Model-based evaluation of single-round mass treatment of sexually transmitted diseases for HIV control in a rural African population
| Autor: | C. van Vliet, Richard J. Hayes, Eline L. Korenromp, Awene Gavyole, Heiner Grosskurth, L Fransen, C. P. B. van der Ploeg, J. D. F. Habbema |
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| Přispěvatelé: | Public Health |
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Rural Population Pediatrics medicine.medical_specialty Adolescent Sexual Behavior Immunology Population Gonorrhea Sexually Transmitted Diseases Prevalence HIV Infections SDG 3 - Good Health and Well-being Disease Transmission Infectious medicine Humans Immunology and Allergy Syphilis education Latent Syphilis Demography education.field_of_study Chlamydia business.industry Incidence (epidemiology) Middle Aged Models Theoretical medicine.disease Chancroid Infectious Diseases Africa Female business Program Evaluation |
| Zdroj: | AIDS, 14, 573-593. Lippincott Williams & Wilkins |
| ISSN: | 1473-5571 0269-9370 |
| Popis: | The objective was to compare the impact of single-round mass treatment of sexually transmitted diseases (STDs) sustained syndromic treatment and their combination on the incidence of HIV in rural Africa. The authors studied the effects of STD interventions by stochastic simulation using the model STDSIM. Parameters were fitted using data from a trial of improved STD treatment services in Mwanza Tanzania. Effectiveness was assessed by comparing the prevalences of gonorrhea chlamydia syphilis and chancroid and the incidence of HIV in the general adult population in simulations with and without intervention. Single-round mass treatment was projected to achieve an immediate substantial reduction in STD prevalences which would return to baseline levels over 5-10 years. The effect on syphilis was somewhat larger if participants cured of latent syphilis were not immediately susceptible to re-infection. At 80% coverage the model projected a reduction in cumulative HIV incidence over 2 years of 36%. A similar impact was achieved if treatment of syphilis was excluded from the intervention or confined to those in the infectious stages. In comparison with sustained syndromic treatment single-round mass treatment had a greater short-term impact on HIV (36 versus (vs.) 30% over 2 years) but a smaller long-term impact (24 vs. 62% over 10 years). Mass treatment combined with improved treatment services led to a rapid and sustained fall in HIV incidence (57% over 2 years; 70% over 10 years). In populations in which STD control can reduce HIV incidence mass treatment may in the short run have an impact comparable to sustained syndromic treatment. Mass treatment combined with sustained syndromic treatment may be particularly effective. (authors) |
| Databáze: | OpenAIRE |
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