The impact of syphilis screening among female sex workers in China: a modelling study.

<h4>Background</h4>In China, female sex workers (FSWs) are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to...

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Autores principales:	Kate M Mitchell, Andrew P Cox, David Mabey, Joseph D Tucker, Rosanna W Peeling, Peter Vickerman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bc0c3688d91c4d7ead6b7ddc55b6f83e
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spelling	oai:doaj.org-article:bc0c3688d91c4d7ead6b7ddc55b6f83e2021-11-18T07:59:22ZThe impact of syphilis screening among female sex workers in China: a modelling study.1932-620310.1371/journal.pone.0055622https://doaj.org/article/bc0c3688d91c4d7ead6b7ddc55b6f83e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23383249/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In China, female sex workers (FSWs) are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved.<h4>Methods</h4>A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%), and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored.<h4>Results</h4>All model structures suggest yearly syphilis screening could substantially reduce (by 72-88%) syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30%) the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings.<h4>Conclusions</h4>Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact.Kate M MitchellAndrew P CoxDavid MabeyJoseph D TuckerRosanna W PeelingPeter VickermanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 1, p e55622 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kate M Mitchell Andrew P Cox David Mabey Joseph D Tucker Rosanna W Peeling Peter Vickerman The impact of syphilis screening among female sex workers in China: a modelling study.
description	<h4>Background</h4>In China, female sex workers (FSWs) are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved.<h4>Methods</h4>A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%), and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored.<h4>Results</h4>All model structures suggest yearly syphilis screening could substantially reduce (by 72-88%) syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30%) the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings.<h4>Conclusions</h4>Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact.
format	article
author	Kate M Mitchell Andrew P Cox David Mabey Joseph D Tucker Rosanna W Peeling Peter Vickerman
author_facet	Kate M Mitchell Andrew P Cox David Mabey Joseph D Tucker Rosanna W Peeling Peter Vickerman
author_sort	Kate M Mitchell
title	The impact of syphilis screening among female sex workers in China: a modelling study.
title_short	The impact of syphilis screening among female sex workers in China: a modelling study.
title_full	The impact of syphilis screening among female sex workers in China: a modelling study.
title_fullStr	The impact of syphilis screening among female sex workers in China: a modelling study.
title_full_unstemmed	The impact of syphilis screening among female sex workers in China: a modelling study.
title_sort	impact of syphilis screening among female sex workers in china: a modelling study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/bc0c3688d91c4d7ead6b7ddc55b6f83e
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The impact of syphilis screening among female sex workers in China: a modelling study.

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