Modelling the impact of screening for chlamydia and gonorrhoea in youth and other high-prevalence groups in a resource-limited setting.

ABSTRACT

OBJECTIVES: Modelling the potential impact of screening for chlamydia and gonorrhoea in youth and other populations in a resource-limited setting. METHODS: We extended an agent-based model of heterosexual chlamydia and gonorrhoea transmission in South Africa to investigate the impact of screening strategies in key populations including youth, patients in HIV care, pregnant women and female sex workers (FSWs). Additionally, we compared the modelled impact of a standardised screening programme to results obtained from other published mathematical models of chlamydia screening. RESULTS: All strategies resulted in reductions in general and targeted population chlamydia and gonorrhoea transmission. Opportunistic screening of patients in youth and HIV care was shown to be the most effective, and FSW screening was shown to be the most efficient strategy. Differences between models could be attributed to differences in the modelled heterogeneity in sexual behaviour as well as differences in assumptions about immunity following chlamydia recovery. CONCLUSIONS: Taking modelling assumptions into account, opportunistic chlamydia and gonorrhoea screening of youth and those in HIV care represents a viable intervention for reducing sexually transmitted infections in the South African population.