Chlamydia transmission:: Concurrency, reproduction number, and the epidemic trajectory
Chlamydia transmission:: Concurrency, reproduction number, and the epidemic trajectory
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DOI：
10.1093/oxfordjournals.aje.a009965
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发表时间：
1999-12-15
影响因子：
5
通讯作者：
White, HA
中科院分区：
文献类型：
--
作者：
Potterat, JJ;Zimmerman-Rogers, H;White, HA
为了确定影响衣原体个体和群体传播的因素，作者于1996年中期至1997年中期在科罗拉多州的科罗拉多斯普林斯对衣原体病例进行了社区范围的接触者追踪。病例患者确定了他们在诊断前6个月内接触过的人;积极寻找接触者并提供DNA扩增检测。性接触网络被用来确定“源病例”和“传播病例”，从而可以估计个人和群体的基本繁殖数（R-0）。使用单变量和多变量程序评估影响R-0的网络和流行病学因素。在1，309名病例患者中，对1，131人（86%）进行了访谈，并确定了2，409名接触者。1，131个受访案例产生了623.9个计算的传播案例，总体R-0为0.55。少数亚组分析得出的平均R-0超过1，这一观察结果与常规监测信息一致，表明科罗拉多斯普林斯的衣原体发病率正在下降。同时性是一种衡量同时伴侣关系的网络指标，是传播的最有力预测因素。使用接触追踪技术直接估计衣原体的基本繁殖数是可行的，可以产生有用的数据，优先考虑控制工作，评估干预措施，并衡量衣原体的流行连续体的位置。
To identify factors that influence individual and group transmission of Chlamydia, the authors conducted community-wide contact tracing of chlamydia cases in Colorado Springs, Colorado, from mid-1996 to mid-1997. Case patients identified persons with whom they had had contact during the 6 months preceding diagnosis; contacts were actively sought and offered DNA amplification testing. Sexual contact networks were used to identify "source cases" and "spread cases," permitting estimation of the basic reproduction number (R-0) for individuals and groups. Network and epidemiologic factors influencing R-0 were assessed using univariate and multivariate procedures. Of 1,309 case patients, 1,131 (86%) were interviewed, and 2,409 contacts were identified. The 1,131 interviewed cases yielded 623.9 computed spread cases, for an overall R-0 of 0.55. Few subgroups analyzed yielded a mean R-0 exceeding unity-an observation in keeping with routine surveillance information which suggests that chlamydia incidence is declining in Colorado Springs. Concurrency, a network measure of simultaneous partnerships, was the most powerful predictor of transmission. Direct estimation of basic reproduction numbers for chlamydia using contact tracing techniques is feasible and can produce useful data with which to prioritize control efforts, evaluate interventions, and gauge the place of chlamydia on the epidemic continuum.