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Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities

OBJECTIVE: Chlamydia trachomatis (Ct) is the most commonly reported sexually transmitted infection in the USA and causes important reproductive morbidity in women. The Centers for Disease Control and Prevention recommend routine screening of sexually active women under age 25 but not among men. Desp...

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Autores principales: Qu, Zhuolin, Azizi, Asma, Schmidt, Norine, Craig-Kuhn, Megan Clare, Stoecker, Charles, Hyman, James Mac, Kissinger, Patricia J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831743/
https://www.ncbi.nlm.nih.gov/pubmed/33483442
http://dx.doi.org/10.1136/bmjopen-2020-040789
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author Qu, Zhuolin
Azizi, Asma
Schmidt, Norine
Craig-Kuhn, Megan Clare
Stoecker, Charles
Hyman, James Mac
Kissinger, Patricia J
author_facet Qu, Zhuolin
Azizi, Asma
Schmidt, Norine
Craig-Kuhn, Megan Clare
Stoecker, Charles
Hyman, James Mac
Kissinger, Patricia J
author_sort Qu, Zhuolin
collection PubMed
description OBJECTIVE: Chlamydia trachomatis (Ct) is the most commonly reported sexually transmitted infection in the USA and causes important reproductive morbidity in women. The Centers for Disease Control and Prevention recommend routine screening of sexually active women under age 25 but not among men. Despite three decades of screening women, chlamydia prevalence in women remains high. Untested and untreated men can serve as a reservoir of infection in women, and male-screening based intervention can be an effective strategy to reduce infection in women. We assessed the impact of screening men on the Ct prevalence in women. DESIGN: We created an individual-based network model to simulate a realistic chlamydia epidemic on sexual contact networks for a synthetic population (n=5000). The model is calibrated to the ongoing routine screening among African American (AA) women in the USA and detailed a male-screening programme, Check It, that bundles best practices for Ct control. We used sensitivity analysis to quantify the relative importance of each intervention component. SETTING: Community-based venues in New Orleans, Louisiana, USA. PARTICIPANTS: Heterosexual AA men, aged 15 to 24, who had sex with women in the past 2 months. INTERVENTION: Venue-based screening, expedited index treatment, expedited partner treatment and rescreening. RESULTS: We estimate that by annually screening 7.5% of the AA male population in the age-range, the chlamydia prevalence would be reduced relatively by 8.1% (95% CI 5.9% to 10.4%) in AA women and 8.8% (95% CI 6.9% to 10.8%) in AA men. Each man screened could prevent 0.062 (95% CI 0.030 to 0.094) cases in men and 0.204 (95% CI 0.143 to 0.267) cases in women. The model suggested the importance of intervention components ranked from high to low as venue-based screening, expedited index treatment, expedited partner treatment and rescreening. CONCLUSION: The findings indicated that male-screening has the potential to substantially reduce the prevalence among women in high-prevalence communities.
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spelling pubmed-78317432021-02-01 Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities Qu, Zhuolin Azizi, Asma Schmidt, Norine Craig-Kuhn, Megan Clare Stoecker, Charles Hyman, James Mac Kissinger, Patricia J BMJ Open Epidemiology OBJECTIVE: Chlamydia trachomatis (Ct) is the most commonly reported sexually transmitted infection in the USA and causes important reproductive morbidity in women. The Centers for Disease Control and Prevention recommend routine screening of sexually active women under age 25 but not among men. Despite three decades of screening women, chlamydia prevalence in women remains high. Untested and untreated men can serve as a reservoir of infection in women, and male-screening based intervention can be an effective strategy to reduce infection in women. We assessed the impact of screening men on the Ct prevalence in women. DESIGN: We created an individual-based network model to simulate a realistic chlamydia epidemic on sexual contact networks for a synthetic population (n=5000). The model is calibrated to the ongoing routine screening among African American (AA) women in the USA and detailed a male-screening programme, Check It, that bundles best practices for Ct control. We used sensitivity analysis to quantify the relative importance of each intervention component. SETTING: Community-based venues in New Orleans, Louisiana, USA. PARTICIPANTS: Heterosexual AA men, aged 15 to 24, who had sex with women in the past 2 months. INTERVENTION: Venue-based screening, expedited index treatment, expedited partner treatment and rescreening. RESULTS: We estimate that by annually screening 7.5% of the AA male population in the age-range, the chlamydia prevalence would be reduced relatively by 8.1% (95% CI 5.9% to 10.4%) in AA women and 8.8% (95% CI 6.9% to 10.8%) in AA men. Each man screened could prevent 0.062 (95% CI 0.030 to 0.094) cases in men and 0.204 (95% CI 0.143 to 0.267) cases in women. The model suggested the importance of intervention components ranked from high to low as venue-based screening, expedited index treatment, expedited partner treatment and rescreening. CONCLUSION: The findings indicated that male-screening has the potential to substantially reduce the prevalence among women in high-prevalence communities. BMJ Publishing Group 2021-01-22 /pmc/articles/PMC7831743/ /pubmed/33483442 http://dx.doi.org/10.1136/bmjopen-2020-040789 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Epidemiology
Qu, Zhuolin
Azizi, Asma
Schmidt, Norine
Craig-Kuhn, Megan Clare
Stoecker, Charles
Hyman, James Mac
Kissinger, Patricia J
Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title_full Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title_fullStr Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title_full_unstemmed Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title_short Effect of screening young men for Chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
title_sort effect of screening young men for chlamydia trachomatis on the rates among women: a network modelling study for high-prevalence communities
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831743/
https://www.ncbi.nlm.nih.gov/pubmed/33483442
http://dx.doi.org/10.1136/bmjopen-2020-040789
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