Cargando…

Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study

BACKGROUND: A syphilis outbreak among Australian Aboriginal and Torres Strait Islander people (respectfully referred to as Aboriginal) has resulted in almost 4000 notifications by 2020, with several congenital syphilis cases and infant deaths. Outbreak control efforts became coordinated under a Nati...

Descripción completa

Detalles Bibliográficos
Autores principales: Hui, Ben B, Ward, James S, Guy, Rebecca, Law, Matthew G, Gray, Richard T, Regan, David G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035217/
https://www.ncbi.nlm.nih.gov/pubmed/35474757
http://dx.doi.org/10.1093/ofid/ofac119
_version_ 1784693250078015488
author Hui, Ben B
Ward, James S
Guy, Rebecca
Law, Matthew G
Gray, Richard T
Regan, David G
author_facet Hui, Ben B
Ward, James S
Guy, Rebecca
Law, Matthew G
Gray, Richard T
Regan, David G
author_sort Hui, Ben B
collection PubMed
description BACKGROUND: A syphilis outbreak among Australian Aboriginal and Torres Strait Islander people (respectfully referred to as Aboriginal) has resulted in almost 4000 notifications by 2020, with several congenital syphilis cases and infant deaths. Outbreak control efforts became coordinated under a National enhanced test and treat response in 2017. We evaluated the impact of these efforts and of expansion of testing interventions on syphilis prevalence. METHODS: We developed an individual-based mathematical model of infectious syphilis transmission among young heterosexual Aboriginal people aged 15–34 years living in and moving between regional and remote areas, and we assessed the impact of existing and hypothetical outbreak control responses on syphilis prevalence. RESULTS: The increased testing coverage achieved through the response (from 18% to 39% over 2011–2020) could stabilize the epidemic from 2021. To return to pre-outbreak prevalence (<0.24%) by 2025, testing coverage must reach 60%. The addition of annual community-wide screening, where 30% of youth in communities are tested over 6 weeks, would reduce prevalence to the pre-outbreak level within 4 years. If testing coverage had been scaled-up to 60% at the start of outbreak in mid-2011, the outbreak would have been mitigated. CONCLUSIONS: Our results suggest that to control the syphilis outbreak, the response needs to be delivered to enable the maximum coverage of testing to be reached in the shortest time to reduce the prevalence to pre-outbreak levels. Reduction could be hastened with community-wide screening at similar time periods across all communities together with increases in annual testing coverage.
format Online
Article
Text
id pubmed-9035217
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-90352172022-04-25 Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study Hui, Ben B Ward, James S Guy, Rebecca Law, Matthew G Gray, Richard T Regan, David G Open Forum Infect Dis Major Article BACKGROUND: A syphilis outbreak among Australian Aboriginal and Torres Strait Islander people (respectfully referred to as Aboriginal) has resulted in almost 4000 notifications by 2020, with several congenital syphilis cases and infant deaths. Outbreak control efforts became coordinated under a National enhanced test and treat response in 2017. We evaluated the impact of these efforts and of expansion of testing interventions on syphilis prevalence. METHODS: We developed an individual-based mathematical model of infectious syphilis transmission among young heterosexual Aboriginal people aged 15–34 years living in and moving between regional and remote areas, and we assessed the impact of existing and hypothetical outbreak control responses on syphilis prevalence. RESULTS: The increased testing coverage achieved through the response (from 18% to 39% over 2011–2020) could stabilize the epidemic from 2021. To return to pre-outbreak prevalence (<0.24%) by 2025, testing coverage must reach 60%. The addition of annual community-wide screening, where 30% of youth in communities are tested over 6 weeks, would reduce prevalence to the pre-outbreak level within 4 years. If testing coverage had been scaled-up to 60% at the start of outbreak in mid-2011, the outbreak would have been mitigated. CONCLUSIONS: Our results suggest that to control the syphilis outbreak, the response needs to be delivered to enable the maximum coverage of testing to be reached in the shortest time to reduce the prevalence to pre-outbreak levels. Reduction could be hastened with community-wide screening at similar time periods across all communities together with increases in annual testing coverage. Oxford University Press 2022-03-09 /pmc/articles/PMC9035217/ /pubmed/35474757 http://dx.doi.org/10.1093/ofid/ofac119 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Hui, Ben B
Ward, James S
Guy, Rebecca
Law, Matthew G
Gray, Richard T
Regan, David G
Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title_full Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title_fullStr Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title_full_unstemmed Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title_short Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
title_sort impact of testing strategies to combat a major syphilis outbreak among australian aboriginal and torres strait islander peoples: a mathematical modeling study
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035217/
https://www.ncbi.nlm.nih.gov/pubmed/35474757
http://dx.doi.org/10.1093/ofid/ofac119
work_keys_str_mv AT huibenb impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy
AT wardjamess impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy
AT guyrebecca impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy
AT lawmatthewg impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy
AT grayrichardt impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy
AT regandavidg impactoftestingstrategiestocombatamajorsyphilisoutbreakamongaustralianaboriginalandtorresstraitislanderpeoplesamathematicalmodelingstudy