# Project

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## Epidemiology and Mathematical Modelling for Infectious disease Control (EpideMMIC)

 English title Epidemiology and mathematical modelling for infectious disease control (EpideMMIC) Low Nicola Minling 135654 Project funding (Div. I-III) Institut für Sozial- und Präventivmedizin Universität Bern University of Berne - BE Methods of Epidemiology and Preventive Medicine 01.05.2011 - 31.03.2015 331'000.00
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### All Disciplines (3)

Discipline
 Methods of Epidemiology and Preventive Medicine
 Public Health and Health Services
 Infectious Diseases

### Keywords (5)

infection disease dynamics; clinical epidemiology; sexually transmitted infections; chlamydia infections; prevention

### Lay Summary (English)

Lay summary

This project is called EpideMMIC, which stands for 'Epidemiology and Mathematical Modelling for Infectious disease Control'. The overall aim of the project is to improve our understanding of how infectious diseases spread, and can be controlled. This project is a continuation of the EpideMMIC project, which began in May 2008. The principle is to obtain the best available epidemiological information that we can use to develop mathematical models to describe the transmission of infections and investigate how interventions work. We continue our work about Chlamydia trachomatis and extend it to other sexually transmitted infections. Our first objective is to determine how likely it is for C. trachomatis to be transmitted during an episode of unprotected heterosexual intercourse. Second, we will use medical records to help find out how soon a chlamydia infection can cause symptoms of complicated infection if it moves up into the fallopian tubes to cause pelvic inflammatory disease. Third, we will use information gained from our previous studies to find out which combinations of chlamydia screening, treatment, re-testing and partner notification can be most effective when targeted toward groups with lower and higher levels of sexual risk behaviour. Fourth, we will extend our models of C. trachomatis to investigate the potential for transmission and prevention of a newly identified sexually transmitted infection, Mycoplasma genitalium. Finally, we will investigate the potential effects that a new vaccine could have on transmission of C. trachomatis and prevention of pelvic inflammatory disease and infertility.  These studies will provide important information for patients, doctors, public health specialists and policy makers.

 Direct link to Lay Summary Last update: 21.02.2013

### Responsible applicant and co-applicants

Name Institute
 Low Nicola Minling Institut für Sozial- und Präventivmedizin Universität Bern

### Employees

Name Institute
 Herzog Sereina Institut für Medizinische Informatik, Statistik und Dokumentation Medizinische Universität Graz
 Min-Heijne Janneke Institut für Sozial- und Präventivmedizin Universität Bern
 Gsteiger Sandro Dipartimento di Matematica Politecnico di Torino
 Althaus Christian Institut für Sozial- und Präventivmedizin Universität Bern

### Publications

Publication
Krauer F., Gsteiger S., Low N., Hansen C. H., Althaus C. L. (2016), Heterogeneity in District-Level Transmission of Ebola Virus Disease during the 2013-2015 Epidemic in West Africa, in PLOS Neglected Tropical Diseases, 10(7), e0004867.
Althaus C. L., Low N., Musa E. O., Shuaib F., Gsteiger S. (2015), Ebola virus disease outbreak in Nigeria: Transmission dynamics and rapid control, in Epidemics, 11, 80-84.
D'Addario Maddalena, Scott Pippa, Redmond Shelagh, Low Nicola (2014), HPV vaccines: systematic review of literature on alternative vaccination schedules Report on a two doses vs. three doses schedule, World Health Organization, Geneva.
Gottlieb Sami L, Low Nicola, Newman Lori M, Bolan Gail, Kamb Mary L, Broutet Nathalie (2014), Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines, in Vaccine, 32(14), 1527-1535.
Heijne Janneke C, Herzog Sereina A, Althaus Christian L, Low Nicola, Kretzschmar Mirjam (2013), Case and partnership reproduction numbers for a curable sexually transmitted infection, in Journal of Theoretical Biology, 331, 38-47.
Herzog Sereina A, Heijne Janneke C, Scott P, Althaus Christian L, Low Nicola (2013), Direct and indirect effects of screening for Chlamydia trachomatis on the prevention of pelvic inflammatory disease: A mathematical modelling study, in Epidemiology, 24(6), 854-862.
Heijne Janneke Cornelia Maria, Herzog Sereina Annik, Althaus Christian Lorenz, Tao Guoyu, Kent Charlotte Kathleen, Low Nicola (2013), Insights into the timing of repeated testing after treatment for Chlamydia trachomatis: data and modelling study., in Sexually transmitted infections, 89(1), 57-62.
Low Nicola, Heijne Janneke Cornelia Maria, Herzog Sereina Annik, Althaus Christian Lorenz (2013), Reinfection by untreated partners of people treated for Chlamydia trachomatis and Neisseria gonorrhoeae: Mathematical modelling study, in Sexually Transmitted Infections, 90(3), 254-256.
Herzog S. A., Heijne J. C., Althaus C. L., Low N. (2012), Describing the progression from Chlamydia trachomatis and Neisseria gonorrhoeae to pelvic inflammatory disease: systematic review of mathematical modeling studies, in Sex Transm Dis, 39(8), 628-637.
Althaus Christian L., Heijne Janneke C. M., Herzog Sereina A., Roellin Adrian, Low Nicola (2012), Individual and Population Level Effects of Partner Notification for Chlamydia trachomatis, in PLOS ONE, 7(12), e51438.
Althaus CL, Heijne JCM, Low N (2012), Towards More Robust Estimates of the Transmissibility of Chlamydia trachomatis, in SEXUALLY TRANSMITTED DISEASES, 39(5), 402-404.

### Collaboration

Group / person Country
Types of collaboration
 Kretzschmar Group/ Dutch National Institute of Public Health Netherlands (Europe)
 - in-depth/constructive exchanges on approaches, methods or results
 Hocking Group/ University of Melbourne Australia (Oceania)
 - in-depth/constructive exchanges on approaches, methods or results
 Mercer Group/ Centre for Sexual Health and HIV, University College London Great Britain and Northern Ireland (Europe)
 - in-depth/constructive exchanges on approaches, methods or results

### Scientific events

#### Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
 British Association of Sexual Health and HIV Conference Poster How common in Mycoplasma genitalium? Systematic review and meta-analysis 10.07.2016 Oxford, Great Britain and Northern Ireland Low Nicola Minling;
 British Association of Sexual Health and HIV Conference Poster Natural history of Mycoplasma genitalium: incidence, persistence, transmissibility and progression to pelvic inflammatory disease: systematic review and meta-analysis 10.07.2016 Oxford, Great Britain and Northern Ireland Low Nicola Minling;
 STI & HIV World Congress 2015 Poster Sex and pelvic inflammatory disease: what's the relationship? Case-control study 13.09.2015 Brisbane, Australia Herzog Sereina; Low Nicola Minling;
 18th IUSTI Asia-Pacific Conference Talk given at a conference Is chlamydia screening doing more harm than good? 11.11.2014 Bangkok, Thailand Low Nicola Minling;
 Kirby Institute Symposium Individual talk Balancing the benefits and harms of chlamydia screening: global challenges in chlamydia control 17.07.2014 Sydney, Australia Low Nicola Minling;
 2014 STD Prevention Conference Talk given at a conference Gini coefficients for STIs: Measuring the distribution of infections among individuals with different sexual activity 09.06.2014 Atlanta, GA, United States of America Althaus Christian; Gsteiger Sandro; Low Nicola Minling;
 2014 STD Prevention Conference. June 9-12 2014, Atlanta, GA Talk given at a conference What is the coverage of chlamydia testing in 15-25 year old women in the USA? A multi-parameter evidence synthesis 09.06.2014 Atlanta, GA, United States of America Min-Heijne Janneke; Gsteiger Sandro; Low Nicola Minling;
 Annual Meeting of the Dutch Medical Microbiology Society Talk given at a conference Chlamydia dynamics in Europe 16.04.2014 Arnhem, Netherlands Low Nicola Minling;
 Epidemics 4 Conference Poster Screening strategies to reduce population level Chlamydia trachomatis transmission 19.11.2013 Amsterdam, Netherlands Min-Heijne Janneke; Low Nicola Minling;
 STI & AIDS World Congress 2013 Talk given at a conference Direct and Indirect Effects of Screening For Chlamydia Trachomatis on the Prevention of Pelvic Inflammatory Disease: Mathematical Modeling Study 14.07.2013 Vienna, Austria Low Nicola Minling; Min-Heijne Janneke; Herzog Sereina; Althaus Christian;
 ESHRE 29th Annual Meeting Talk given at a conference Can chlamydia screening programmes prevent infertility? 07.07.2013 London, Great Britain and Northern Ireland Low Nicola Minling;
 13th International Union Against STI World Congress and Australasian Sexual Health Conference. Melbourne, Australia Talk given at a conference Sexual behaviour in heterosexual populations: implications for chlamydia control 14.10.2012 Melbourne, Australia, Australia Low Nicola Minling;
 19th Biennial Conference of the International Society for STD Research Poster Impact of a Hypothetical Chlamydia Vaccine on Population Prevalence: a Mathematical Modeling Study 10.07.2011 Quebec, Canada Althaus Christian; Herzog Sereina; Low Nicola Minling; Min-Heijne Janneke;

#### Self-organised

Title Date Place
 5th Swiss Meeting of Infectious Disease Dynamics 11.09.2014 Bern, Switzerland

### Awards

Title Year
 26th Annual Sexually Transmitted Disease Lecturer, Indiana University School of Medicine 2012

### Associated projects

Number Title Start Funding scheme
 118424 Integrating epidemiology and mathematical modelling to investigate the impact of interventions to control infectious diseases 01.05.2008 Project funding (Div. I-III)
 124952 Epidemiology and Mathematical Modelling for Infectious disease Control (EpideMMIC) 01.04.2009 ProDoc
 133960 Investigating the transmissibility and early dynamics of Chlamydia trachomatis infections 01.11.2010 International Exploratory Workshops
 160320 Epidemiology and Mathematical Modelling for Infectious disease Control (EpideMMIC) 01.08.2015 Project funding (Div. I-III)

### Abstract

Background: Sexually transmitted Chlamydia trachomatis is the most common notifiable condition in countries such as Switzerland, Sweden and the USA. Insights into the dynamics of existing and new sexually transmitted infections and robust information about the expected impact of feasible and achievable control interventions are urgently needed. Goals: The overall goal of the project is to integrate epidemiological expertise and mathematical modelling to improve the utility of modelling for public health decision making in two main areas: Objective 1. Improve parameter estimates in C. trachomatis infection transmission system. Objective 2. Predicting the effects of new and existing interventions. Methods of investigation: This project involves collaborations with several international researchers. For each objective we define one or more epidemiological datasets and corresponding mathematical modelling analysis and sensitivity analyses. Specific studies are: Objective 1.1 Determine the transmissibility of C. trachomatis per episode of unprotected heterosexual intercourse using prospective cohort data from young women and their partners with genotyping and chlamydia organism load data incorporated into a deterministic model; 1.2 Determine the relationship between lower genital tract C. trachomatis infection and clinical presentation of pelvic inflammatory disease based on case-control data about the time interval between new sexual partnerships and the onset of symptoms in women with chlamydial pelvic inflammatory disease or clinic attendance in those without; 2.1 To determine the most effective and achievable chlamydia screening strategies based on empirical data from four different interventions incorporated in a pair model; 2.2 To investigate the transmission dynamics and effects of screening for M. genitalium using prospective data about prevalence, persistence and pelvic inflammatory disease incidence in women with and without infection; 2.3 To investigate the potential effects of vaccination against C. trachomatis using data and model outputs from the earlier objectives in a pair model. Timescale: May 2011 to Apr 2014Importance and Impact: The proposed EpideMMIC project will consolidate earlier achievements in integration of epidemiology and mathematical modelling by a) increasing the robustness of model predictions about the effects real life of chlamydia screening and partner notification interventions, b) producing new insights into the effects of chlamydia infection and control and M. genitalium infection dynamics, and c) integrating the outputs of project components to investigate the potential effects of a future chlamydia vaccine. We have established the Swiss Meeting for Infectious Disease Dynamics (inaugural meeting at the University of Bern in May 2010), to establish a networking forum for infectious disease modellers in Switzerland and ensure that these projects and their outputs contribute to infection transmission science in Switzerland and internationally. The EpideMMIC project is particularly relevant in Switzerland now, as a new National Programme for HIV and sexually transmitted infections for 2011-2017 is being launched. The strategy recognises, for the first time, the importance of control strategies for sexually transmitted infections other than HIV.
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