The effect of syndromic management interventions on the prevalence of sexually transmitted infections in South Africa
The effect of syndromic management interventions on the prevalence of sexually transmitted infections in South Africa
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DOI：
10.1016/j.srhc.2010.08.006
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发表时间：
2011-01-01
影响因子：
1.8
通讯作者：
Coetzee, David J.
中科院分区：
文献类型：
--
作者：
Johnson, Leigh F.;Dorrington, Rob E.;Coetzee, David J.
很少有研究评估了综合征管理干预措施对人群性传播感染患病率的影响。本研究旨在确定南非自1994年以来引入的综合征管理方案的效果。研究设计：采用南非性行为模式的数学模型来模拟HIV、生殖器疱疹、梅毒、软下疳、淋病、衣原体感染、滴虫病、细菌性阴道病和阴道念珠菌病的发病率。关于求医行为和治疗效果的假设是基于南非的调查数据。该模型适用于现有的性传播感染流行率数据。主要结果指标：减少性病患病率由于syndromic management.Results：在1995年和2005年之间，有显着减少梅毒，软下疳，淋病，滴虫病和衣原体感染的患病率。在15 - 49岁的女性中，综合征管理导致梅毒患病率下降33%（95%CI：23-43%），淋病患病率下降6%（95%CI：3-11%），细菌性阴道病患病率下降5%（95%CI：1-13%），软下疳患病率大幅下降。然而，综合征管理并没有显着降低其他性传播感染的患病率。对于所有的性传播感染，在1995年和2005年之间的性传播感染的患病率减少的建模可以归因于增加安全套的使用或艾滋病mortality.Conclusions：性病的综合征管理可以预期减少可治愈的性传播感染的患病率，往往成为症状，但对大多数是无症状的性传播感染的患病率几乎没有影响。(C)2010爱思唯尔有限公司版权所有。
Few studies have assessed the effect of syndromic management interventions on the prevalence of sexually transmitted infections (STIs) at a population level. This study aims to determine the effect of syndromic management protocols that have been introduced in South Africa since 1994.Study design: A mathematical model of sexual behaviour patterns in South Africa was used to model the incidence of HIV, genital herpes, syphilis, chancroid, gonorrhoea, chlamydial infection, trichomoniasis, bacterial vaginosis and vaginal candidiasis. Assumptions about health seeking behaviour and treatment effectiveness were based on South African survey data. The model was fitted to available STI prevalence data. Main outcome measures: Reductions in STI prevalence due to syndromic management.Results: Between 1995 and 2005, there were significant reductions in the prevalence of syphilis, chancroid, gonorrhoea, trichomoniasis and chlamydial infection. In women aged between 15 and 49, syndromic management resulted in a 33% (95% CI: 23-43%) decline in syphilis prevalence, a 6% (95% CI: 3-11%) reduction in gonorrhoea prevalence, a 5% (95% CI: 1-13%) reduction in the prevalence of bacterial vaginosis and a substantial decline in chancroid. However, syndromic management did not significantly reduce the prevalence of other STIs. For all STIs, much of the modelled reduction in STI prevalence between 1995 and 2005 can be attributed to either increased condom usage or AIDS mortality.Conclusions: Syndromic management of STIs can be expected to decrease the prevalence of curable STIs that tend to become symptomatic, but has little effect on the prevalence of STIs that are mostly asymptomatic. (C) 2010 Elsevier B.V. All rights reserved.