A community-level RCT of expedited partner treatment for gonorrhea and chlamydia

淋病和衣原体快速伴侣治疗的社区级随机对照试验

• 批准号: 7747947
• 负责人: Matthew R Golden
• 金额: $ 52.94万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-15 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7747947
• 关键词: Affect; Area; Case Report Form; Case Study; Centers for Disease Control and Prevention (U.S.); Chlamydia; Chlamydia Infections; Chlamydia trachomatis; Cities; Clinic; Collaborations; Communicable Diseases; Communities; Contracts; County; Data; Developed Countries; Evaluation; Family Planning; Funding; Genital system; Gonorrhea; Health; Incidence; Infection; Infertility; Institutes; Institution; Intervention; Interview; Maintenance; Measures; Methods; Modeling; Morbidity - disease rate; Partner Notification; Patients; Persons; Pharmaceutical Preparations; Pharmacy facility; Population; Prevalence; Prevention; Public Health; Randomized; Randomized Controlled Trials; Relative (related person); Reporting; Research Personnel; Sampling; Screening procedure; Sexual Partners; Sexually Transmitted Diseases; Testing; Therapeutic Intervention; Triage; United States; Washington; Woman; Work; base; cost; cost effectiveness; design; high risk; improved; population based; prevent; programs; randomized trial

Neiserria gonorrhoeae and Chlamydia trachomatis are the two most common bacterial sexually transmitted infections (STI) in the United States, affecting an estimated 4 million persons annually at a cost of over $3 billion. After a period of declining morbidity, the prevalence of chlamydial infection is now rising in some areas of the U.S., while rates of gonorrhea are stable, but no longer decreasing. New public health interventions are needed to decrease morbidity from these infections. Improved partner notification and treatment might be such an intervention. Recent randomized controlled trials have demonstrated that expedited partner therapy (EPT), the practice of treating the sex partners of persons with curable STI without their mandatory prior examination by a clinician, can increase the number of partners of persons with gonorrhea or chlamydial infection treated, and can decrease rates of STI reinfection. Study investigators have shown that a public health EPT program can be instituted in a single city to increase partner treatment, but the feasibility of wider scale public health EPT programs has not been established, and the population-level impact and cost-effectiveness of larger EPT programs is unknown. This application proposes a stepped-wedge community-level randomized controlled trial of EPT for gonorrhea and chlamydial infection in Washington (WA) State. A population-based EPT program modeled after one already in place in King County, WA will be instituted in a randomly selected temporal order in 28 health districts in WA State. Free medication will be provided to patients to deliver to their sex partners, and a new case-reporting form will triage public health partner notification assistance to persons at high-risk for not notifying partners. Free medications will be distributed directly to patients via larger clinics in each health district and through a network of commercial pharmacies contracted to participate in the program. The study will assess the impact of EPT on the prevalence of chlamydial infection among women tested in clinics receiving CDC Infertility Prevention Project funding, and on the incidence of reported gonorrhea among women in the state. The proportion of sex partners treated before and after the institution of the EPT program will be estimated based on interviews with a random sample of reported cases: Investigators will evaluate the intervention's cost- effectiveness both from a societal perspective and relative to other publicly funded measures to control gonorrhea and chlamydial infection.

Neiserria Gonorrhoeae和衣原体沙眼是最常见的两个性别传播的两个 美国的感染（STI）每年以超过30亿美元的价格影响400万人。 一段时间的发病率下降后，衣原体感染的患病率现在在该地区的某些地区上升 美国，虽然淋病率是稳定的，但不再降低。需要新的公共卫生干预措施 从这些感染中降低发病率。改进的伴侣通知和治疗可能是这样的 干涉。最近的随机对照试验表明，加快合作伙伴治疗（EPT）， 治疗具有可治愈性传播疾病的人的性伴侣的实践，而无需先前检查 临床医生，可以增加接受淋病或衣原体感染患者的伴侣的数量，并且可以 减少STI再感染的发生率。研究研究人员表明，公共卫生EPT计划可以是 在一个城市建立以增加合作伙伴的治疗，但规模更广泛的公共卫生EPT的可行性 尚未建立计划，以及较大EPT的人群级别的影响和成本效益 程序未知。该申请提出了一项阶梯窗格社区级的随机对照试验 华盛顿州淋病和衣原体感染的EPT。基于人群的EPT计划 在金县已经建立的一个以随机选择的时间顺序制定后，以仿制在金县的建模。 西澳州的28个卫生区。将向患者提供免费药物，以分娩给他们的性伴侣 新的案件报告表将对高风险的人进行分类公共卫生合作伙伴通知援助 通知合作伙伴。免费药物将通过每个健康区的大型诊所直接分配给患者 并通过签约参加该计划的商业药房网络。该研究将评估 EPT对接受疾病预防控制中心的诊所测试的妇女的衣原体感染的影响 预防项目资金，以及该州妇女报告的淋病发生率。这 将根据EPT计划之前和之后的性伴侣比例的比例。 对报告案件的随机样本进行访谈：调查人员将评估干预的成本 - 从社会的角度和相对于其他公开筹集资金的措施来控制淋病的有效性 和衣原体感染。

项目成果

The legal aspects of expedited partner therapy practice: do state laws and policies really matter?

• DOI: 10.1097/01.olq.0000431358.18959.d4
• 发表时间: 2013-08
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Cramer R;Leichliter JS;Stenger MR;Loosier PS;Slive L;SSuN Working Group
• 通讯作者: SSuN Working Group

Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010-2012.

美国患者报告的淋病快速合作伙伴治疗：2010-2012 年 STD 监测网络的调查结果。

• DOI: 10.1097/olq.0000000000000329
• 发表时间: 2015
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Stenger,MarkR;Kerani,RoxanneP;Bauer,HeidiM;Burghardt,Nicole;Anschuetz,GretaL;Klingler,Ellen;Schumacher,ChristinaM;Simon,Julie;Golden,Matthew
• 通讯作者: Golden,Matthew