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05 September 2022 | Story Andrè Damons | Photo Andrè Damons
Prof Abdon Atangana
Prof Abdon Atangana, Professor of Applied Mathematics in the Institute for Groundwater Studies (IGS) and a highly cited mathematician for the years 2019-2021, says existing mathematical models are used to first fit collected data and then predict future events. It is for this reason he introduced a new concept that can be used to test whether the spread will have one or several waves.

With a new outbreak of the Ebola Virus Disease (EVD) reported this year in Democratic Republic of the Congo (DRC) – the 14th EVD outbreak in the country – researchers at the University of the Free State (UFS) introduced a new concept that can be used to test whether the spread will have one or several waves. They believe the focus should be to identify the source or the hosts of this virus for it to be a complete eradication. 

According to the Centers for Disease Control and Prevention (CDC), the Ministry of Health in the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola in Mbandaka health zone, Equateur Province on April 23, 2022. EVD, formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness affecting humans and other primates. The virus is transmitted to people from wild animals (such as fruit bats, porcupines and non-human primates) and then spreads in the human population through direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids, according to the World Health Organisation (WHO).
 
Prof Abdon Atangana, Professor of Applied Mathematics in the Institute for Groundwater Studies (IGS), says existing mathematical models are used to first fit collected data and then predict future events. Predictions help lawmakers to take decisions that will help protect their citizens and their environments. The outbreaks of COVID-19 and other infectious diseases have exposed the weakness of these models as they failed to predict the number of waves and in several instances; they failed to predict accurately day-to-day new infections, daily deaths and recoveries.

Solving the challenges of the current models

In the case of COVID-19 in South Africa, it is predicted that the country had far more infections than what was recorded, which is due to challenges faced by the medical facilities, poverty, inequality, and other factors. With Ebola in the DRC, data recorded are not far from reality due to the nature of the virus and its symptoms. However, the predictions show although some measures have been put in place in DRC and other places where the Ebola virus spread, they will still face some challenges in the future, as the virus will continue to spread but may have less impact. 

“To solve the challenges with the current models, we suggested a new methodology. We suggested that each class should be divided into two subclasses (Detected and undetected) and we also suggested that rates of infection, recovery, death and vaccination classes should be a function of time not constant as suggested previously. These rates are obtained from what we called daily indicator functions. For example, an infection rate should be obtained from recorded data with the addition of an uncertain function that represents non-recorded data (Here more work is still to be done to get a better approximation).

“I introduced a new concept called strength number that can be used to test whether the spread will have one or several waves. The strength number is an accelerative force that helps to provide speed changes, thus if this number is less than zero we have deceleration, meaning there will be a decline in the number of infections. If the number is positive, we have acceleration, meaning we will have an increase in numbers. If the number is zero, the current situation will remain the same,” according to Prof Atangana. 

To provide better prediction, he continues, reliable data are first fitted with the suggested mathematical model. This helps them to know if their mathematical model is replicating the dynamic process of the spread. The next step is to predict future events, to do this, we create three sub-daily indicator functions (minimum, actual, and maximum). These will lead to three systems, the first system represents the worst-case scenario, the second is the actual scenario, and the last is a best-case scenario.

Virus will continue to spread but with less impact

Using this method, Prof Atangana, a highly cited mathematician for the years 2019-2021, says he and Dr Seda Igret Araz, postdoctoral student, were able to predict that, although some measures have been put in place in DRC and other places where the Ebola virus spreads, they will still face some challenges in the future as the virus will continue to spread but may have less impact. 

To properly achieve the conversion from observed facts into mathematical formulations and to address these limitations, he had to ask fundamental questions such as what is the rate of infection, what is the strength of the infection, what are the crossover patterns presented by the spread, how can day-to-day new infected numbers be predicted and what differential operator should be used to model a dynamic process followed by the spread?

This approach was tested for several infectious diseases where we present the case of Ebola in Congo and Covid-19 in South Africa.  

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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