The epidemiology of human papilloma virus infection and vaccination, its impact on cervical cancer in Ghana

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This thesis is devoted to assess the impact of bivalent Human Papillomavirus (HPV) vaccine and Pap test on prevalence of carcinogenic HPV 16/18 types in Ghanaian females. For this purpose, a non-linear dynamic SIR model of homoge-neous transmission for HPV 16/18 type's infection is developed, which accounts for immunity due to vaccination in particular. The recovery class was R parti-tioned into two compartments, temporal recovery RT and permanent recovery Rp . We propose ODE equations to study HPV infection in the general female pop-ulation. Since HPV infection and its vaccination is age dependent, we propose PDE equations to study their behavior in two age groups, adolescent (9 25) and adult 25 and above. The vaccinated reproduction number R0 for general female population was derived using the approach described by Diekmann (2010) called the Next Generation Operator approach. We used a theory by Kermsck and McKendrick (1927) to derived basic reproductive number R0 for the adoles-cent and adult female population. The two models proposed were analyzed using quantitative method, with regard to steady-state stability and sensitivity analy-sis. Precisely, the stability of the models is investigated depending on the value for R0 for the disease free steady-state and Routh-Hurwitz criterion employed to study the stability of the endemic steady-state. Prevalence data are used to t a numerical HPV model, so as to assess infection rates. We also support our theoretical analysis with numerical simulations. This pro-vides a framework for future research and public-health policy to determine the dependence of HPV vaccination programs on age, as well as how the vaccine and Pap test can reduce the number of infections and deaths due to cervical cancer.
A thesis submitted to the Department of Mathematics, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the award of the degree of M.Phil Applied Mathematics