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ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

Optimal Control of diarrhea Disease model With Vaccination

AND Treatment

Pardi Affandi1, Nur Salam 2

1
Department of Mathematics, Lambung Mangkurat University, Indonesia
2
Department of Statistic, Lambung Mangkurat University, Indonesia

Corresponding author: p_affandi@ulm.ac.id

Abstract. This study aims to analyze the spread of diarrheal diseases using a SIR-VT
(Susceptible-Infected-Recovered with Vaccination and Treatment) mathematical model and
analyze the characteristics of the spread of diarrheal disease. Based on the model obtained, it can
then be analyzed the stability criteria around the disease-free equilibrium point seen from its
basic reproductive number. Next, perform Optimal Control by involving vaccines and
treatments. Furthermore, by involving The Pontryagin's maximum principle to complete the
Mathematical Model of the Diarrhea Disease obtained.

1. Introduction

Diarrhea is a disease with signs of changes in the shape and consistency of feces, which softens to
the point of melting and increases the frequency of defecation more than usual, three or more times a
day or the disease occurs when there is a change in the stool consistency of the frequency of bowel
movements. Someone said to suffer from diarrhea when the stool is more runny than usual, or when
defecating three or more times, or defecating watery but not bleeding within 24 hours [6].
The eradication of diarrheal diseases is always carried out by the government through the South
Kalimantan Health Service (2016) and their achievements have improved, especially after the dry
season, but it is still a problem and need to make even harder efforts to achieve the target of diarrhea
free of 2025. So in addition to treatment, also needed the right treatment, treatment is a step taken to
overcome existing problems.
A model is a general characteristic that represents a group of existing forms or representations of a
problem in a simpler and easier to work form. Mathematical models obtained from a given mathematical
problem, then solved by the rules of the existing rules. Settlement obtained, needs to be tested to
determine whether the settlement is valid or not. A valid result will correctly answer the mathematical
model and is called a mathematical solution. If the solution is invalid or does not meet the mathematical
model, then the solution to the problem has not been found, and need to solve the mathematical model
[5].
Therefore, it is necessary to have an action to reduce the rate of spread of diarrheal diseases, one of
which is to know the pattern of spread of diarrheal disease. Mathematics can be used to determine the
spread pattern of diarrheal diseases by utilizing the SIR-VT mathematical model. Mathemathical SIR
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ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

model and SEIR model research by P Affandi and collegues [1][2]. Research on the model of the spread
of diarrheal disease has been widely carried out. One of them is modeling the spread of diarrheal disease
as a result of research by Ojaswita Chaturvedi and colleagues [3]. The research formed a SIR
mathematical model with a case study of the spread of diarrheal disease with one population, because it
only examined one population then in this model the death rate of diarrheal disease was not considered.
S.O. Adewale and colleagues (2015) also maked research about model considered four (4)
compartmental models to gain insight into the effect of vaccine on the dynamical spread of diarrhea
disease in a community [7].
In this study, The SIR-VT population model is a mathematical model to describe a disease involving
vaccines and treatments where an infected patient can recover and get the disease again. The initial step
is to determine the parameters that most influence diarrheal disease. Furthermore, controlling involves
involving vaccines and treatment of individuals, and analyzing the level of diarrheal infection.

2. Literature Review
2.1. Differential Equation Model mathematic SIR
One of the epidemic diseases and can make be model in mathematical models. The establishment of
this desease model. The assumptions used in the diarrheal disease model population of toddlers and
adults whose natural birth and death rates are considered constant, population is homogeneous, meaning
that every individual has the same chance of developing diarrhea. Individuals who recover from
diarrheal disease will become vulnerable again.

Figure 1. Model SIR

2.2 Diarrheal disease
Diarrheal diseases remain a leading cause of preventable death, especially among children under
five in developing countries. This chapter reviews and prioritizes a number of available interventions.
The normal intestinal tract regulates the absorption and secretion of electrolytes and water to meet the
body’s physiological needs. Diarrhea is caused by infectious organisms, including viruses, bacteria,
protozoa, and helminths, that are transmitted from the stool of one individual to the mouth of another,
termed fecal-oral transmission. Some are well known, others are recently discovered or emerging new
agents, and presumably many remain to be identified. [15].

2.3 Optimal Control

In the following discussion, the problems given in the case of optimal control with state end and the
end time is known. In other words, the target set S shaped{𝑆 = 𝑥1 (𝑡1 )}in the form (𝑥1, 𝑡1 )with𝑥1
specially element in Rn and 𝑡1 element at (T1,T2). Given the state system by the end and the end time
unknown 𝑥̇ (𝑡) = 𝑓[𝑥 (𝑡), 𝑢 (𝑡), 𝑡]with x(t) vector state size d𝑛𝑥1, u(t) input vector size d𝑚𝑥1, f a
vector valued function. Initially given state is X0 and initially time ist0. Target set S form
(𝑥1, 𝑡1 )witht 1 ϵ (T1 , T2 )knownvalueand 𝑡1 > 𝑡0 .Optimal control problem is to find the admissible
control u(t) with the initial value (𝑥0, 𝑡0 )and thefinal value (𝑥1, 𝑡1 ) that maximizes the objective
𝑡
function𝐽(𝑢) = ∫𝑡 1 𝐿(𝑥 (𝑡), 𝑢 (𝑡), 𝑡) 𝑑𝑡. To solve the problems mentioned above optimal control, first
0
determined necessary condition for optimal control are met [13].

3. Methodology
The research is planned to begin by conducting a literature review in the form of research results that
reveal the formation of diarrheal disease models, especially the factors and assumptions of the models

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ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

that have been carried out by several previous researchers. The results of the study form the basis for
developing initial assumptions and determining initial models that can be implemented and collecting
secondary data through survey data through an appropriate, reliable and valid data questionnaire.
Stages of processing research data using steps in the statistical method, beginning with
determining the parameters that are most influential as a factor causing diarrheal disease. This is done
with the help of the regression method so that from several factors a dominant factor will be obtained.

4. Model Formulation
In this paper we consider an SIR-VT model. This model subdivides SIR-VT model. Thus, at time t,
the total population:
N(t) = S(t) + I(t) + R(t) + T(t) + V(t)

Figure 2. Schematic representation of model

Table 1. Description of Variables and Parameters of the model.

Parameters Description

S(t) the number of susceptible individuals at time t

I(t) the number of infected individuals at time t
R(t) the number of recovered at time t
V(t) the number of vaccinated individuals at time t
T(t) treated class at time t
þ class of susceptible recruited individuals to be vaccinated
α constant recovery rate
β rate of contact that is sufficient to transmit the disease
b rate at which the vaccine wears offs
d death rate due to diarrhea disease
µ rate of natural death.
u1 rate at which the susceptible population is vaccinated
u2 rate at which infected people are treated
A Recruitment rate by birth or immigration
τ rate at which infected people are recovered

The population of susceptible individuals further reduced by natural death at the rate µ. We have
𝑑𝑆
= (1 − þ)A − βSI(t) + bV(t) − 𝑢1 S(t) − μS(t)
𝑑𝑡
The class population infected diarrhea individual increases by the susceptible individuals the rate β the
population later decreased by treatment rate (τ) for diarrhea infected individual and finally reduced by
the natural death rate, induced mortality death rate at µ. Thus,

3
ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

𝑑𝐼
= βSI(t) + (α + µ)I(t) − (α + 𝑢2 )𝐼 (t) − pØI(t)
𝑑𝑡
Recovered individuals are those that is further denoted by the number of individuals. The population
increased by new recovered from infected individuals who acquire diarrhea infection with effective
𝑑𝑅
contact with people infected with diarrhea. Hence, 𝑑𝑡 = (α + 𝑢2 )𝐼 (t) + τT(t) − µR(t)
The vaccinated individuals is increased by the fraction of vaccination from susceptible
individuals at the rate u1S and also þ . This population is decreased by natural death rate and vaccine
wanes off of vaccinated individuals at the rate µ respectively. Then, we have,
𝑑𝑉
= þA + 𝑢1 𝑆(t) − bVT(t) − µV(t)
𝑑𝑡
Individuals the treated class at time t denotes with,
𝑑𝑇
= pØI(t) − τT(t) − µI(t)
𝑑𝑡

4.2 Analysis Model

From the description of the dynamics of diarrhea as depicted in Figure 1, we have the following
set of ordinary differential equations system.
𝑑𝑆
= (1 − þ)A − βSI(t) + bV(t) − 𝑢1 S(t) − μS(t)
𝑑𝑡
𝑑𝐼
= βSI(t) + (α + µ)I(t) − (α + 𝑢2 )𝐼 (t) − pØI(t)
𝑑𝑡
𝑑𝑅
= (α + 𝑢2 )𝐼 (t) + τT(t) − µR(t)
𝑑𝑡
𝑑𝑉
= þA + 𝑢1 𝑆(t) − bVT(t) − µV(t)
𝑑𝑡
𝑑𝑇
= pØI(t) − τT(t) − µI(t)
𝑑𝑡
with initial conditions S(0) = S0, V(0) = V0, I(0) = I0, R(0) = R0, T(0) = T0.

5. Results
For the Existence and Uniqueness of solution,
Theorem 1: Following (Derrick and Grossman 1976) Let
𝑥11 = 𝑓1 (𝑥1 , 𝑥2 , 𝑥3 , … , 𝑡), 𝑥1 (𝑡0 ) = 𝑥1𝐴
𝑥21 = 𝑓1 (𝑥1 , 𝑥2 , 𝑥3 , … , 𝑡), 𝑥2 (𝑡0 ) = 𝑥2𝐴
.
.
𝑥𝑛1 = 𝑓𝑛 (𝑥1 , 𝑥2 , 𝑥3 , … , 𝑡), 𝑥𝑛 (𝑡0 ) = 𝑥𝑛𝐴

Let D denote the region in [(n+1)-dimensional space one dimension for t and n dimensions for the vector
∂fi
x]. If the partial derivatives , i, j = 1,2,..., n are continuous D = {(x,t),/t-t0/≤a, x-x0/≤b }. Then there
∂xj
is a constant δ >0 such that there exists a unique continuous vector solution
𝑥 = [𝑥1 (𝑡), 𝑥2 (𝑡), 𝑥3 (𝑡), … , 𝑥𝑛 (𝑡)]. Hence the problem has taken a unique solution and the model is
mathematically and epidemiologically well posed.
The point of free equilibrium is the state at which there are no infections in the population also
stability of an equilibrium point can be determined based on the eigenvalues matrix. System we have with
model nonlinear differential equations it can be determined by linearizing using a Jacobian matrix.
This diarrhea disease model has two equilibrium points, namely the disease-free equilibrium
point and the endemic equilibrium point. By definition, equilibrium point equations are derived from
𝑑𝑆 𝑑𝐼 𝑑𝑅 𝑑𝑉 𝑑𝑇
𝑑𝑡
= 0, 𝑑𝑡 = 0, 𝑑𝑡 = 0, 𝑑𝑡 = 0 , 𝑑𝑡 = 0. To determine the equilibrium point, the equation is formed

4
ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

𝑑𝐼
into, 𝑑𝑡 = 0 . Therefore I = 0. At this state, the only non-zero class is the susceptible class. So obtained
µ−𝑢2
value S∗ = 𝛽
order to get the asymptotic state, the right hand equation will be equated to zero.
The point of disease-free equilibrium no more infected individuals if I = 0 substituted to the
µ−𝑢 µ−𝑢
previous equation then obtained: S = 𝛽 2 . Then E0= ( 𝛽 2 ,0,0,0,0).
The endemic equilibrium point is a condition in which the invading disease still exists and is
still spreading if I ≠0 then we have
p(µ−𝑢2)
E1 = ( 𝛽
, (α+d+b)/β, (B + K)β-μ(α+d+L)/β(α+d+L), (B + K)βα-μα(α+d+p), βμ(α+d+L)).
3.3 Optimal Control For Diarrhea Disease Model
In this Section we use the optimal control theory to investigate the behavior of the model system.
Our main goal is to vaccinate as many susceptibles as to minimize the number of infected individuals
due to diarrhea and the cost of this strategy. The action of this drug can be controlled optimally by
applying the maximum principle of Pontryagin. The maximum principle of Pontryagin is a condition
such that it can be obtained by completion of optimal control in accordance with the objective of
maximizing performance index [9]. The state equation is:
𝑆 𝑆̇
𝐼 𝐼̇
ẋ = f(x(t), u(t), t) dan x = 𝑅 so the state equation becomes 𝑥̇ = 𝑅̇ or we have
𝑉 𝑉̇
[𝑇 ] [𝑇̇ ]
(1 − þ)A − βSI(t) + bV(t) − 𝑢1 S(t) − μS(t)
𝐼βSI(t) + (α + µ)I(t) − (α + 𝑢2 )𝐼(t) − pØI(t)
𝑥̇ = (α + 𝑢2 )𝐼(t) + τT(t) − µR(t)
þA + 𝑢1 𝑆(t) − bVT(t) − µV(t)
[ pØI(t) − τT(t) − µI(t) ]

The terminal time T, the problem is to minimize the objective functional J given as:
𝑇
𝑎1 2 𝑎2 2
𝐽(u1 , u 2 ) = ∫ (𝐼(𝑡) + u + u1 ) 𝑑𝑡
2 1 2
0
𝑈 = {𝑢 = (u1 , u 2 ) 0 ≤ u𝑖 ≤ u𝑖 max, i = 1,2}
Where 𝑎1 u
2 1
2
is minimization of cost of vaccine and vaccine rate; 𝑎2 u 2 is minimization of cost of
2 1
treatment and treatment rate. The goal is to find an optimal control pair u∗=(u1 ∗, u 2 ∗).
The representation of the optimal controls relies on Pontryagin’s maximum principle [12]. To apply this
we need to convert the optimal control problem into a problem of minimizing point-wise a Hamiltonian,
H, with respect to u. The Hamiltonian associated to our problem is:
𝐻 = 𝐿(𝑥 (𝑡), 𝑢(𝑡), 𝑡) + ∑𝑛𝑖=1 𝜆𝑖 (𝑡)(𝑓𝑖 (𝑥(𝑡)), 𝑢 (𝑡), 𝑡)
𝑎1 𝑎2
= 𝐼 (𝑡) + 2 u1 2 + 2 u1 2 + ∑5𝑖=1 𝜆𝑖 𝑓𝑖 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢)
𝑎1 𝑎2
= 𝐼 (𝑡) + 2 u1 2 + 2 u1 2 + 𝜆1 𝑓1 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢) + 𝜆2 𝑓2 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢) +
𝜆3 𝑓3 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢) + 𝜆4 𝑓4 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢) + 𝜆5 𝑓5 (𝑆, 𝐼, 𝑅, 𝑉, 𝑇, 𝑢)
𝑎1 𝑎2
= 𝐼 (𝑡) + u1 2 + u1 2 + 𝜆1 (1 − þ)A − βSI (t) + bV (t) − 𝑢1 S(t) − μS(t) + 𝜆2 𝐼βSI(t) + (α + µ)I(t)
2 2
(α + 𝑢2 )𝐼(t) − pØI(t) + 𝜆3 (α + 𝑢2 )𝐼(t) + τT(t) − µR(t) + 𝜆4( þA + 𝑢1 𝑆(t) − bVT (t) − µV(t))
−
𝜆5 (pØI(t) − τT(t) − µI(t))
+
Based on [10] [11] [13], if the control u∗ and the corresponding state φ∗ are an optimal couple,
necessarily there exists a non-trivial adjoint vector λ = ( λ1, λ2, λ3, λ4, λ5) satisfying the following
equality.

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ICSINTESA 2019 IOP Publishing
Journal of Physics: Conference Series 1807 (2021) 012032 doi:10.1088/1742-6596/1807/1/012032

𝜕𝐻
𝜆̇𝑖 = − , (𝑖 = 1,2, … 𝑛)
𝜕𝑥𝑖
𝜕𝐻
𝑥̇ 𝑖 = , (𝑖 = 1,2, … , 𝑛)
𝜕𝜆𝑖
(𝜆 −𝜆 )𝐼
So we have 𝑢1 ∗ = 𝑢1 ∗ , 0 < 1 𝑉 3 < 𝑢1 𝑚𝑎𝑥 and 𝑢2 ∗ = 𝑢2 ∗ , 0 < 𝜆3 𝑏 < 𝑢2 𝑚𝑎𝑥
This can be rewritten in compact notation as another equation. Next, we check the optimal control and
we find that it is indeed a minimum.

6. Conlusion and Future Scope

Deterministic epidemic model (SIR-VT) was considered to gain more insight into the effect of
vaccine and treatment of infected individuals on the dynamical spread of diarrhea in a population.
Vaccine give a vital in the control of the spread of diarrhea disease, the increase in susceptible
individuals is dependent of effectiveness of the vaccine given against diarrhea, if the vaccine decrease,
the lower would be the susceptible individuals and the lower would be the spread of the disease but
when the vaccine decrease off quickly it increases the number of infected individuals. This suggests that
vaccine should be given as early as possible immediately after birth before the exposure to diarrhea
infection and vaccine to be given must be effective in order to minimize the spread of the disease and
the cost.

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