Kretzschmar M, Welte R, van den Hoek A, Postma M J
Department of Infectious Disease Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Am J Epidemiol. 2001 Jan 1;153(1):90-101. doi: 10.1093/aje/153.1.90.
The design of a screening program for asymptomatic genital infections with Chlamydia trachomatis, requires decisions about which sex or age group should be targeted and whether partner referral should be included in the program. To investigate the effects of various screening programs on the prevalence and incidence of asymptomatic C. trachomatis infections in women, in May 1996 to April 1997 in Bilthoven, the Netherlands, the authors used a stochastic simulation model for C. trachomatis transmission in an age-structured, heterosexual population with a sexually highly active core group. Different screening scenarios were implemented over a time period of 10 years. Prevalence, incidence, and the fraction of infected persons found by partner referral were computed. Through screening of men and women between ages 15 and 24 years (baseline scenario), the prevalence of asymptomatic infections in women could be reduced from 4.2% to 1.4% in 10 years. Increasing the age range of screening up to ages 29 or 34 years led to prevalences of 0.4% and 0.06%, respectively, after 10 years. About 28% of all infected persons were found via partner referral. There are considerable indirect positive effects of screening on those population groups that are not included in the screening because of the reduced risk of becoming infected. Partner referral contributes substantially to prevalence reduction.
针对无症状沙眼衣原体生殖器感染的筛查项目设计，需要决定目标人群应为哪个性别或年龄组，以及该项目是否应包括性伴侣转诊。为了研究各种筛查项目对女性无症状沙眼衣原体感染患病率和发病率的影响，1996年5月至1997年4月，在荷兰比尔瑟姆，作者使用了一个沙眼衣原体传播的随机模拟模型，该模型适用于一个年龄结构分明、有性活跃核心群体的异性恋人群。在10年的时间里实施了不同的筛查方案。计算了患病率、发病率以及通过性伴侣转诊发现的感染者比例。通过筛查15至24岁的男性和女性（基线方案），10年内女性无症状感染的患病率可从4.2%降至1.4%。将筛查年龄范围扩大到29岁或34岁，10年后患病率分别为0.4%和0.06%。约28%的所有感染者是通过性伴侣转诊发现的。筛查对那些因感染风险降低而未纳入筛查的人群组有相当大的间接积极影响。性伴侣转诊对降低患病率有很大贡献。
