Garnett G P, Bowden F J
Wellcome Trust Centre for the Epidemiology of Infectious Disease, University of Oxford, United Kingdom.
Sex Transm Dis. 2000 Nov;27(10):588-99. doi: 10.1097/00007435-200011000-00007.
Despite the availability of safe and effective treatment, infection with bacterial sexually transmitted diseases persists at a high prevalence in many populations.
To review the difficulties of parameter estimation when a cure is readily available and to explore the impact of different treatment and screening strategies that might maximize the benefits of using available treatments.
A standard deterministic model for the spread of a bacterial sexually transmitted disease that causes symptomatic and asymptomatic infections, in which the population is stratified according to sex and sexual activity, is further stratified into two host groups to enable the modeling of different treatment and screening strategies.
In the presence of a core group, if an infection has a high transmission probability, then screening for asymptomatic infections has a short-lived benefit. Repeated screening is slightly better if it is not restricted to a fraction of the at-risk population, but targeting of high-risk groups should be effective. Screening to treat asymptomatic infections in men could be beneficial if a substantial fraction of cases remain asymptomatic.
After the initial gains achieved through treating symptomatic infections, further reductions in the prevalence of infections can be achieved by finding asymptomatic infections. However, these gains are difficult to achieve, especially in the case of gonorrhea. Because men are likely to have an asymptomatic chlamydial infection, screening of men for chlamydia should be worthwhile.
尽管有安全有效的治疗方法，但细菌性性传播疾病感染在许多人群中仍普遍高发。
回顾在有现成治愈方法时参数估计的困难，并探讨不同治疗和筛查策略的影响，这些策略可能会使使用现有治疗方法的益处最大化。
一个用于细菌性性传播疾病传播的标准确定性模型，该疾病会导致有症状和无症状感染，其中人群按性别和性活动分层，进一步分为两个宿主组，以便对不同治疗和筛查策略进行建模。
在存在核心群体的情况下，如果感染具有高传播概率，那么对无症状感染进行筛查的益处是短暂的。如果不局限于部分高危人群，重复筛查会稍好一些，但针对高危群体应该是有效的。如果相当一部分病例仍无症状，对男性无症状感染进行筛查治疗可能有益。
在通过治疗有症状感染取得初步成效后，通过发现无症状感染可进一步降低感染率。然而，这些成效很难实现，尤其是在淋病的情况下。由于男性可能有无症状衣原体感染，对男性进行衣原体筛查应该是值得的。
