Screening for gonorrhoea and chlamydia: identifying key target populations and intensity-a modelling study of MSM in Belgium.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES

Sexually Transmitted Infections Pub Date : 2025-06-15 DOI:10.1136/sextrans-2025-056540

Achilleas Tsoumanis, Thibaut Vanbaelen, Christophe Van Dijck, Chris Kenyon, Niel Hens

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引用次数: 0

Abstract

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are two of the most common bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM). Screening for CT and NG has been promoted as an intervention to reduce the prevalence of these STIs. We aimed to evaluate the effect of different screening intensities on the prevalence of CT, NG and the emergence of azithromycin-resistant NG (AR-NG) in an MSM population.

Methods: We developed a network-based model for CT and NG transmission among MSM in Belgium to estimate the prevalence of CT, NG and AR-NG in the population. The model simulates transmission of CT/NG among three anatomical sites in a population of 10 000 MSM, divided into high-activity and low-activity groups, over 10 years. The effect of different screening frequencies and coverage was evaluated in terms of CT, NG and AR-NG prevalence.

Results: Gonorrhoea prevalence ranged between 12% and 16% in scenarios screening 0-80% of the population. Screening among the low-activity MSM (LA-MSM) group had little effect on NG prevalence but increased the risk of AR-NG. Infrequent screening (less than every 180 days) with high coverage (over 40%) resulted in the highest risk for the spread of AR-NG in the population. Screening up to 40% of low-activity (HA-MSM) every 90 days and up to 20% of LA-MSM reduced NG prevalence to 14% without selecting for AMR. Screening coverage and frequency had little impact on CT prevalence in all scenarios.

Conclusions: Our model suggests that NG/CT screening has a modest effect in controlling the prevalence of these infections in the MSM population in Belgium. Screening efforts should move away from LA-MSM. Screening alone would not be sufficient to control the CT/NG epidemic, and future models should incorporate the impact of additional interventions such as vaccination and doxycycline post-exposure prophylaxis.

查看原文本刊更多论文

淋病和衣原体筛查：确定关键目标人群和强度-比利时男男性行为的模拟研究。

背景：沙眼衣原体（CT）和淋病奈瑟菌（NG）是男男性行为者（MSM）中最常见的两种细菌性传播感染（sti）。CT和NG筛查已被推广为减少这些性传播感染流行的干预措施。我们的目的是评估不同筛查强度对MSM人群中CT、NG患病率和阿奇霉素耐药NG （AR-NG）出现的影响。方法：我们在比利时的MSM中建立了一个基于网络的CT和NG传播模型，以估计人群中CT， NG和AR-NG的患病率。该模型模拟了CT/NG在10,000名MSM人群中三个解剖部位的传播，这些人群被分为高活动组和低活动组，为期10年。根据CT、NG和AR-NG的患病率评估不同筛查频率和覆盖率的效果。结果：在筛查0-80%人群的情况下，淋病患病率在12% - 16%之间。低活动MSM （LA-MSM）组的筛查对NG患病率影响不大，但增加了AR-NG的风险。覆盖率高（40%以上）的不频繁筛查（少于每180天）导致AR-NG在人群中传播的风险最高。在不选择AMR的情况下，每90天筛查高达40%的低活动性（HA-MSM）和高达20%的LA-MSM可将NG患病率降低至14%。在所有情况下，筛查覆盖率和频率对CT患病率影响不大。结论：我们的模型表明，NG/CT筛查在控制比利时MSM人群中这些感染的流行方面具有适度的效果。筛查工作应该远离LA-MSM。单独的筛查不足以控制CT/NG流行，未来的模型应纳入额外干预措施的影响，如疫苗接种和多西环素暴露后预防。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sexually Transmitted Infections 医学-传染病学

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.