Mathematical Models for Predicting and Mitigating the Spread of Chlamydia Sexually Transmitted Infection

TL;DR

This paper develops mathematical models to understand and evaluate interventions for reducing the spread of Chlamydia among young African Americans in New Orleans, highlighting the importance of combined notification strategies.

Contribution

It introduces multi-risk and agent-based models to analyze Chlamydia transmission and assess the effectiveness of various behavioral and biomedical interventions.

Findings

Increased condom use reduces prevalence.

Screening alone is insufficient to control the epidemic.

Combined partner and social friend notification are necessary.

Abstract

Chlamydia trachomatis (Ct) is the most common bacterial sexually transmitted infection (STI) in the United States and is major cause of infertility, pelvic inflammatory disease, and ectopic pregnancy among women. Despite decades of screening women for Ct, rates continue to increase among them in high prevalent areas such as New Orleans. A pilot study in New Orleans found approximately 11% of 14-24 year old of African Americans (AAs) were infected with Ct. Our goal is to mathematically model the impact of different interventions for AA men resident in New Orleans on the general rate of Ct among women resident at the same region. We create and analyze mathematical models such as multi-risk and continuous-risk compartmental models and agent-based network model to first help understand the spread of Ct and second evaluate and estimate behavioral and biomedical interventions including condom-use, screening, partner notification, social friend notification, and rescreening. Our compartmental models predict the Ct prevalence is a function of the number of partners for a person, and quantify how this distribution changes as a function of condom-use. We also observe that although increased Ct screening and rescreening, and treating partners of infected people will reduce the prevalence, these mitigations alone are not sufficient to control the epidemic. A combination of both sexual partner and social friend notification is needed to mitigate Ct.