Chlamydia transmission : Concurrency, reproduction number, and the epidemic trajectory

To identify factors that influence individual and group transmission of Chlamydia, the authors conducted community-wide contact tracing of chlamydia cases in Colorado Springs, Colorado, from mid-1996 to mid-1997. Case patients identified persons with whom they had had contact during the 6 months pre...

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Bibliographic Details
Published in:American journal of epidemiology 1999-12, Vol.150 (12), p.1331-1339
Main Authors: POTTERAT, J. J, ZIMMERMAN-ROGERS, H, MUTH, S. Q, ROTHENBERG, R. B, GREEN, D. L, TAYLOR, J. E, BONNEY, M. S, WHITE, H. A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bacterial diseases
Bacterial diseases of the genital system
Biological and medical sciences
Case-Control Studies
Chlamydia
Chlamydia Infections - epidemiology
Chlamydia Infections - transmission
Colorado - epidemiology
Communicable Disease Control
Disease Outbreaks
Epidemiologic Methods
Female
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Reproduction
Sexually Transmitted Diseases - epidemiology
Sexually Transmitted Diseases - transmission
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Summary:To identify factors that influence individual and group transmission of Chlamydia, the authors conducted community-wide contact tracing of chlamydia cases in Colorado Springs, Colorado, from mid-1996 to mid-1997. Case patients identified persons with whom they had had contact during the 6 months preceding diagnosis; contacts were actively sought and offered DNA amplification testing. Sexual contact networks were used to identify "source cases" and "spread cases," permitting estimation of the basic reproduction number (R0) for individuals and groups. Network and epidemiologic factors influencing R0 were assessed using univariate and multivariate procedures. Of 1,309 case patients, 1,131 (86%) were interviewed, and 2,409 contacts were identified. The 1,131 interviewed cases yielded 623.9 computed spread cases, for an overall R0 of 0.55. Few subgroups analyzed yielded a mean R0 exceeding unity-an observation in keeping with routine surveillance information which suggests that chlamydia incidence is declining in Colorado Springs. Concurrency, a network measure of simultaneous partnerships, was the most powerful predictor of transmission. Direct estimation of basic reproduction numbers for chlamydia using contact tracing techniques is feasible and can produce useful data with which to prioritize control efforts, evaluate interventions, and gauge the place of chlamydia on the epidemic continuum.
ISSN:0002-9262
1476-6256