Thèse soutenue

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Auteur / Autrice : Margarita Pons Salort
Direction : Didier GuillemotVéronique Letort
Type : Thèse de doctorat
Discipline(s) : Biostatistiques/Biomathématiques
Date : Soutenance en 2013
Etablissement(s) : Paris 6
Jury : Rapporteurs / Rapporteuses : Samuel Alizon

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Résumé

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This thesis falls within the field of community epidemiology, an ecological perspective of infectious diseases that takes into account communities of hosts and/or communities of pathogens to study various current problems in infectious disease epidemiology. Mathematical and statistical approaches, mainly multi-pathogen and multi-host transmission models, are used to address different questions related to pathogen persistence and coexistence. The first part of the thesis concentrates on the mechanisms responsible for multi-host-pathogen persistence. We investigate the role of different bat species and their biological traits on Lyssavirus persistence in a metapopulation system of caves. The second part focuses on how patterns of strain diversity are affected by vaccines that target a subset of strains, and how changes in strain diversity might affect disease incidence. These questions are investigated for Human Papillomavirus (HPV) and Streptococcus pneumoniae. Concerning HPV, we first explore the conditions for genotype replacement as a consequence of mass vaccination. And then, we re-examine the oncogenic potential of HPV types with respect to invasive cervical cancer performing meta-analyses of published data. Regarding the pneumococcus, we study how the 7-valent pneumococcal conjugate vaccine changed the trends of pneumococcal meningitis incidence in France, and how a concurrent and substantial reduction in antibiotic use modulated the phenomenon of serotype replacement.