Modelling response strategies for controlling gonorrhoea outbreaks in men who have sex with men in Australia

Abstract

The ability to treat gonorrhoea with current first-line drugs is threatened by the global spread of extensively drug resistant (XDR) Neisseria gonorrhoeae (NG) strains. In Australia, urban transmission is high among men who have sex with men (MSM) and importation of an XDR NG strain in this population could result in an epidemic that would be difficult and costly to control. An individual-based, anatomical site-specific mathematical model of NG transmission among Australian MSM was developed and used to evaluate the potential for elimination of an imported NG strain under a range of case-based and population-based test-and-treat strategies. When initiated upon detection of the imported strain, these strategies enhance the probability of elimination and reduce the outbreak size compared with current practice (current testing levels and no contact tracing). The most effective strategies combine testing targeted at regular and casual partners with increased rates of population testing. However, even with the most effective strategies, outbreaks can persist for up to 2 years post-detection. Our simulations suggest that local elimination of imported NG strains can be achieved with high probability using combined case-based and population-based test-and-treat strategies. These strategies may be an effective means of preserving current treatments in the event of wider XDR NG emergence.

Estimating Partnership Duration among MSM in Belgium—A Modeling Study

“…Many studies have mentioned in their limitations the lack of available high-quality social network and behavioral parameters [ 8 , 16 , 17 , 18 , 26 , 29 , 32 , 34 , 35 , 40 , 41 , 43 , 45 ]. In this paper, we present an alternative approach to estimate underlying networks, even with the lack of high-quality social network parameters.…”

“…Several modeling studies have described the transmission of CT and NG among MSM [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], which cluster in a few Western countries, mainly from the US [ 9 , 13 , 14 , 19 , 25 , 26 , 27 , 28 , 35 , 36 ] and Australia [ 18 , 22 , 23 , 24 , 32 , 40 , 41 , 42 , 43 ]. In Europe, notable modeling studies have been conducted in the UK [ 31 , …”

“…Many models mention the lack of parameters in the literature to inform simulation models, leading to limitations in the validity and interpretation of the results [ 8 , 16 , 17 , 18 , 26 , 29 , 32 , 34 , 35 , 40 , 41 , 43 , 45 ]. Besides transmission probabilities that are difficult to calculate in a clinical setting, high-quality clinical parameters such as the probability of symptoms and time intervals until recovery are not readily available in the literature, especially when reported by different anatomical sites [ 46 , 47 ].…”

“…Several modeling studies have described the transmission of CT and NG among MSM , which cluster in a few Western countries, mainly from the US [9,13,14,19,[25][26][27][28]35,36] and Australia [18,[22][23][24]32,[40][41][42][43]. In Europe, notable modeling studies have been conducted in the UK [31,37,38,45] and The Netherlands [17,29,30,33,39,44], with few papers from France [34], Belgium [8,16] and Switzerland [20,21].…”

Estimating Partnership Duration among MSM in Belgium – a Modelling Study

“…Many models mention the lack of parameters in literature, to inform simulation models, leading to limitations in the validity and interpretation of the results 8,10,18,22,25,27,28,34,35,37,39,44,45 . Besides transmission probabilities, that are difficult to calculate in a clinical setting, high quality clinical parameters such as the probability of symptoms and time intervals until recovery are not readily available in literature, especially reported by different anatomical sites 46,47 .…”