and social programs that ensure minimal recruitment into alcohol or methamphetamine abuse. Model analysis using the time-dependent controls (policies) emphasizes the need to allocate even more resources on educational campaigns against substance abuse and on effective treatment services that minimizes or eliminates rampant cases of relapse into substance abuse.

AFRIKAANSE OPSOMMING: Kliniese resultate toon dat die misbruik van meer as een dwelmmiddel verwoestende gesondheids-en sosiale gevolge het. Die gekombineerde misbruik van alkohol en die hoogsverslawende methamphetamine het die dwelm-epidemie in Suid-Afrika vererger, veral in die Wes-Kaapse provinsie. Deur van nie-lineere gewone diffensiaalvergelykings gebruik te maak, formuleer ons ’n deterministiese wiskundige model vir epidemie van die gesamentlike misbruik van alkohol en methamphetamine. Ons toon aan dat die groei van die sogenaamde mede-misbruik epidemie afhanklik is van die drumpelparameters van die individuele middels wat misbruik word. Die middels met die grootste voortbringende syfer domineer die epidemie. Ons bewys ook dat die ekwilibriumpunte van die mede-misbruik submodelle plaaslik en globaal asimptoties stabiel is wanneer die sub-model drumpelparameters kleiner as een is. Deur die submodelle op werklike data te pas word waardes vir die drumpelparameters afgelei en word daar beraam dat daar ongeveer 1% van die populasie mede-misbruikers van alkohol en methamphetamine onder behandeling is. Alhoewel die data ’n klein persentasie van mede-misbruikers van alkohol en methamphetamine in die provinsie toon, dui die voorkomskurwe op ’n groeiende endemie en voortdurende probleem. Resultate uit numeriese simulasie toon dat die mede-misbruik epidemie sal voortduur indien beide reproduserende syfers groter as een sal wees. Resultate van sensitiwiteitsanalise toon dat die individuele middeloordragkoerse tussen gebruikers van methamphetamine en/of alkohol en die gewone vatbare populasie die mees noodsaaklike parameters in die mede-misbruik epidemie is. Dit stel voor dat daar meer klem gelê moet word op voorkomingsmaatreëls deur opvoedkundige veldtogte en sosiale programme om te verseker dat minder alkohol en/of methamphetamine misbruik sal word. Model-analise wat gebruik maak van tyd-afhanklike kontroles (beleide) lê verder klem op die feit dat selfs meer hulpbronne aan opvoedkundige veldtogte teen dwelmmisbruik toegewy moet word, asook die effektiewe behandeling wat gevalle van terugval in dwelmmisbruik sal minimeer of elimineer.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/95982
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