Oxman G L, Smolkowski K, Noell J
Multnomah County Health Department, Portland, Oregon, USA.
Sex Transm Dis. 1996 Jan-Feb;23(1):30-9. doi: 10.1097/00007435-199601000-00008.
The past 10 years' wave of syphilis epidemics has challenged syphilis control programs. Although apparently connected to drugs-for-sex trading of crack cocaine, the genesis and resolution of these epidemics is poorly understood.
The goals of this study were to develop a mathematical model of epidemic syphilis transmission based on empiric data, to stimulate and ascertain behavioral and sociologic features necessary to produce epidemic transmission, and to explore mechanisms leading to resolution of epidemic transmission.
The study used multi-compartment iterative computer simulation using empirically derived input data.
Epidemic transmission resulted from adding a small core group of individuals with very high levels of partner exchange (300-400 partners per year) to a population with levels of partner exchange seen in the general population. Epidemic resolution could result from immunity or subtle changes in the size or partner exchange rate of the core group.
There is a need for sexually transmitted disease control programs to reevaluate their approach to prevention and control of epidemic syphilis in light of data on transmission dynamics.
过去十年梅毒流行潮对梅毒防控项目构成了挑战。尽管这些流行潮显然与快克可卡因的性交易相关，但人们对其起源和消退情况知之甚少。
本研究的目标是基于实证数据建立梅毒流行传播的数学模型，模拟并确定产生流行传播所需的行为和社会学特征，以及探索导致流行传播消退的机制。
该研究使用多隔室迭代计算机模拟，并采用实证得出的输入数据。
在普通人群伴侣更换水平的人群中加入一小群伴侣更换水平极高（每年300 - 400个伴侣）的核心个体，会导致流行传播。流行消退可能是由于免疫或核心群体规模或伴侣更换率的细微变化。
鉴于传播动力学数据，性传播疾病防控项目有必要重新评估其对梅毒流行的预防和控制方法。
