Estimating Household and Community Transmission of Ocular Chlamydia trachomatis 英文参考文献.docVIP

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Estimating Household and Community Transmission of Ocular Chlamydia trachomatis 英文参考文献.doc

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Estimating Household and Community Transmission of Ocular Chlamydia trachomatis 英文参考文献

EstimatingHouseholdandCommunityTransmissionof OcularChlamydiatrachomatis IsobelM.Blake1*,MatthewJ.Burton2,RobinL.Bailey2,AnthonyW.Solomon2,SheilaWest3 ,Beatriz Mun?oz3,MartinJ.Holland2,DavidC.W.Mabey2,ManojGambhir1,Mar?′a-GloriaBasa′n?ez1,NicholasC. Grassly1 1Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom, 2London School of Hygiene and Tropical Medicine, London, UnitedKingdom,3DanaCenterforPreventiveOphthalmology,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica Abstract Introduction:Community-wideadministrationofantibioticsisonearmofafour-prongedstrategyintheglobalinitiativeto eliminate blindness due to trachoma. The potential impact of more efficient, targeted treatment of infected households depends onthe relative contribution of communityandhousehold transmissionof infection, which havenot previously beenestimated. Methods: A mathematical model of the household transmission of ocular Chlamydia trachomatis was fit to detailed demographic and prevalence data from four endemic populations in The Gambia and Tanzania. Maximum likelihood estimatesofthehouseholdandcommunitytransmissioncoefficientswereobtained. Results:Theestimatedhouseholdtransmissioncoefficientexceededboththecommunitytransmissioncoefficientandthe rateofclearanceofinfectionbyindividualsinthreeofthefourpopulations,allowingpersistenttransmissionofinfection withinhouseholds.Inallpopulations,individualsinlargerhouseholdscontributedmoretotheincidenceofinfectionthan thoseinsmallerhouseholds. Discussion:TransmissionofocularC.trachomatisinfectionwithinhouseholdsistypicallyveryefficient.Failuretotreatall infectedmembersofahouseholdduringmassadministrationofantibioticsislikelytoresultinrapidre-infectionofthat household,followedbymoregradualspreadacrossthecommunity.Thefeasibilityandeffectivenessofhouseholdtargeted strategiesshouldbeexplored. Citation: Blake IM, Burton MJ, Bailey RL, Solomon AW, West S, et al. (2009) Estimating Household and Community