Journal of Physics: Conference

Series

PAPER • OPEN ACCESS You may also like

- Application of C4.5 and Naïve Bayes
Stability analysis of a diarrheal disease model Algorithm for Detection of Potential
Increased Case Fatality Rate Diarrhea
elucidated multiple transmission pathways and Mochamad Wahyudi and Anik Andriani

- Relation of knowledge and level of

infants as the most vulnerable education to the rationality of self-
medication on childhood diarrhea on the
Code River banks in Jogoyudan, Jetis,
To cite this article: A Fitriyah 2021 J. Phys.: Conf. Ser. 1882 012039 Yogyakarta
H Dania and M N Ihsan

- A spatial shared component random

intercept model for assessing risk of
diarrhea among men and women
View the article online for updates and enhancements. Kismiantini and I G N M Jaya

This content was downloaded from IP address 180.241.178.117 on 08/05/2024 at 16:08

SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

Stability analysis of a diarrheal disease model elucidated

multiple transmission pathways and infants as the most
vulnerable

A Fitriyah1
1
Universitas Islam Negeri Walisongo Semarang, Jl. Prof. Dr. Hamka Km. 1 Semarang,
Indonesia

E-mail: ainifitriyah@walisongo.ac.id

Abstract. This study forms and analyzes a mathematical model of diarrheal disease.The model
allows two pathways of disease transmission through infected people and water resources
contaminated by pathogens that cause diarrhea. Babies are the most vulnerable to diarrhea, so
that this modeling considers the difference in effective contact rate between susceptible babies
and adults. Based on the assumptions, the model has formed a system of ordinary differential
equations. A literature study is used to analyze the equilibrium and stability of it. Analysis found
a disease-free equilibrium and an endemic equilibrium that are stable depends on a basic
reproduction number (R0). The disease-free equilibrium is locally asymptotically stable when
R0<1. It means diarrhea will disappear so that population is free from diarrhea for a long time.
Furthermore, if R0>1 and several conditions are fulfilled, then the endemic equilibrium is also
locally asymptotically stable. It means that for a long time, diarrhea will be an epidemic in
population. Simulation of the model is given by using Matlab to verify the result of analysis.

1. Introduction
Diarrhea is one of waterborne diseases which are caused by pathogens. It affects almost all regions in
the world. However, it commonly hits in low and middle income countries that have not had proper
sanitation, water and hygiene (wash) [1]. Indonesia is also one of countries where many people suffer
from diarrhea. It is recorded that Indonesian residents from various provinces have diarrhea sufferers.
The tootal sufferers of diarrhea in Indonesia reached 8% in 2018 [2].
Researchers have previously carried out modeling and analysis of diarrheal diseases. However, each
model compiled is different. This is because researchers have their own objectives, problem boundaries
and assumptions which are certainly different from one another. Previous studies was related to the
mathematical model of diarrhea was conducted by Adewale and friends [3]. They studied a
mathematical model of diarrheal disease in regard to vaccine administration. Furthermore, in another
study research, a mathematical model of diarrheal disease was in the form of SIS or Susceptible-Infected-
Susceptible by noticing that diarrhea often causes death in children [4].
Another mathematical model analysis of diarrheal diseases was also carried out by Chaturvedi and
friends [5]. They had developed, analyzed and simulated a diarrhea model as a form for preventing the
spreading of disease and mortality because of it. On the other hand, Ebenezer Bonyah and friends [6]
conducted an analysis of diarrheal diseases with a saturated incidence rate. Next in the same year, Hailay
Weldegiorgis Berhe and friends [7] conducted a sensitivity analysis of an epidemic model of diarrhea
dysentery and estimation of the parameters that appeared in it.
Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution
of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Published under licence by IOP Publishing Ltd 1
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

Referring to those previous studies, this paper analyzes diarrheal diseases using a different
mathematical model. Based on literature studies, it is known that pathogens that cause infectious
diarrhea can live and thrive in water at certain temperatures and salt content [8]. However, these
pathogens also die easily under acidic conditions in water [9]. Therefore, in this study, a mathematical
model of diarrhea disease was formed by creating a new compartment that represents the concentration
of pathogens that cause diarrhea in resevoir.
The arrangement of the model in this study also refers to the research which is conducted by Sri
Rejeki Retno Yuliani [4]. The study noted that infants and children are the main sufferers of diarrhea.
This is also consistent with the date data from World Health Organization [1][10]. Therefore, the model
in this paper is divided into two subpopulations, namely the subpopulations of babies and adults who
are prone to diarrhea.

2. Model description
Diarrhea can be divided into two types. They are the infectious diarrhea and the non-infectious diarrhea.
The infectious diarrhea is caused by pathogens such as viruses, parasites and bacteria. It can be
transmitted quickly to susceptible individual who has contact with the pathogens. Meanwhile, the non-
infectious diarrhea is caused by toxins, chronic diseases, or antibiotics. In contrast to the infectious
diarrhea, it cannot be transmitted from person to person [11].
This article discusses about the infectious diarrhea. The pathogens that cause diarrhea can die or
decrease in number in the water. Pathogens from an infected individuals can spread and transmit the
disease to susceptible individuals or reservoir. Transmission can easily occur in an environment that has
poor sanitation or people who do not wash their hands properly.
Susceptible individuals are divided into two kinds, namely babies and adults. That is because babies
and children are more prone to diarrhea than adults. So they are susceptible to diarrhea if having a
contact with contaminated reservoir or infected individuals. Individuals who recover from diarrhea are
assumed to be immune to the disease. The other assumptions in this study are diarrhea does not cause
death, the incubation period is short, and the population is constant.
Based on those assumptions, a mathematical model of diarrheal disease is formed as in figure 1. The
variables and parameters desription can be seen in table 1 and table 2. Based on figure 1, we can form a
differential equation system (1).

dSb
  N   Sb   b Sb I   b SbW   Sb
dt
dS d
  Sb   S d   d S d I   d S d W
dt
dI
  b Sb I   b SbW   d S d I   d S dW   I   I
dt
dR
  I  R
dt
dW
  I  W
dt
(1)

2
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

Figure 1. Diagram transfer of diarrheal mathematical model.

The next step is the model is changed to be dimensionless variables to simplify the analysis by
considering:
Sb Sd
sb  , sd  ,
N N
I R
i , r ,
N N
W
w ,
N
b N
ab   b N , bb  ,

 N
ad   d N , bd  d .

We have a new differential equation system (2).
dsb
    sb  ab sbi  bb sb w   sb
dt
dsd
  sb   sd  ad sd i  bd sd w
dt
di
 ab sbi  bb sb w  ad sd i  bd sd w  i   i (2)
dt
dr
  i  r
dt
dw
  (i  w)
dt

dr
In the next analysis process, the equation in System (2) will be ignored. This is because of the
dt
variable r has no effect on the other equations.

3
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

Table 1. Definition of variables are used in the system (1).

Variable Description Sample unit

Sb Susceptible baby density Individual km2
Sd Susceptible adult density Individual km2
I Infected individual density Individual km2
R Removed/ recovered individual density Individual km2
W Pathogen concentration in the water sources Cell/ml
N Total population density Individual km2

Table 2. Definition of parameters are used in the system (1).

Parameter Description Sample unit
 Natural birth/ death rate Per day
km 2
b Infective contact rate of infected individuals and susceptible babies
individual day
km 2
d Infective contact rate of infected individuals and susceptible adults
individual day
ml
b Infective contact rate of susceptible babies and contaminated water cell day
ml
d Infective contact rate of susceptible adults and contaminated water cell day
 Growth rate from susceptible toddlers to susceptible adults Per day
 Recovery rate Per day
cell km 2
 The pathogen shedding rate to reservoir by infected individuals
ml individual day
 Pathogen decay rate in the water Per day

3. Result and discussion

   
System (2) always has a disease-free equilibrium point namely E*   , , 0, 0  . Next,
     
we determine the basic reproduction number which uses the next generation matrix method. The
equation for compartments i and w are taken and then we set up matrix F dan V as follows
 a s i  bb sb w  ad sd i  bd sd w   i   i 
F b b  and V    (i  w) 
 0   
Then the matrix F and V in order 2  2 are formed as
 F   V 
F   i (0, y0 )  and V   i (0, y0 )  with i, j  1, 2 and (0, y0 ) is the point of disease-free
 x j   x j 
Fi a s  a s b s  b s  Vi    0 
equilibrium. if ( x, y)   b b d d b b d d  and ( x, y)    then
x j  0 0  x j    

4
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

 ab   ad  bb   bd  
   0
F         and V  
 
. So we have the next matrix generation is
   
 0 0 
 ab   ad  bb   bd  bb   bd  
 
FV 1
 (    )(    ) (    )(    ) (    ) 
 
 0 0 
ab   ad  bb   bd 
The two eigen values of matrix FV 1 are 0 and  . Since all parameters
(    )(    ) (    )(    )
 ,  ,  and variables ab , bb , ad , bd are positive, the spectral radius of matrix FV 1 or the basic
reproduction number of the model is
(ab  bb )   (ad  bd )
R0 
(    )(    )
Based on the value of R0 , if R0  1 system (2) has an endemic equilibrium point Eˆ  ( sˆb , sˆd , iˆ, w
ˆ)
with

sˆb  ,
    (ab  bb )iˆ

sˆd 
(   ( ad  bd )i )((    )  (ab  bb )iˆ)
ˆ

 B  B 2  4 AC
iˆ 
2A
A  (    )(ab  bb )(ad  bd )
B  (    )(    )(ad  bd )
  (ab  bb )      (ad  bd ) 
C   (    )(    )(1  R0 )
wˆ  iˆ

   
Theorem 1. If R0  1 , then the disease-free equilibrium point E*   , , 0, 0  of system
     
(2) is locally asymptotically stable.

Proof. The characteristic equation for J ( E*) is by taking  as the eigenvalue we have
J ( E*)  I  0,
 a   ad       
 (   )(     )  b       (  )   bb  bd     0 (3)
           
We get two eigen values  1   and  2      .
ab   ad 
While the other two eigenvalues are obtained by assuming A    
 
   
and B   bb  bd  then from equation (3) we can write
      

5
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

 2  (  A)  A  B  0 , or z0 2  z1  z2  0 with z0  1 , z1    A and z2   A  B .

z1 z
When R0  1 we obtain  0 , 2  0 , 1  0 and  2  0 . Based on Routh-Hurwitz criterion, it is
z0 z0
found that the real part of the other two eigenvalues of characteristic equation for J ( E*) is negative.

So, we can conclude that when R0  1 we get all real parts of eigen values of matrix system (2) are
negative. Hence the disease-free equilibrium point E*  ( sb *, sd *, i*, w*) is locally asymptotically
stable. ∎
Furthermore, analysis will be carried out which is related to the stability of the endemic equilibrium
point. Suppose:

g11     abiˆ  bb wˆ   , g13   ab sˆb , g14  bb sˆb , g 22     ad ibˆ d wˆ ,

g 23   ad sˆd , g 24  bd sˆd , g31  abiˆ  bb wˆ , g 32  ad iˆ  bd wˆ ,
g33  ab sˆb  ad sˆd     , g34  bb sˆb  bd sˆd ,

 g11 0 g13 g14 

 g 22 g 23 g 24 
Then J ( Eˆ ) can be stated as J ( Eˆ )   . Supposed the following equations:
 g31 g32 g33 g34 
 
0 0   

P0  1
P1    g33  g11  g 22
P2  g11 g33  g 22 g33  g11 g 22  g13 g31  g 23 g 32   ( g 33  g11  g 22  g 34 )
P3  g13 g31 g 22  g11 g 23 g 32  g11 g 22 g33  g13 g32   ( g13 g31  g 23 g 32
 g11 g33  g 22 g33  g11 g 22  g14 g31  g 24 g32  g11 g34  g 22 g34 )
P4   ( g11 g 22 g33  g13 g32  g13 g31 g 22  g11 g 23 g32  g11 g 22 g34
 g14 g32  g14 g31 g 22  g11 g 24 g32 )

The characteristic equation of J ( Eˆ ) is found by taking  as the eigenvalues then we have

P0 4  P1 3  P2 2  P3  P4  0

The endemic equilibrium point is locally asymptotically stable if
P1 , P2 , P3 , P4  0 , P1 P2  P3 and P3 ( PP
1 2  P3 )  P1 P4
2
(4)
This is because all real parts of the eigen values of the characteristic equation will be negative under
these conditions based on Routh-Hurwitz’s criterion. So we get the following theorem.

Theorem 2. The endemic equilibrium point is exist and locally asymptotically stable when R 0>1 and
some conditions (4) are met.

6
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

4. Simulations
Numerical simulation in this article is done bu using Matlab. It is assumed that the total population in a
diarrheal infected area is 10,000 people. The first case is taken the parameter values as table 3. Based
on the values we have R0  0, 44  1 as the basic reproduction number and E*  (0, 45;0,55;0;0) as
the disease-free equilibrium point. The solution graph is presented in figure 2. The graph is moving
towards the disease-free equilibrium point E * . So It shows that the simulation and analysis result are
relevant and we can conclude that the disease-free equilibrium point is locally asymptotically stable.

Table 3. The parameter values for simulation.

Parameter Nilai Sumber
 0,000457 [7]
b 108 Assumed
d 11109 [12]
b 0,0005 Assumed
d 0,0001 [13]
 0,00055 [4]
 0,333 [14]
 0,025 [13]
 0,048 [9]

Figure 2. The solution graph when R0  1 . Figure 3. The solution graph when R0  1 .

The second case is taken the parameter values as Table 3 but  b and b values are assumed to be
10 and 0,005 respectively. Based on the values we have R0  3, 63  1 as the basic reproduction
7

number and Eˆ  (0,1253;0,1352;0,001;0,001) as the endemic equilibrium point. The solution graph
is presented in figure 3. The graph is moving towards the endemic equilibrium point Ê . So it shows
that the simulation and analysis result are relevant and we can conclude that the endemic equilibrium
point is locally asymptotically stable.

7
SEA-STEM 2020 IOP Publishing
Journal of Physics: Conference Series 1882 (2021) 012039 doi:10.1088/1742-6596/1882/1/012039

5. Conclusion
Based on assumptions, model is in the form of an ordinary differential equation system as (2). Analysis
found a disease-free and endemic equilibrium are stable depend on a basic reproduction number ( R0 ).
The disease-free equilibrium is locally asymptotically stable when R0  1 . It means diarrhea will
disappear so that population is free from diarrhea for a long time. Furthermore, if R0  1 and several
conditions are fulfilled, then the endemic equilibrium is also locally asymptotically stable. It means that
for a long time, diarrhea will be an epidemic in the population. Simulation of the model is done using
Matlab to verify the result of analysis.

References
[1] World Health Organization 2019 update Safer Water Better Health (Geneva: World Health
Organization)
[2] Kementerian Kesehatan Republik Indonesia 2018 Hasil Utama Riskedas 2018 (Indonesia:
Kementerian Kesehatan RI)
[3] Adewale S O, Olopade I A, Ajao S O and Adeniran G A 2015 Mathematical analysis of Diarrhea
in the presence of vaccine International Journal of Scientific & Engineering Research 6 396-
404.
[4] Yuliani S R 2016 Analisis Penyebaran Penyakit Diare Sebagai Salah Satu Penyebab Kematian
Balita Menggunakan Model Matematika SIS (Yogyakarta: UNY)
[5] Chaturvedi, O, Masupe S and Lungu E 2017 Epidemic model formulation, analysis and
simulation of Rotavirus Diarrhea for prevention Asian Research Journal of Mathematics 6 1-
14
[6] Bonyah E, Twagirumukiza G and Gambrah P P 2019 Mathematical analysis of Diarrhea model
with saturated incidence rate Open Journal of Mathematical Sciences 3 29-39
[7] Berhe H W, Makinde O D and Theuri D M 2019 Parameter estimation and sensitivity analysis of
Dysentery Diarrhea epidemic model Journal of Applied Mathematics 2019 1-13
[8] Hunter P R 1997 Waterborne Infection- Epidemiology (England: John Wiley & Son)
[9] Amelia S 2005 Vibrio Cholerae (Medan: Departemen Mikrobilogi Fakultas Kedokteran
Universitas Sumatera Utara)
[10] World Health Organization 2010 WHO Recommendations on The Management of Diarrhoea and
Pneumonia in HIV-Infected Infants and Children (Geneva: World Health Organization)
[11] New Hampshire Department of Health and Human Services 2018 revised Diarrhea (Infectious
Diarrhea) (Bureau of Infectious Disease Control)
[12] Posny D, Wang J, Mukandavire Z, and Modnak C 2015 Analyzing transmission dynamics of
Cholera with public health interventions Mathematical Biosciences 264 38-53.
[13] Misra A K and Singh V 2012 A delay mathematical model for the spread and control of
waterborne diseases Journal of Theoretical Biology 301 49-56
[14] Shuai Z and Driessche P 2011 Global dynamics of Cholera models with differential infectivity
Mathematical Biosciences 234 118-26