In this paper, we present a new method for developing a class of nested multiscale models for directly transmitted infectious disease systems that integrates within-host scale and between-host scale using community pathogen load (CPL) as a new public health measure of a community’s level of infectiousness and as an indicator of the effectiveness of health interventions. The approach develops a multiscale modeling science base for directly transmitted infectious disease systems (where the inside-host environment’s biological entities such as cells, tissues, organs, body fluids, whole body are the reservoir of infective pathogen in the community) that is comparable to an existing multiscale modeling science base for environmentally transmitted infectious diseases (where the outside-host geographical environment’s physical entities such as soil, air, formites/contact surfaces, food and water are the reservoir of infective pathogen in the community) where pathogen load in the environment is explicitly incorporated into the model. This is achieved by assuming that infected hosts in the community are homogeneous and unevenly distributed microbial habitats. We illustrate the utility of this multiscale modeling methodology by evaluating the comparative effectiveness of HIV/AIDS preventive and treatment interventions as a case study.

中文翻译：

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从个人健康到社区健康：迈向直接传播传染病系统的多尺度建模

在本文中，我们提出了一种新方法，用于开发一类用于直接传播的传染病系统的嵌套多尺度模型，该模型使用社区病原体负荷 (CPL) 作为社区病原体负荷的新公共卫生措施，整合宿主内尺度和宿主间尺度。传染性水平，并作为卫生干预措施有效性的指标。该方法为直接传播的传染病系统（其中宿主内部环境的生物实体，如细胞、组织、器官、体液、全身是群落中传染性病原体的储存库）开发了一个多尺度建模科学基础，该系统可与现有的环境传播传染病多尺度建模科学基础（其中外部宿主地理环境的物理实体，如土壤、空气、甲醛/接触表面、食物和水是社区中感染性病原体的储存库），其中环境中的病原体负荷被明确纳入模型。这是通过假设社区中受感染的宿主是同质且分布不均匀的微生物栖息地来实现的。我们通过评估 HIV/AIDS 预防和治疗干预措施的比较有效性作为案例研究来说明这种多尺度建模方法的效用。