<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">AID</journal-id><journal-title-group><journal-title>Advances in Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">2164-2648</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/aid.2015.51001</article-id><article-id pub-id-type="publisher-id">AID-54138</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  Mathematical Analysis of Control Strategies of HCV in a Community with Inflow of Infected Immigrants
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>eterindwa</surname><given-names>Ainea</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Estomih</surname><given-names>S. Massawe</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Oluwole</surname><given-names>Daniel Makinde</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lucy</surname><given-names>Namkinga</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Mathematics Department, University of Dar es Salaam, Dar es Salaam, Tanzania</addr-line></aff><aff id="aff2"><addr-line>Faculty of Military Science, Stellenbosch University, Cape Town, South Africa</addr-line></aff><aff id="aff3"><addr-line>Department of Molecular Biology and Biotechnology, University of Dar es Salaam, Dar es Salaam, Tanzania</addr-line></aff><pub-date pub-type="epub"><day>16</day><month>02</month><year>2015</year></pub-date><volume>05</volume><issue>01</issue><fpage>1</fpage><lpage>13</lpage><history><date date-type="received"><day>24</day>	<month>January</month>	<year>2015</year></date><date date-type="rev-recd"><day>accepted</day>	<month>15</month>	<year>February</year>	</date><date date-type="accepted"><day>16</day>	<month>February</month>	<year>2015</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  In this paper, we derive and analyse rigorously a mathematical model of control strategies (screening, education, health care and immunization) of HCV in a community with inflow of infected immigrants. Both qualitative and quantitative analysis of the model is performed with respect to stability of the disease free and endemic equilibria. The results show that the disease free equilibrium is locally stable at threshold parameter less than unity and unstable at threshold parameter greater than unity. Using Lyapunov method, endemic equilibrium is globally stable under certain conditions. Numerical simulation of the model is implemented to investigate the sensitivity of certain key parameters on the HCV model in a community with inflow of infected immigrants. However, analysis shows that screening, education, health care and immunization have the effect of reducing the transmission of the disease in the community.
 
</p></abstract><kwd-group><kwd>HCV Disease</kwd><kwd> Infected Immigrants</kwd><kwd> Stability</kwd><kwd> Sensitivity Index</kwd><kwd> Lyapunov Method</kwd><kwd> Screening</kwd><kwd> Education</kwd><kwd> Health Care and Immunization</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>Hepatitis C is a blood borne liver disease, caused by the Hepatitis C Virus (HCV), first identified by [<xref ref-type="bibr" rid="scirp.54138-ref1">1</xref>] . Moreover, the link between infectious diseases and screening must be understood in relation to infectives on the spread of HCV infections. [<xref ref-type="bibr" rid="scirp.54138-ref2">2</xref>] analysed the screening of HCV in a health maintenance Organization. Mathematical modelling of the spread of infectious diseases continues to become an important tool in understanding the dynamics of diseases and in decision making processes regarding diseases intervention programs for disease in many countries. For instance, [<xref ref-type="bibr" rid="scirp.54138-ref3">3</xref>] formulated and analysed a mathematical model on the effect of Treatment and Infected Immigrants on the spread of Hepatitis C Virus disease at Acute and Chronic stages. [<xref ref-type="bibr" rid="scirp.54138-ref4">4</xref>] considered SEI (Susceptible-Exposed-Infective) epidemic model with acute and chronic stages. [<xref ref-type="bibr" rid="scirp.54138-ref5">5</xref>] investigated the effects of a HCV educational intervention or a motivational intervention on alcohol use and sexual risk behaviours among injection drug users. [<xref ref-type="bibr" rid="scirp.54138-ref6">6</xref>] studied the potential impact of vaccination on the hep C virus epidemic in injection drug users. [<xref ref-type="bibr" rid="scirp.54138-ref7">7</xref>] presented the study on immunization strategies in chronic HCV infection. [<xref ref-type="bibr" rid="scirp.54138-ref8">8</xref>] reported that HCV patient education is associated with positive outcomes in various models of HCV care. However, in all the above studies, none of them incorporated the HCV infectiology and control strategies (screening, education, health care and immunization) in a community with inflow of infected immigrants. The aim of the paper is to have a deeper understanding of the effects of screening, education, health care and immunization in controlling the spread of HCV.</p></sec><sec id="s2"><title>2. Model Formulation</title><p>A mathematical model is proposed and analysed to study the effect of screening, education, health care and immunization on the spread of HCV disease in the community. The model has five epidemiological classes: The susceptible<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x6.png" xlink:type="simple"/></inline-formula>, exposed individuals<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x7.png" xlink:type="simple"/></inline-formula>, the acute Infectives<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x8.png" xlink:type="simple"/></inline-formula>, the chronic infectives <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x9.png" xlink:type="simple"/></inline-formula> and recovered group<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x10.png" xlink:type="simple"/></inline-formula>. Total population at time <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x11.png" xlink:type="simple"/></inline-formula> is given by:</p><disp-formula id="scirp.54138-formula135"><label>(1)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x12.png"  xlink:type="simple"/></disp-formula><p>The interaction between the classes is being assumed as follows: Exposed individuals, acute infected and chronic infected immigrants enter into the population with the rates <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x13.png" xlink:type="simple"/></inline-formula> respectively. Susceptible indi-</p><p>viduals are infected with the HCV virus at a rate<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x14.png" xlink:type="simple"/></inline-formula>, where <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x15.png" xlink:type="simple"/></inline-formula> and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x16.png" xlink:type="simple"/></inline-formula> are effective con-</p><p>tact rate of individuals with acute and chronic hepatitis C respectively. It is assumed that the rate of contact of susceptibles with chronic individuals is much less than that of acute infectives <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x17.png" xlink:type="simple"/></inline-formula> because at chronic stage, people become aware of their infection and may choose to use control measures and change their behaviour and thus may contribute little in spreading the infection. The control variable based on screening programme aimed at, reduces the inflow of infected immigrants into the community at the rate <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x18.png" xlink:type="simple"/></inline-formula> and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x19.png" xlink:type="simple"/></inline-formula> is the control variable based on education, health care and immunization to decrease the infection contact rate.</p><p>Taking into account the above considerations, we then have the following schematic flow diagram (<xref ref-type="fig" rid="fig1">Figure 1</xref>):</p><fig id="fig1"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref></label><caption><title> Model flowchart</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x20.png"/></fig><p>From the above flow chart, and with</p><disp-formula id="scirp.54138-formula136"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x21.png"  xlink:type="simple"/></disp-formula><p>the model will be governed by the following system of equations:</p><disp-formula id="scirp.54138-formula137"><label>(2)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x22.png"  xlink:type="simple"/></disp-formula><p>with nonnegative initial conditions and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x23.png" xlink:type="simple"/></inline-formula>.</p><p>where</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x24.png" xlink:type="simple"/></inline-formula>are the effective contact rates of individuals with acute and HCV respectively,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x25.png" xlink:type="simple"/></inline-formula>are the rates at which exposed, acute and Chronic infected immigrants enter into the population respectively,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x28.png" xlink:type="simple"/></inline-formula>is the recruitment rate,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x29.png" xlink:type="simple"/></inline-formula>is the rate of progression to acute infected class from exposed class,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x30.png" xlink:type="simple"/></inline-formula>are the rates at which acute and exposed infective develop chronic respectively,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x31.png" xlink:type="simple"/></inline-formula>are the rates at which acute and chronic individuals recovered respectively,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x32.png" xlink:type="simple"/></inline-formula>is the death rate of acute infected group due to the disease,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x33.png" xlink:type="simple"/></inline-formula>is the rate at which infectious humans after recovery become immediately susceptible again,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x34.png" xlink:type="simple"/></inline-formula>is the natural death rate,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x35.png" xlink:type="simple"/></inline-formula>is the death rate of chronic infected group due to the disease,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x36.png" xlink:type="simple"/></inline-formula>is the screening rate of infected immigrants.</p></sec><sec id="s3"><title>3. Model Analysis</title><p>The model system of Equations (2) will be analysed qualitatively to get insight into its dynamical features which will give a better understanding of the effects of screening, education, health care and immunization on the transmission of HCV infection in the population with inflow of infected immigrants. The threshold which governs elimination or persistence of HCV will be determined and studied. We begin by finding the invariant region and show that all solutions of system (2) are positive<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x37.png" xlink:type="simple"/></inline-formula>.</p><sec id="s3_1"><title>3.1. Invariant Region</title><p>In this section, a region in which solutions of the model system (2) are uniformly bounded is the proper subset</p><disp-formula id="scirp.54138-formula138"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x38.png"  xlink:type="simple"/></disp-formula><p>Let <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x39.png" xlink:type="simple"/></inline-formula> be any solution with positive initial conditions. Then from Equation (2) it is noted that in the absence of the disease related mortality (i.e.<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x39.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x40.png" xlink:type="simple"/></inline-formula>), the rate of change of the population is given by,</p><disp-formula id="scirp.54138-formula139"><label>(3)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x41.png"  xlink:type="simple"/></disp-formula><p>Using Birkhoff and Rota’s theorem [<xref ref-type="bibr" rid="scirp.54138-ref9">9</xref>] on the differential inequality (3), the following expression is obtained;</p><disp-formula id="scirp.54138-formula140"><label>(4)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x42.png"  xlink:type="simple"/></disp-formula><p>where <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x43.png" xlink:type="simple"/></inline-formula> is the value evaluated at the initial conditions of the respective variables.</p><p>Thus, as <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x44.png" xlink:type="simple"/></inline-formula> in (4), the population size, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x44.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x45.png" xlink:type="simple"/></inline-formula>, which implies that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x44.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x45.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x46.png" xlink:type="simple"/></inline-formula> In respectof this, all the feasible solutions of system (2) enter the region<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x44.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x45.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x46.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x47.png" xlink:type="simple"/></inline-formula>.</p><p>Hence, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x48.png" xlink:type="simple"/></inline-formula>is positively invariant and it issufficient to consider solutions in<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x48.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x49.png" xlink:type="simple"/></inline-formula>.</p><p>Furthermore, existence, uniqueness and continuation of results for system (2) hold in this region.</p><p>Lemma 1: The region <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x50.png" xlink:type="simple"/></inline-formula> is positively invariant for the model system (2) with initial conditions in<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x50.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x51.png" xlink:type="simple"/></inline-formula>.</p></sec><sec id="s3_2"><title>3.2. Positivity of Solutions</title><p>Lemma 2: Let the initial data be <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x52.png" xlink:type="simple"/></inline-formula> then, the solution set <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x52.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x53.png" xlink:type="simple"/></inline-formula> of the system (2) is positive <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x52.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x53.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x54.png" xlink:type="simple"/></inline-formula></p><p>Proof:</p><p>From the first equation of the model system (2), we have</p><disp-formula id="scirp.54138-formula141"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x55.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.54138-formula142"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x56.png"  xlink:type="simple"/></disp-formula><p>The Integration factor is<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x57.png" xlink:type="simple"/></inline-formula>, multiplying both sides by the integration factor and integrating leads to</p><disp-formula id="scirp.54138-formula143"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x58.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.54138-formula144"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x59.png"  xlink:type="simple"/></disp-formula><p>Equations for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x60.png" xlink:type="simple"/></inline-formula> can be similarly be obtained.</p><p>Thus <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x61.png" xlink:type="simple"/></inline-formula> are positive<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x61.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x62.png" xlink:type="simple"/></inline-formula>.</p></sec><sec id="s3_3"><title>3.3. The Disease Free Equilibrium Point (DFE)</title><p>In the absence of the disease, which implies that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x63.png" xlink:type="simple"/></inline-formula> the disease free equilibrium points is given by</p><disp-formula id="scirp.54138-formula145"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x64.png"  xlink:type="simple"/></disp-formula></sec><sec id="s3_4"><title>3.4. The Effective Reproductive Number R<sub>e</sub></title><p>In this section, the threshold parameter that governs the spread of a disease which is called the effective reproduction number is determined. Mathematically, it is the spectral radius of the next generation matrix [<xref ref-type="bibr" rid="scirp.54138-ref10">10</xref>] .</p><p>This definition is given for the models that represent spread of infection in a population. It is obtained by taking the largest (dominant) Eigen value, (spectral radius) of</p><disp-formula id="scirp.54138-formula146"><label>(5)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x65.png"  xlink:type="simple"/></disp-formula><p>where <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x66.png" xlink:type="simple"/></inline-formula> is the rate of appearance of new infection in compartment<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x67.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x68.png" xlink:type="simple"/></inline-formula>is the transfer of individuals out of the compartment <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x68.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x69.png" xlink:type="simple"/></inline-formula> by all other means and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x66.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x67.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x68.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x69.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x70.png" xlink:type="simple"/></inline-formula> is the disease free equilibrium.</p><p>Therefore,</p><disp-formula id="scirp.54138-formula147"><label>(6)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x71.png"  xlink:type="simple"/></disp-formula><p>and</p><disp-formula id="scirp.54138-formula148"><label>(7)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x72.png"  xlink:type="simple"/></disp-formula><p>The partial derivatives if (6) and (7) with respect to <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x73.png" xlink:type="simple"/></inline-formula> gives</p><disp-formula id="scirp.54138-formula149"><label>(8)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x74.png"  xlink:type="simple"/></disp-formula><p>and</p><disp-formula id="scirp.54138-formula150"><label>(9)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x75.png"  xlink:type="simple"/></disp-formula><p>In the absence of the disease and when<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x76.png" xlink:type="simple"/></inline-formula>, the matrix (8) becomes</p><disp-formula id="scirp.54138-formula151"><label>(10)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x77.png"  xlink:type="simple"/></disp-formula><p>Now, taking the inverse of matrix (9) leads to</p><disp-formula id="scirp.54138-formula152"><label>(11)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x78.png"  xlink:type="simple"/></disp-formula><p>where</p><disp-formula id="scirp.54138-formula153"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x79.png"  xlink:type="simple"/></disp-formula><p>The spectral radius (dominant eigenvalue) of the matrix <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x80.png" xlink:type="simple"/></inline-formula> is</p><disp-formula id="scirp.54138-formula154"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x81.png"  xlink:type="simple"/></disp-formula><p>Hence, the effective reproduction number of the model system (2) is given by</p><disp-formula id="scirp.54138-formula155"><label>(12)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x82.png"  xlink:type="simple"/></disp-formula><p>The effective reproduction number <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x83.png" xlink:type="simple"/></inline-formula> measures the average number of new infections generated by a typical infectious individual in a community with inflow of infected immigrants when screening, education, health care and immunization strategies are in place.</p><p>Theorem 1: The disease free equilibrium of the model system (2) is locally asymptotically stable if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x84.png" xlink:type="simple"/></inline-formula> and unstable if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x84.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x85.png" xlink:type="simple"/></inline-formula>.</p><p>Theorem 1 implies that HCV can be eliminated from the community when <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x86.png" xlink:type="simple"/></inline-formula> if the initial size of the sub population of the model are in the basin of attraction of the disease free equilibrium. That means if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x86.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x87.png" xlink:type="simple"/></inline-formula>, then on average an infected individual produce less than one new infected individual over the course of its infectious period and the infection cannot grow.</p><p>From Equation (12), for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x88.png" xlink:type="simple"/></inline-formula> to be less than 1 this will only be possible when <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x88.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x89.png" xlink:type="simple"/></inline-formula> (which implies HCV education, health care and immunization) are increased without bound in collaboration with other intervention strategies to all people including immigrants in a given locality which may result into the decreasing effect on<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x88.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x89.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x90.png" xlink:type="simple"/></inline-formula>.</p><p>In the absence of interventions (screening, education, health care and immunization) that is<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x91.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x91.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x92.png" xlink:type="simple"/></inline-formula>is reduced to:</p><disp-formula id="scirp.54138-formula156"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x93.png"  xlink:type="simple"/></disp-formula><p>Thus<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x94.png" xlink:type="simple"/></inline-formula>. Hence the presence of screening, education, health care and immunization can eradicate the HCV infection if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x94.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x95.png" xlink:type="simple"/></inline-formula> can be reduced to below unity.</p></sec><sec id="s3_5"><title>3.5. Local Stability of Disease Free Equilibrium (DFE)</title><p>Local stability of disease free equilibrium<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x96.png" xlink:type="simple"/></inline-formula>, can be determined by the variational matrix <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x96.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x97.png" xlink:type="simple"/></inline-formula> of the model system (2). The Jacobian matrix at the steady states is given by;</p><disp-formula id="scirp.54138-formula157"><label>(13)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x98.png"  xlink:type="simple"/></disp-formula><p>The local stability analysis of the Jacobian matrix (13) of the system (2) can be done by the trace/determinant method. Where by matrix <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x99.png" xlink:type="simple"/></inline-formula> is locally asymptotically stable if and only if the trace of matrix <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x99.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x100.png" xlink:type="simple"/></inline-formula> is strictly negative and its determinant is strictly positive. Whose trace and determinant are given by</p><disp-formula id="scirp.54138-formula158"><label>(14)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x101.png"  xlink:type="simple"/></disp-formula><p>and</p><disp-formula id="scirp.54138-formula159"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x102.png"  xlink:type="simple"/></disp-formula><p>where<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x104.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x104.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x105.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x104.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x105.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x106.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x104.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x105.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x106.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x107.png" xlink:type="simple"/></inline-formula>,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x103.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x104.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x105.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x106.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x107.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x108.png" xlink:type="simple"/></inline-formula>.</p><p>Hence <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x109.png" xlink:type="simple"/></inline-formula> if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x109.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x110.png" xlink:type="simple"/></inline-formula></p><p>That is equivalent to</p><disp-formula id="scirp.54138-formula160"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x111.png"  xlink:type="simple"/></disp-formula><p>since <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x112.png" xlink:type="simple"/></inline-formula></p><p>Thus, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x113.png" xlink:type="simple"/></inline-formula>is locally asymptotically stable if and only if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x113.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x114.png" xlink:type="simple"/></inline-formula>. These results are summarized with the theorem 1.</p></sec><sec id="s3_6"><title>3.6. The Endemic Equilibrium Point D</title><p>Endemic equilibrium point <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x115.png" xlink:type="simple"/></inline-formula> is a steady state solution in which the disease persists in the population (i.e.<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x115.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x116.png" xlink:type="simple"/></inline-formula>)</p><disp-formula id="scirp.54138-formula161"><label>(15)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x117.png"  xlink:type="simple"/></disp-formula><p>where,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x118.png" xlink:type="simple"/></inline-formula>, , ,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x121.png" xlink:type="simple"/></inline-formula>, , , , ,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x126.png" xlink:type="simple"/></inline-formula>, , , ,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x130.png" xlink:type="simple"/></inline-formula>, , , , ,</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x135.png" xlink:type="simple"/></inline-formula>, , ,</p><p>and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x139.png" xlink:type="simple"/></inline-formula> is the solution of the quadratic polynomial</p><disp-formula id="scirp.54138-formula162"><label>(16)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x140.png"  xlink:type="simple"/></disp-formula><p>where,</p><disp-formula id="scirp.54138-formula163"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x141.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.54138-formula164"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x142.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.54138-formula165"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x143.png"  xlink:type="simple"/></disp-formula><p>The equation, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x144.png" xlink:type="simple"/></inline-formula>corresponds to a situation when the disease persists (endemic). In case of backward bifurcation, multiple endemic equilibrium must exist.</p><p>However it is important to note that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x145.png" xlink:type="simple"/></inline-formula> is always positive if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x145.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x146.png" xlink:type="simple"/></inline-formula> and negative if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x145.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x146.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x147.png" xlink:type="simple"/></inline-formula>.</p><p>Theorem 2: The HCV model with screening, education, health care and immunization interventions have:</p><p>i) Precisely one unique endemic equilibrium if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x148.png" xlink:type="simple"/></inline-formula></p><p>ii) Precisely one unique endemic equilibrium if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x149.png" xlink:type="simple"/></inline-formula> and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x149.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x150.png" xlink:type="simple"/></inline-formula> or <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x149.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x150.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x151.png" xlink:type="simple"/></inline-formula></p><p>iii) Precisely two endemic equilibrium if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x152.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x152.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x153.png" xlink:type="simple"/></inline-formula>and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x152.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x153.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x154.png" xlink:type="simple"/></inline-formula>.</p><p>iv) None otherwise.</p><p>Theorem 3: A unique endemic equilibrium point, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x155.png" xlink:type="simple"/></inline-formula>exists if and only if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x155.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x156.png" xlink:type="simple"/></inline-formula>.</p></sec><sec id="s3_7"><title>3.7. Global Stability of the Endemic Equilibrium Point D</title><p>The global stability of the endemic equilibrium <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x157.png" xlink:type="simple"/></inline-formula> is analysed using the following constructed Lyapunov function by [<xref ref-type="bibr" rid="scirp.54138-ref11">11</xref>]</p><p>Theorem 4: If<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x158.png" xlink:type="simple"/></inline-formula>, the endemic equilibrium <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x158.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x159.png" xlink:type="simple"/></inline-formula> of the model (2) is globally asymptotically stable.</p><p>Proof: To establish the global stability of the endemic equilibrium<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x160.png" xlink:type="simple"/></inline-formula>, we construct the following Lyapunov function:</p><disp-formula id="scirp.54138-formula166"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x161.png"  xlink:type="simple"/></disp-formula><p>By direct calculating the derivative of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x162.png" xlink:type="simple"/></inline-formula> along the solution of (2) we have;</p><disp-formula id="scirp.54138-formula167"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x163.png"  xlink:type="simple"/></disp-formula><p>or</p><disp-formula id="scirp.54138-formula168"><label>(17)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x164.png"  xlink:type="simple"/></disp-formula><p>where,</p><disp-formula id="scirp.54138-formula169"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x165.png"  xlink:type="simple"/></disp-formula><disp-formula id="scirp.54138-formula170"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x166.png"  xlink:type="simple"/></disp-formula><p>Thus if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula> then<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula>; Noting that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula> if and only if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula>;<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x171.png" xlink:type="simple"/></inline-formula>;<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x171.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x172.png" xlink:type="simple"/></inline-formula>;<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x171.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x172.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x173.png" xlink:type="simple"/></inline-formula>;<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x171.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x172.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x173.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x174.png" xlink:type="simple"/></inline-formula>: Therefore, the largest compact invariant set in <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x167.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x168.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x169.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x170.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x171.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x172.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x173.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x174.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x175.png" xlink:type="simple"/></inline-formula> is the singleton</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x176.png" xlink:type="simple"/></inline-formula>where <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x176.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x177.png" xlink:type="simple"/></inline-formula> is the endemic equilibrium of the system (2). By LaSalle’s invariant principle, it implies that <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x176.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x177.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x178.png" xlink:type="simple"/></inline-formula> is globally asymptotically stable in <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x176.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x177.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x178.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x179.png" xlink:type="simple"/></inline-formula> if<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x176.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x177.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x178.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x179.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x180.png" xlink:type="simple"/></inline-formula>.</p></sec><sec id="s3_8"><title>3.8. Numerical Sensitivity Analysis</title><p>In determining how best to reduce human mortality and morbidity due to HCV, we calculate the sensitivity indices of the basic reproduction number, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x181.png" xlink:type="simple"/></inline-formula>to the parameters in the model using approach of [<xref ref-type="bibr" rid="scirp.54138-ref12">12</xref>] . These indices are crucial in determining the importance of each individual parameter in transmission dynamics and prevalence of the disease. Sensitivity analysis determines parameters that have a high impact on <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x181.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x182.png" xlink:type="simple"/></inline-formula> and should be targeted by intervention strategies. Sensitivity indices allow us to measure the relative change in a state variablewhen a parameter changes [<xref ref-type="bibr" rid="scirp.54138-ref12">12</xref>] . When a variable is a differentiable function of the parameter, the sensitivity index may be alternatively defined using partial derivatives.</p><p>Numerical values of sensitivity indices of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula> to parameter values for the HCV model, evaluated using the following estimated parameter values:<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x190.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x190.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x191.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x190.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x191.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x192.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x190.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x191.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x192.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x193.png" xlink:type="simple"/></inline-formula>and<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x183.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x184.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x185.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x186.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x187.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x188.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x189.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x190.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x191.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x192.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x193.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x194.png" xlink:type="simple"/></inline-formula>.</p><p>Definition 1: The normalised forward sensitivity index of a variable “<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x195.png" xlink:type="simple"/></inline-formula>” that depends differentiable on a parameter “<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x195.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x196.png" xlink:type="simple"/></inline-formula>” is defined as:</p><disp-formula id="scirp.54138-formula171"><label>(18)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/1-1950169x197.png"  xlink:type="simple"/></disp-formula><p>Having an explicit formula for <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x198.png" xlink:type="simple"/></inline-formula> in Equation (18), we derive an analytical expression for the sensitivity of</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x199.png" xlink:type="simple"/></inline-formula>as <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x199.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x200.png" xlink:type="simple"/></inline-formula> to each of parameters involved in<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x199.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x200.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x201.png" xlink:type="simple"/></inline-formula>. For example the sensitivity indices of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x199.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x200.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x201.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x202.png" xlink:type="simple"/></inline-formula> with</p><p>respect to <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x203.png" xlink:type="simple"/></inline-formula> and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x203.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x204.png" xlink:type="simple"/></inline-formula> are given by;</p><p><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x205.png" xlink:type="simple"/></inline-formula>and</p><p>Other indices</p><disp-formula id="scirp.54138-formula172"><graphic  xlink:href="http://html.scirp.org/file/1-1950169x207.png"  xlink:type="simple"/></disp-formula><p>are obtained following the same method and tabulated as follows:</p><p>From <xref ref-type="table" rid="table1">Table 1</xref>, it can be observed that when the parameters<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula>and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula> are increased keeping the other parameters constant they increase the value of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula> implying that they increase the endemicity of the dis- ease as they have positive indices. While the parameters<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x216.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x216.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x217.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x216.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x217.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x218.png" xlink:type="simple"/></inline-formula>and <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x216.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x217.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x218.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x219.png" xlink:type="simple"/></inline-formula> decrease the value of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x208.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x209.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x210.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x211.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x212.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x213.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x214.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x215.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x216.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x217.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x218.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x219.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x220.png" xlink:type="simple"/></inline-formula> when they are increased while keeping the other parameters constant, implying that they decrease the</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Numerical values of sensitivity indices of<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x221.png" xlink:type="simple"/></inline-formula></title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Parameter Symbol</th><th align="center" valign="middle" >Sensitivity Index</th></tr></thead><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x222.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.666666666</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x223.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.6658711218</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x224.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.520211814</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x225.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.3341288785</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x226.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.251532594</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x227.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.104042362</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x228.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.100613037</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x229.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.0734173793</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x230.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.05209089976</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x231.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >−0.0303517690</td></tr><tr><td align="center" valign="middle" ><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x232.png" xlink:type="simple"/></inline-formula></td><td align="center" valign="middle" >0.02807805705</td></tr></tbody></table></table-wrap><p>endemicity of the disease as they have negative indices.</p><p>The specific interpretation of each parameter shows that, the most sensitive parameter is the control based on education, health care and immunization<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula>, followed by effective contact rate of individuals with chronic disease<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula>, then recovered rate of chronic individuals due to treatment<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula>, effective contact rate of individuals with acute<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula>, followed by recovery rate naturally from acute<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula>, death rate of chronic infected<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula>, recovered rate of acute individuals due to treatment<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x239.png" xlink:type="simple"/></inline-formula>, natural mortality rate<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x239.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x240.png" xlink:type="simple"/></inline-formula>, rate at which exposed develop chronic<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x239.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x240.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x241.png" xlink:type="simple"/></inline-formula>, the rate at which acute infective are detected by a screening method from exposed group<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x239.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x240.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x241.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x242.png" xlink:type="simple"/></inline-formula>, the rate at which screened develop to chronic<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x233.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x234.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x235.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x236.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x237.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x238.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x239.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x240.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x241.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x242.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x243.png" xlink:type="simple"/></inline-formula>, which is the least sensitive parameter.</p></sec><sec id="s3_9"><title>3.9. Numerical Simulations</title><p>In this section, we illustrate the analytical results of the study by carrying out numerical simulations of the model system (2) using the following estimated parameter values:<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x254.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x254.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x255.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x254.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x255.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x256.png" xlink:type="simple"/></inline-formula>, <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x254.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x255.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x256.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x257.png" xlink:type="simple"/></inline-formula>,<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x244.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x245.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x246.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x247.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x248.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x249.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x250.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x251.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x252.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x253.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x254.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x255.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x256.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x257.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x258.png" xlink:type="simple"/></inline-formula>.</p><p>Figures 2(a)-(d) show the proportion of HCV exposed, infective populations (acute, chronic) and proportion of HCV infectives all plotted against the proportion of susceptible population. This shows the dynamic beha-</p><fig-group id="fig2"><label><xref ref-type="fig" rid="fig2">Figure 2</xref></label><caption><title> Phase portrait of the dynamics of susceptibles and the infected and recovered population.</title></caption><fig id ="fig2_1"><label> (b)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x259.png"/></fig><fig id ="fig2_2"><label>(c)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x260.png"/></fig><fig id ="fig2_3"><label> (d)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x261.png"/></fig><fig id ="fig2_4"><label></label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x262.png"/></fig></fig-group><p>viour of the endemic equilibrium of the model system (2) using the estimated parameter values above.</p><p>The phase portrait in Figures 2(a)-(d) shows that for any initial starting point or initial value, the solution curves tend to the endemic equilibrium point<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x263.png" xlink:type="simple"/></inline-formula>. Hence, we infer that the system (2) is globally stable about the endemic equilibrium point <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x263.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x264.png" xlink:type="simple"/></inline-formula> for the set of parameters above.</p><p>In Figures 3(a)-(d), the variation of proportions of exposed, recovered, acute and chronic infective populations for different rates of education, health care and immunization <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x265.png" xlink:type="simple"/></inline-formula> is shown.</p><p>Figures 3(a)-(d), shows that the infected population decreases as the control strategies (education, health care and immunization), <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x266.png" xlink:type="simple"/></inline-formula>increased. This confirms that, if <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x266.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x267.png" xlink:type="simple"/></inline-formula> is not effective the disease will invade the population.</p><p>Figures 4(a)-(d) shows the variation of proportions of exposed, acute and chronic infective populations and recovered population for different rates of screening.</p><p>From Figures 4(a)-(d) we vary the screened rate of infected immigrants, and it is seen that as the degree of screening increases, the infected population decreases. The results further show that increasing the screening rate, decreases the severity of the epidemic. Once again this confirms that, screening can reduce the inflow of infected immigrants into the community.</p><fig-group id="fig3"><label><xref ref-type="fig" rid="fig3">Figure 3</xref></label><caption><title> Variation population under different values of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x272.png" xlink:type="simple"/></inline-formula> (education, health care and immunization).</title></caption><fig id ="fig3_1"><label> (b)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x268.png"/></fig><fig id ="fig3_2"><label>(c)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x269.png"/></fig><fig id ="fig3_3"><label> (d)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x270.png"/></fig><fig id ="fig3_4"><label></label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x271.png"/></fig></fig-group><fig-group id="fig4"><label><xref ref-type="fig" rid="fig4">Figure 4</xref></label><caption><title> Variation of population under different values of <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x277.png" xlink:type="simple"/></inline-formula> (screening).</title></caption><fig id ="fig4_1"><label> (b)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x273.png"/></fig><fig id ="fig4_2"><label>(c)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x274.png"/></fig><fig id ="fig4_3"><label> (d)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x275.png"/></fig><fig id ="fig4_4"><label></label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-1950169x276.png"/></fig></fig-group></sec></sec><sec id="s4"><title>4. Discussions and Conclusion</title><p>In this paper, a mathematical model of control strategies of HCV in a community with inflow of infected immigrants been established. Both qualitative and numerical analysis of the model was done. The model incorporates the assumption that infected immigrants enter in the community. It is shown that there exists a feasible region where the model is well posed in which a unique disease free equilibrium point exists. The disease free and endemic equilibrium points were obtained and their stabilities investigated. The model showed that the disease free equilibrium is locally stable at threshold parameter less than unity and unstable at threshold parameter greater than unity. Using Lyapunov method, endemic equilibrium is globally stable under certain conditions. A sensitivity analysis shows that the control based on education, health care and immunization <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x278.png" xlink:type="simple"/></inline-formula> is the most sensitive parameter on <inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x278.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x279.png" xlink:type="simple"/></inline-formula> and the least is<inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x278.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x279.png" xlink:type="simple"/></inline-formula><inline-formula><inline-graphic xlink:href="http://html.scirp.org/file/1-1950169x280.png" xlink:type="simple"/></inline-formula>. A numerical study of the model has been conducted to see the effect of certain key parameters on the spread of the disease. It was observed that the spread of the disease decreases due to the presence of control strategies (screening, education, health care and immunization). As the control strategies increase, the exposed, acute and chronic infective individuals also decrease in the population. Finally, from the analysis, it may be hypothesized that preventive measures, through reducing rates of transmission of HCV are therefore necessary to the community. Since reduced transmission leads to lower prevalence of the disease in the long-term, the national health care to HCV should therefore seek to ensure that all people at risk or that have been at risk in the past, have access to and are supported in the use of HCV screening, education, health care immunization, regardless of their social and economic status.</p></sec><sec id="s5"><title>NOTES</title></sec></body><back><ref-list><title>References</title><ref id="scirp.54138-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Choo, L., Kuo, G. and Weiner, A.J. (1989) Isolation of a cDNA Clone Derived from a Blood-Borne Non-A, Non-B Viral Hep Atitis Genome. PubMed, 244, 359-362.</mixed-citation></ref><ref id="scirp.54138-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Fischer, L.R., Tope, D.H., Kathleen, S., Conboy, R.N., Hedblom, B.D., Ronberg, E., Shewmake, D.K. and Butter, J.C. 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