论文标题
建模男性对沙眼衣原体的影响对女性患病率的影响
Modelling the Impact of Screening Men for Chlamydia Trachomatis on the Prevalence in Women
论文作者
论文摘要
沙眼衣原体是美国最常见的传染病,引起女性的重要生殖发病率。疾病控制和预防中心建议对25岁以下的性活跃女性进行常规筛查,但不建议在男性中进行筛查。因此,未经测试和未经治疗的男性可能是女性感染的水库。尽管筛查了三十年的妇女,但衣原体的患病率仍在增加。此外,与白人相比,在非裔美国人(AA)青年中,衣原体的常见五倍,构成了重要的健康差异。检查IT计划是针对与女性发生性关系的AA男性的捆绑CT干预措施。我们创建了一个基于个体的网络模型,以模拟目标人群的性接触网络上现实的衣原体流行。根据检查的做法,我们量化了筛查年轻男性对女性衣原体患病率的影响。我们使用灵敏度分析来量化每个检查IT干预组件的相对重要性,并且从高到低的显着性是基于场地的筛查,加快索引治疗,加快伙伴待遇,重新纠正。我们估计,通过每年筛查目标男性的7.5%,男性和女性的衣原体患病率分别将分别降低8.1%和8.8%。研究结果表明,男性筛查有可能显着降低女性的患病率。
Chlamydia trachomatis is the most commonly reported infectious disease in the United States and causes important reproductive morbidity in women. The Centers for Disease Control and Prevention have recommended routine screening of sexually active women under age 25 but have not recommended screening among men. Consequently, untested and untreated men may serve as a reservoir of infection in women. Despite three decades of screening women, the chlamydia prevalence has continued to increase. Moreover, chlamydia is five times more common in African American (AA) youth compared to Whites, constituting an important health disparity. The Check It program is a bundled Ct intervention targeting AA men aged 15-24 who have sex with women. We created an individual-based network model to simulate a realistic chlamydia epidemic on sexual contact networks for the target population. Based on the practice in Check It, we quantified the impact of screening young AA men on the chlamydia prevalence in women. We used sensitivity analysis to quantify the relative importance of each Check It intervention component, and the significance ranked from high to low was venue-based screening, expedited index treatment, expedited partner treatment, rescreening. We estimated that by annually screening 7.5% of the target male population, the chlamydia prevalence would be reduced by 8.1% and 8.8% in men and women, respectively. The findings suggested that male-screening has the potential to significantly reduce the prevalence among women.