Investigating the Potential Public Health Benefit of Jail-based Screening and Treatment Programs for Chlamydia
Observational studies have found mixed results on the impact of jail-based chlamydia screen-and-treat programs on community prevalence. In the absence of controlled trials or prospectively designed studies, dynamic mathematical models that incorporate movements in and out of jail and sexual contacts...
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| Veröffentlicht in: | American journal of epidemiology 2013-03, Vol.177 (5), p.463-473 |
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| creator | OWUSU-EDUSEI, Kwame GIFT, Thomas L CHESSON, Harrell W KENT, Charlotte K |
| description | Observational studies have found mixed results on the impact of jail-based chlamydia screen-and-treat programs on community prevalence. In the absence of controlled trials or prospectively designed studies, dynamic mathematical models that incorporate movements in and out of jail and sexual contacts (including disease transmission) can provide useful information. We explored the impact of jail-based chlamydia screening on a hypothetical community's prevalence with a deterministic compartmental model focusing on heterosexual transmission. Parameter values were obtained from the published literature. Two analyses were conducted. One used national values (large community); the other used values reported among African Americans--the population with the highest incarceration rates and chlamydia burden (small community). A comprehensive sensitivity analysis was carried out. For the large-community analysis, chlamydia prevalence decreased by 13% (from 2.3% to 2.0%), and based on the ranges of parameter values (including screening coverage of 10%-100% and a postscreening treatment rate of 50%-100%) used in the sensitivity analysis, this decrease ranged from 0.1% to 58%. For the small-community analysis, chlamydia prevalence decreased by 54% (from 4.6% to 2.1%). Jail-based chlamydia screen-and-treat programs have the potential to reduce chlamydia prevalence in communities with high incarceration rates. However, the magnitude of this potential decrease is subject to considerable uncertainty. |
| doi_str_mv | 10.1093/aje/kws240 |
| format | Article |
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In the absence of controlled trials or prospectively designed studies, dynamic mathematical models that incorporate movements in and out of jail and sexual contacts (including disease transmission) can provide useful information. We explored the impact of jail-based chlamydia screening on a hypothetical community's prevalence with a deterministic compartmental model focusing on heterosexual transmission. Parameter values were obtained from the published literature. Two analyses were conducted. One used national values (large community); the other used values reported among African Americans--the population with the highest incarceration rates and chlamydia burden (small community). A comprehensive sensitivity analysis was carried out. For the large-community analysis, chlamydia prevalence decreased by 13% (from 2.3% to 2.0%), and based on the ranges of parameter values (including screening coverage of 10%-100% and a postscreening treatment rate of 50%-100%) used in the sensitivity analysis, this decrease ranged from 0.1% to 58%. For the small-community analysis, chlamydia prevalence decreased by 54% (from 4.6% to 2.1%). Jail-based chlamydia screen-and-treat programs have the potential to reduce chlamydia prevalence in communities with high incarceration rates. However, the magnitude of this potential decrease is subject to considerable uncertainty.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/aje/kws240</identifier><identifier>PMID: 23403986</identifier><identifier>CODEN: AJEPAS</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>Adolescent ; Adult ; African Americans ; Biological and medical sciences ; Chlamydia ; Chlamydia Infections - diagnosis ; Chlamydia Infections - prevention & control ; Chlamydia Infections - transmission ; Cost of Illness ; Disease Transmission, Infectious - prevention & control ; Epidemiology ; Female ; General aspects ; Heterosexuality ; Humans ; Male ; Mass Screening - methods ; Mathematical models ; Medical sciences ; Medical screening ; Medical treatment ; Miscellaneous ; Models, Theoretical ; Prevalence ; Prevention and actions ; Prisons ; Public Health ; Public health. 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In the absence of controlled trials or prospectively designed studies, dynamic mathematical models that incorporate movements in and out of jail and sexual contacts (including disease transmission) can provide useful information. We explored the impact of jail-based chlamydia screening on a hypothetical community's prevalence with a deterministic compartmental model focusing on heterosexual transmission. Parameter values were obtained from the published literature. Two analyses were conducted. One used national values (large community); the other used values reported among African Americans--the population with the highest incarceration rates and chlamydia burden (small community). A comprehensive sensitivity analysis was carried out. For the large-community analysis, chlamydia prevalence decreased by 13% (from 2.3% to 2.0%), and based on the ranges of parameter values (including screening coverage of 10%-100% and a postscreening treatment rate of 50%-100%) used in the sensitivity analysis, this decrease ranged from 0.1% to 58%. For the small-community analysis, chlamydia prevalence decreased by 54% (from 4.6% to 2.1%). Jail-based chlamydia screen-and-treat programs have the potential to reduce chlamydia prevalence in communities with high incarceration rates. However, the magnitude of this potential decrease is subject to considerable uncertainty.</description><subject>Adolescent</subject><subject>Adult</subject><subject>African Americans</subject><subject>Biological and medical sciences</subject><subject>Chlamydia</subject><subject>Chlamydia Infections - diagnosis</subject><subject>Chlamydia Infections - prevention & control</subject><subject>Chlamydia Infections - transmission</subject><subject>Cost of Illness</subject><subject>Disease Transmission, Infectious - prevention & control</subject><subject>Epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Heterosexuality</subject><subject>Humans</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Mathematical models</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Medical treatment</subject><subject>Miscellaneous</subject><subject>Models, Theoretical</subject><subject>Prevalence</subject><subject>Prevention and actions</subject><subject>Prisons</subject><subject>Public Health</subject><subject>Public health. 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Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>OWUSU-EDUSEI, Kwame</creatorcontrib><creatorcontrib>GIFT, Thomas L</creatorcontrib><creatorcontrib>CHESSON, Harrell W</creatorcontrib><creatorcontrib>KENT, Charlotte K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Aqualine</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Water Resources Abstracts</collection><jtitle>American journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>OWUSU-EDUSEI, Kwame</au><au>GIFT, Thomas L</au><au>CHESSON, Harrell W</au><au>KENT, Charlotte K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Investigating the Potential Public Health Benefit of Jail-based Screening and Treatment Programs for Chlamydia</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>177</volume><issue>5</issue><spage>463</spage><epage>473</epage><pages>463-473</pages><issn>0002-9262</issn><eissn>1476-6256</eissn><coden>AJEPAS</coden><abstract>Observational studies have found mixed results on the impact of jail-based chlamydia screen-and-treat programs on community prevalence. In the absence of controlled trials or prospectively designed studies, dynamic mathematical models that incorporate movements in and out of jail and sexual contacts (including disease transmission) can provide useful information. We explored the impact of jail-based chlamydia screening on a hypothetical community's prevalence with a deterministic compartmental model focusing on heterosexual transmission. Parameter values were obtained from the published literature. Two analyses were conducted. One used national values (large community); the other used values reported among African Americans--the population with the highest incarceration rates and chlamydia burden (small community). A comprehensive sensitivity analysis was carried out. 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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult African Americans Biological and medical sciences Chlamydia Chlamydia Infections - diagnosis Chlamydia Infections - prevention & control Chlamydia Infections - transmission Cost of Illness Disease Transmission, Infectious - prevention & control Epidemiology Female General aspects Heterosexuality Humans Male Mass Screening - methods Mathematical models Medical sciences Medical screening Medical treatment Miscellaneous Models, Theoretical Prevalence Prevention and actions Prisons Public Health Public health. Hygiene Public health. Hygiene-occupational medicine |
| title | Investigating the Potential Public Health Benefit of Jail-based Screening and Treatment Programs for Chlamydia |
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