The Evolving Epidemiology of Chlamydial and Gonococcal Infections in Response to Control Programs in Winnipeg, Canada.
Blanchard, James F. MD, PhD; Moses, Stephen MD, MPH; Greenaway, Christina MD, FRCP; Orr, Pamela MD, MSc, FRCP; Hammond, Greg W. MD, FRCP; Brunham, Robert C. MD, FRCP
[Article] American Journal of Public Health. 88(10):1496-1502, October 1998.

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Objectives: The purpose of this study was to describe and compare the transmission dynamics of chlamydia and gonorrhea in Winnipeg, Manitoba, Canada, and to assess implications for control programs.

Methods: Chlamydia and gonorrhea surveillance case reports (1988 through 1995) and contact-tracing reports (1991 through 1995) were examined.

Results: High incidence rates of both chlamydia and gonorrhea clustered in geographic core areas characterized by low socioeconomic status. A decline in the number of reported cases of chlamydia (61%) and gonorrhea (64%) occurred between 1988 and 1995. For chlamydia, the decline was most prominent in non-core area cases, while for gonorrhea it was similar in core and noncore areas.

Conclusions: Chlamydia and gonorrhea appear to be evolving through different epidemic phases, with chlamydia transmission, in response to a newly introduced control program, becoming more core dependent and gonorrhea transmission becoming more sporadic in the face of a sustained control effort. Focused control programs, based on an understanding of the transmission dynamics of chlamydia and gonorrhea, may make their elimination a feasible goal. (Am J Public Health. 1998;88:1496-1502)

Copyright (C) 1998 by the American Public Health Association, Inc.