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- Title
Genital Chlamydia trachomatis Infections Clear More Slowly in Men Than Women, but Are Less Likely to Become Established.
- Authors
Lewis, Joanna; Price, Malcolm J.; Horner, Paddy J.; White, Peter J.
- Abstract
<bold>Background: </bold>Rigorous estimates for clearance rates of untreated chlamydia infections are important for understanding chlamydia epidemiology and designing control interventions, but were previously only available for women.<bold>Methods: </bold>We used data from published studies of chlamydia-infected men who were retested at a later date without having received treatment. Our analysis allowed new infections to take one of 1, 2, or 3 courses, each clearing at a different rate. We determined which of these 3 models had the most empirical support.<bold>Results: </bold>The best-fitting model had 2 courses of infection in men, as was previously found for women: "slow-clearing" and "fast-clearing." Only 68% (57%-78%) (posterior median and 95% credible interval [CrI]) of incident infections in men were slow-clearing, vs 77% (69%-84%) in women. The slow clearance rate in men (based on 6 months' follow-up) was 0.35 (.05-1.15) year-1 (posterior median and 95% CrI), corresponding to mean infection duration 2.84 (.87-18.79) years. This compares to 1.35 (1.13-1.63) years in women.<bold>Conclusions: </bold>Our estimated clearance rate is slower than previously assumed. Fewer infections become established in men than women but once established, they clear more slowly. This study provides an improved description of chlamydia's natural history to inform public health decision making. We describe how further data collection could reduce uncertainty in estimates.
- Subjects
CHLAMYDIA; CHLAMYDIACEAE; PUBLIC health; CHLAMYDIALES; CHLAMYDIA infections; BACTERIAL diseases; CHLAMYDIA trachomatis; MATHEMATICAL models; PROBABILITY theory; SEX distribution; THEORY; DISEASE progression
- Publication
Journal of Infectious Diseases, 2017, Vol 216, Issue 2, p237
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jix283