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Cited by 30Mathematical and Theoretical Epidemiology and Ecology ModelsSyphilis Diagnosis and TreatmentHIV, TB, and STIs Epidemiology

Go big or go home: impact of screening coverage on syphilis infection dynamics.

Tuite, Ashleigh, Fisman, David·2016·Sexually Transmitted Infections
DOI 10.1136/sextrans-2014-052001
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Abstract

OBJECTIVES: Syphilis outbreaks in urban men who have sex with men (MSM) are an ongoing public health challenge in many high-income countries, despite intensification of efforts to screen and treat at-risk individuals. We sought to understand how population-level coverage of asymptomatic screening impacts the ability to control syphilis transmission. METHODS: We developed a risk-structured deterministic compartmental mathematical model of syphilis transmission in a population of sexually active MSM. We assumed a baseline level of treatment of syphilis cases due to seeking medical care in all scenarios. We evaluated the impact of sustained annual population-wide screening coverage ranging from 0% to 90% on syphilis incidence over the short term (20 years) and at endemic equilibrium. RESULTS: The relationship between screening coverage and equilibrium syphilis incidence displayed an inverted U-shape relationship, with peak equilibrium incidence occurring with 20-30% annual screening coverage. Annual screening of 62% of the population was required for local elimination (incidence <1 case per 100 000 population). Results were qualitatively similar in the face of differing programmatic, behavioural and natural history assumptions, although the screening thresholds for local elimination differed. With 6-monthly or 3-monthly screening, the population coverage required to achieve local elimination was reduced to 39% or 23%, respectively. CONCLUSIONS: Although screening has the potential to control syphilis outbreaks, suboptimal coverage may paradoxically lead to a higher equilibrium infection incidence than that observed in the absence of intervention. Suboptimal screening programme design should be considered as a possible contributor to unsuccessful syphilis control programmes in the context of the current epidemic.

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Crossref · 10.1136/sextrans-2014-052001

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  • MSM screening coverage needed for eliminating syphilis among a population is substantially reduced from 62% with annual screening to 23% with quarterly screening.

    “Furthermore, MSM screening coverage needed for eliminating syphilis among a population is substantially reduced from 62% with annual screening to 23% with quarterly screening (226,227).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [226]

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Authors
Tuite, A., & Fisman, D.
Affiliations
University of Toronto (CA)
Corresponding author
Tuite, Ashleigh
ORCID
Venue
Sexually Transmitted Infections
Publisher
BMJ
Published
2015-05-07
Volume
92
Issue
1
Pages
49-54
ISSN
  • 0007-134X (ISSN-L)
  • 1368-4973
  • 1472-3263
DOI
10.1136/sextrans-2014-052001
OpenAlex
W1841404852
Cited by
30
References
25
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 8 · 2021: 4 · 2020: 4 · 2019: 4 · 2017: 3 · 2016: 2
FWCI
1.79
Type
journal article
Language
en
Open access
closed
Locations
  • Sexually Transmitted Infections (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
Keywords
syphilis, men who have sex with men, asymptomatic screening, screening coverage, syphilis incidence, syphilis elimination, inverted U-shaped relationship, compartmental model, screening frequency
MeSH terms
Adult, Ambulatory Care, Anti-Bacterial Agents, Canada, Cost-Benefit Analysis, Humans, Male, Mass Screening, Models, Theoretical, Patient Acceptance of Health Care, Sexual Behavior, Sexual Partners, Syphilis, Incidence, Contact Tracing, Program Development, Homosexuality, Male

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