Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

<h4>Background</h4>A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in...

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Autores principales:	Boris V Schmid, Eelco A B Over, Ingrid V F van den Broek, Eline L M Op de Coul, Jan E A M van Bergen, Johan S A Fennema, Hannelore M Götz, Christian J P A Hoebe, G Ardine de Wit, Marianne A B van der Sande, Mirjam E E Kretzschmar
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1e5eb67dbbd54b398f14e9f728069bde
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spelling	oai:doaj.org-article:1e5eb67dbbd54b398f14e9f728069bde2021-11-18T07:52:43ZEffects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.1932-620310.1371/journal.pone.0058674https://doaj.org/article/1e5eb67dbbd54b398f14e9f728069bde2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23527005/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future.<h4>Methods and findings</h4>We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run.<h4>Conclusions</h4>Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level, the effectiveness of screening on prevalence will remain limited.Boris V SchmidEelco A B OverIngrid V F van den BroekEline L M Op de CoulJan E A M van BergenJohan S A FennemaHannelore M GötzChristian J P A HoebeG Ardine de WitMarianne A B van der SandeMirjam E E KretzschmarPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58674 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Boris V Schmid Eelco A B Over Ingrid V F van den Broek Eline L M Op de Coul Jan E A M van Bergen Johan S A Fennema Hannelore M Götz Christian J P A Hoebe G Ardine de Wit Marianne A B van der Sande Mirjam E E Kretzschmar Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
description	<h4>Background</h4>A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future.<h4>Methods and findings</h4>We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run.<h4>Conclusions</h4>Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level, the effectiveness of screening on prevalence will remain limited.
format	article
author	Boris V Schmid Eelco A B Over Ingrid V F van den Broek Eline L M Op de Coul Jan E A M van Bergen Johan S A Fennema Hannelore M Götz Christian J P A Hoebe G Ardine de Wit Marianne A B van der Sande Mirjam E E Kretzschmar
author_facet	Boris V Schmid Eelco A B Over Ingrid V F van den Broek Eline L M Op de Coul Jan E A M van Bergen Johan S A Fennema Hannelore M Götz Christian J P A Hoebe G Ardine de Wit Marianne A B van der Sande Mirjam E E Kretzschmar
author_sort	Boris V Schmid
title	Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
title_short	Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
title_full	Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
title_fullStr	Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
title_full_unstemmed	Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.
title_sort	effects of population based screening for chlamydia infections in the netherlands limited by declining participation rates.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/1e5eb67dbbd54b398f14e9f728069bde
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Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

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