OBJECTIVES: Model impact of increasing screening and partner notification (PN) on chlamydia positivity. METHODS: We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15-24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment. RESULTS: The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably. CONCLUSIONS: Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.
OBJECTIVES: Model impact of increasing screening and partner notification (PN) on chlamydia positivity. METHODS: We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15-24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment. RESULTS: The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably. CONCLUSIONS: Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.
Authors: Anna Buchsbaum; Maria F Gallo; Maura K Whiteman; Carrie Cwiak; Peggy Goedken; Joan Marie Kraft; Denise J Jamieson; Melissa Kottke Journal: Infect Dis Obstet Gynecol Date: 2014-12-25
Authors: Boris V Schmid; Eelco A B Over; Ingrid V F van den Broek; Eline L M Op de Coul; Jan E A M van Bergen; Johan S A Fennema; Hannelore M Götz; Christian J P A Hoebe; G Ardine de Wit; Marianne A B van der Sande; Mirjam E E Kretzschmar Journal: PLoS One Date: 2013-03-20 Impact factor: 3.240
Authors: Carlos Fernández-Benítez; Patricia Mejuto-López; Luis Otero-Guerra; Mario Juan Margolles-Martins; Pilar Suárez-Leiva; Fernando Vazquez Journal: BMC Infect Dis Date: 2013-08-22 Impact factor: 3.090