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

Qibin Duan, Chris Carmody, Basil Donovan, Rebecca J. Guy, Ben B. Hui, John M. Kaldor, Monica M. Lahra, Matthew G. Law, David A. Lewis, Michael Maley, Skye McGregor, Anna McNulty, Christine Selvey, David J. Templeton, David M. Whiley, David G. Regan, James G. Wood*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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-andtreat 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.

Original languageEnglish
Article numbere1009385
JournalPLoS Computational Biology
Volume17
Issue number11
DOIs
Publication statusPublished - Nov 2021
Externally publishedYes

Bibliographical note

Funding Information:
DGR, JGW, BD, DMW and DAL received funding from the Australian National Health and Medical Research Council (NHMRC) under grant number APP1145642. JGW, DR, ML, MM, DL, BD, CC, DMW, CS, JK, SM, BH, QD received funding from a SPHERE III seed grant awarded in 2018. QD received salary support from APP1145642 and the III seed grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
Copyright © 2021 Duan et al.

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