Estimated Impact of Screening on Gonorrhea Epidemiology in the United States: Insights From a Mathematical Model.
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ABSTRACT: Methods
We developed a national-level transmission model that divides the population by race/ethnicity, preferred gender of sex partners, age, gender, and sexual activity level. We compared our fitted model ("base case") to 4 alternative strategies: (i) no screening, (ii) full adherence to current screening guidelines, (iii) annual universal screening, or (iv) enhanced screening in groups with the highest infection burden. Main outcomes were incidence, infections averted, and incidence rate ratios by race/ethnicity. Mean values and 95% credible intervals were calculated from 1000 draws from parameter posterior distributions.Results
The calibrated model reproduced observed trends in gonorrhea, including disparities in infection burden by race/ethnicity. We estimated that screening for gonorrhea from 2000 to 2015 averted 30% (95% credible intervals, 18-44%) of total infections that would otherwise have occurred. All alternative active screening strategies were estimated to further reduce, but not eliminate, gonorrhea infections relative to the base case, with differential impacts on the subpopulations of interest.Conclusions
Our model results suggest that screening has reduced gonorrhea incidence in the US population. Additional reductions in infection burden may have been possible over this period with increased screening, but elimination was unlikely.
SUBMITTER: Tuite AR
PROVIDER: S-EPMC6813831 | biostudies-literature |
REPOSITORIES: biostudies-literature
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