Estimating the likely public health impact of partner notification for a clinical service: An evidence-based algorithm

Catherine H. Mercer, Catherine R.H. Aicken, M. Gary Brook, Claudia S. Estcourt, Jackie A. Cassell

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives. We present the first evidence-based method for estimating public health and cost impacts of partner notification (PN) that takes account of sexual partnership type. Methods. Our algorithm uses routine clinical data, probability survey data, and transmission parameters. We propose 2 new epidemiological concepts to quantify PN impact: "[the] absolute reduction in onward transmission" and its reciprocal, "[the] number needed to treat to interrupt transmission" (i.e., the number of partners who need to be treated to interrupt 1 onward transmission). We demonstrate these concepts for 273 chlamydia cases diagnosed at a UK genitourinary medicine clinic. Results. The number needed to treat to interrupt transmission (overall, for casual partners, and for regular partners, respectively) was 1.47, 1.11, and 2.50, respectively, for men younger than 25 years; 1.60, 0.83, and 1.25, respectively, for women younger than 25 years; 2.35, 1.39, and 2.08, respectively, for men older than 25 years; and 2.14, 0.93, and 2.08, respectively, for women older than 25 years. Conclusions. PN that targets casual partners, rather than regular or live-in partners, prevents more secondary transmissions per partnership; it is also more resource intensive, but the public health benefit is greater.

    Original languageEnglish
    Pages (from-to)2117-2123
    Number of pages7
    JournalAmerican Journal of Public Health
    Volume101
    Issue number11
    DOIs
    Publication statusPublished - 1 Nov 2011

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