Imperial College London

DrMinttuRonn

Faculty of MedicineSchool of Public Health

Honorary Research Associate
 
 
 
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minttu.ronn08

 
 
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Pread StMedical SchoolSt Mary's Campus

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Summary

 

Publications

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41 results found

Yaesoubi R, Xi Q, Hsu K, Gift TL, St Cyr SB, Rönn MM, Salomon JA, Grad YHet al., 2024, The Impact of Rapid Drug Susceptibility Tests on Gonorrhea Burden and the Life Span of Antibiotic Treatments: A Modeling Study Among Men Who Have Sex With Men in the United States, American Journal of Epidemiology, Vol: 193, Pages: 17-25, ISSN: 0002-9262

<jats:title>Abstract</jats:title> <jats:p>Rapid point-of-care tests that diagnose gonococcal infections and identify susceptibility to antibiotics enable individualized treatment. This could improve patient outcomes and slow the emergence and spread of antibiotic resistance. However, little is known about the long-term impact of such diagnostics on the burden of gonorrhea and the effective life span of antibiotics. We used a mathematical model of gonorrhea transmission among men who have sex with men in the United States to project the annual rate of reported gonorrhea cases and the effective life span of ceftriaxone, the recommended antibiotic for first-line treatment of gonorrhea, as well as 2 previously recommended antibiotics, ciprofloxacin and tetracycline, when a rapid drug susceptibility test that estimates susceptibility to ciprofloxacin and tetracycline is available. The use of a rapid drug susceptibility test with ≥50% sensitivity and ≥95% specificity, defined in terms of correct ascertainment of drug susceptibility and nonsusceptibility status, could increase the combined effective life span of ciprofloxacin, tetracycline, and ceftriaxone by at least 2 years over 25 years of simulation. If test specificity is imperfect, however, the increase in the effective life span of antibiotics is accompanied by an increase in the rate of reported gonorrhea cases even under perfect sensitivity.</jats:p>

Journal article

Yokoji K, Giguère K, Malagón T, Rönn MM, Mayaud P, Kelly H, Delany-Moretlwe S, Drolet M, Brisson M, Boily M-C, Maheu-Giroux Met al., 2023, Association of naturally acquired type-specific HPV antibodies and subsequent HPV re-detection: systematic review and meta-analysis, Infectious Agents and Cancer, Vol: 18, ISSN: 1750-9378

BackgroundUnderstanding the role of naturally acquired (i.e., infection-induced) human papillomavirus (HPV) antibodies against reinfection is important given the high incidence of this sexually transmitted infection. However, the protective effect of naturally acquired antibodies in terms of the level of protection, duration, and differential effect by sex remains incompletely understood. We conducted a systematic review and a meta-analysis to (1) strengthen the evidence on the association between HPV antibodies acquired through past infection and subsequent type-specific HPV detection, (2) investigate the potential influence of type-specific HPV antibody levels, and (3) assess differential effects by HIV status.MethodsWe searched Embase and Medline databases to identify studies which prospectively assessed the risk of type-specific HPV detection by baseline homologous HPV serostatus among unvaccinated individuals. Random-effect models were used to pool the measures of association of naturally acquired HPV antibodies against subsequent incident detection and persistent HPV positivity. Sources of heterogeneity for each type were assessed through subgroup analyses stratified by sex, anatomical site of infection, male sexual orientation, age group, and length of follow-up period. Evidence of a dose-response relationship of the association between levels of baseline HPV antibodies and type-specific HPV detection was assessed. Finally, we pooled estimates from publications reporting associations between HPV serostatus and type-specific HPV detection by baseline HIV status.ResultsWe identified 26 publications (16 independent studies, with 62,363 participants) reporting associations between baseline HPV serostatus and incident HPV detection, mainly for HPV-16 and HPV-18, the most detected HPV type. We found evidence of protective effects of baseline HPV seropositivity and subsequent detection of HPV DNA (0.70, 95% CI 0.61–0.80, NE = 11) and persistent H

Journal article

Ronn MM, Menzies NA, Salomon JA, 2023, Vaccination and Voting Patterns in the US: Analysis of COVID-19 and Flu Surveys From 2010 to 2022, AMERICAN JOURNAL OF PREVENTIVE MEDICINE, Vol: 65, Pages: 458-466, ISSN: 0749-3797

Journal article

Li Y, You S, Lee K, Yaesoubi R, Hsu K, Gift TL, Chesson HW, Berruti AA, Salomon JA, Ronn MMet al., 2023, The Estimated Lifetime Quality-Adjusted Life-Years Lost Due to Chlamydia, Gonorrhea, and Trichomoniasis in the United States in 2018, JOURNAL OF INFECTIOUS DISEASES, Vol: 227, Pages: 1007-1018, ISSN: 0022-1899

Journal article

You S, Yaesoubi R, Lee K, Li Y, Eppink ST, Hsu KK, Chesson HW, Gift TL, Berruti AA, Salomon JA, Rönn MMet al., 2023, Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study, Lancet Regional Health - Americas, Vol: 19

Background: Genital herpes (GH), caused by herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), is a common sexually transmitted disease associated with adverse health outcomes. Symptoms associated with GH outbreaks can be reduced by antiviral medications, but the infection is incurable and lifelong. In this study, we estimate the long-term health impacts of GH in the United States using quality-adjusted life years (QALYs) lost. Methods: We used probability trees to model the natural history of GH secondary to infection with HSV-1 and HSV-2 among people aged 18–49 years. We modelled the following outcomes to quantify the major causes of health losses following infection: symptomatic herpes outbreaks, psychosocial impacts associated with diagnosis and recurrences, urinary retention caused by sacral radiculitis, aseptic meningitis, Mollaret's meningitis, and neonatal herpes. The model was parameterized based on published literature on the natural history of GH. We summarized losses of health by computing the lifetime number of QALYs lost per genital HSV-1 and HSV-2 infection, and we combined this information with incidence estimates to compute the total lifetime number of QALYs lost due to infections acquired in 2018 in the United States. Findings: We estimated 0.05 (95% uncertainty interval (UI) 0.02–0.08) lifetime QALYs lost per incident GH infection acquired in 2018, equivalent to losing 0.05 years or about 18 days of life for one person with perfect health. The average number of QALYs lost per GH infection due to genital HSV-1 and HSV-2 was 0.01 (95% UI 0.01–0.02) and 0.05 (95% UI 0.02–0.09), respectively. The burden of genital HSV-1 is higher among women, while the burden of HSV-2 is higher among men. QALYs lost per neonatal herpes infection was estimated to be 7.93 (95% UI 6.63–9.19). At the population level, the total estimated lifetime QALYs lost as a result of GH infections acquired in 2018 was 33,100 (95% UI 12,600–67,90

Journal article

Reichert E, Yaesoubi R, Rönn MM, Gift TL, Salomon JA, Grad YHet al., 2023, Resistance-minimizing strategies for introducing a novel antibiotic for gonorrhea treatment: a mathematical modeling study., medRxiv

BACKGROUND: Gonorrhea is a highly prevalent sexually transmitted infection and an urgent public health concern due to increasing antibiotic resistance. Only ceftriaxone remains as the recommended treatment in the U.S. The prospect of approval of new anti-gonococcal antibiotics raises the question of how to deploy a new drug to maximize its clinically useful lifespan. METHODS: We used a compartmental model of gonorrhea transmission in the U.S. population of men who have sex with men to compare strategies for introducing a new antibiotic for gonorrhea treatment. The strategies tested included holding the new antibiotic in reserve until the current therapy reached a threshold prevalence of resistance; using either drug, considering immediate and gradual introduction of the new drug; and combination therapy. The primary outcome of interest was the time until 5% prevalence of resistance to both the novel drug and to the current first-line drug (ceftriaxone). FINDINGS: The reserve strategy was consistently inferior for mitigating antibiotic resistance under the parameter space explored. The reserve strategy was increasingly outperformed by the other strategies as the probability of de novo resistance emergence decreased and as the fitness costs associated with resistance increased. Combination therapy tended to prolong the development of antibiotic resistance and minimize the number of annual gonococcal infections. INTERPRETATION: Our study argues for rapid introduction of new anti-gonococcal antibiotics, recognizing that the feasibility of each strategy must incorporate cost, safety, and other practical concerns. The analyses should be revisited once robust estimates of key parameters-likelihood of emergence of resistance and fitness costs of resistance for the new antibiotic-are available. FUNDING: U.S. Centers for Disease Control and Prevention (CDC), National Institute of Allergy and Infectious Diseases.

Journal article

Lee K, You S, Li Y, Chesson H, Gift TL, Berruti AA, Hsu K, Yaesoubi R, Salomon JA, Ronn Met al., 2023, Estimation of the Lifetime Quality-Adjusted Life Years (QALYs) Lost Due to Syphilis Acquired in the United States in 2018, CLINICAL INFECTIOUS DISEASES, Vol: 76, Pages: E810-E819, ISSN: 1058-4838

Journal article

Yang L, Boily M-C, Rönn MM, Obiri-Yeboah D, Morhason-Bello I, Meda N, Lompo O, Mayaud P, Pickles M, Brisson M, Hodgins C, Delany-Moretlwe S, Maheu-Giroux Met al., 2023, Regional and country-level trends in cervical cancer screening coverage in sub-Saharan Africa: a systematic analysis of population-based surveys (2000-2020), PLoS Medicine, Vol: 20, Pages: 1-18, ISSN: 1549-1277

BACKGROUND: Sub-Saharan Africa (SSA) has the highest cervical cancer (CC) burden globally-worsened by its HIV epidemics. In 2020, the World Health Organization (WHO) introduced a CC elimination strategy with goals for vaccination, screening, and treatment. To benchmark progress, we examined temporal trends in screening coverage, percent screened at least twice by the age of 45, screening coverage among women living with HIV (WLHIV), and pre-cancer treatment coverage in SSA. METHODS AND FINDINGS: We conducted a systematic analysis of cross-sectional population-based surveys. It included 52 surveys from 28 countries (2000 to 2020) with information on CC screening among women aged 25 to 49 years (N = 151,338 women). We estimated lifetime and past 3-year screening coverage by age, year, country, and HIV serostatus using a Bayesian multilevel model. Post-stratification and imputations were done to obtain aggregate national, regional, and SSA-level estimates. To measure re-screening by age 45, a life table model was developed. Finally, self-reported pre-cancer treatment coverage was pooled across surveys using a Bayesian meta-analysis. Overall, an estimated 14% (95% credible intervals [95% CrI]: 11% to 21%) of women aged 30 to 49 years had ever been screened for CC in 2020, with important regional and country-level differences. In Eastern and Western/Central Africa, regional screening coverages remained constant from 2000 to 2020 and WLHIV had greater odds of being screened compared to women without HIV. In Southern Africa, however, screening coverages increased and WLHIV had equal odds of screening. Notably this region was found to have higher screening coverage in comparison to other African regions. Rescreening rates were high among women who have already been screened; however, it was estimated that only 12% (95% CrI: 10% to 18%) of women had been screened twice or more by age 45 in 2020. Finally, treatment coverage among 4 countries with data was 84% (95% CrI: 70% to

Journal article

Li Y, Ronn MM, Tuite AR, Chesson HW, Gift TL, Trikalinos TA, Testa C, Bellerose M, Hsu K, Berruti AA, Malyuta Y, Menzies NA, Salomon JAet al., 2022, Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: A modelling study of overall burden and disparities by age, race/ethnicity, and other factors, LANCET REGIONAL HEALTH-AMERICAS, Vol: 16, ISSN: 2667-193X

Journal article

Boily M-C, Barnabas R, Ronn MM, Bayer CJ, van Schalkwyk C, Soni N, Rao DW, Staadegaard L, Liu G, Silhol R, Brisson M, Johnson LF, Bloem P, Gottlieb S, Broutet N, Dalal Set al., 2022, Estimating the effect of HIV on cervical cancer elimination in South Africa: comparative modelling of the impact of vaccination and screening, EClinicalMedicine, Vol: 54, Pages: 1-18, ISSN: 2589-5370

BackgroundIn 2020, the World Health Organization (WHO) launched its initiative to eliminate cervical cancer as a public health problem. To inform global efforts for countries with high HIV and cervical cancer burden, we assessed the impact of human papillomavirus (HPV) vaccination and cervical cancer screening and treatment in South Africa, on cervical cancer and the potential for achieving elimination before 2120, considering faster HPV disease progression and higher cervical cancer risk among women living with HIV(WLHIV) and HIV interventions.MethodsThree independent transmission-dynamic models simulating HIV and HPV infections and disease progression were used to predict the impact on cervical cancer incidence of three scenarios for all women: 1) girls' vaccination (9–14 years old), 2) girls' vaccination plus 1 lifetime cervical screen (at 35 years), and 3) girls’ vaccination plus 2 lifetime cervical screens (at 35 and 45 years) and three enhanced scenarios for WLHIV: 4) vaccination of young WLHIV aged 15–24 years, 5) three-yearly cervical screening of WLHIV aged 15–49 years, or 6) both. Vaccination assumed 90% coverage and 100% lifetime protection with the nonavalent vaccine (against HPV-16/18/31/33/45/52/58). Cervical cancer screening assumed HPV testing with uptake increasing from 45% (2023), 70% (2030) to 90% (2045+). We also assumed that UNAIDS 90-90-90 HIV treatment and 70% male circumcision targets are reached by 2030. We examined three elimination thresholds: age-standardised cervical cancer incidence rates below 4 or 10 per 100,000 women-years, and >85% reduction in cervical cancer incidence rate. We conducted sensitivity analyses and presented the median age-standardised predictions of outcomes of the three models (minimum–maximum across models).FindingsGirls' vaccination could reduce age-standardised cervical cancer incidence from a median of 47.6 (40.9–79.2) in 2020 to 4.5 (3.2–6.3) per 100,000 women-years

Journal article

Staadegaard L, Rönn MM, Soni N, Bellerose ME, Bloem P, Brisson M, Maheu-Giroux M, Barnabas RV, Drolet M, Mayaud P, Dalal S, Boily M-Cet al., 2022, Immunogenicity, safety, and efficacy of the HPV vaccines among people living with HIV: A systematic review and meta-analysis, EClinicalMedicine, Vol: 52, ISSN: 2589-5370

Background: Vaccines have been demonstrated to protect against high-risk human papillomavirus infection (HPV), including HPV-16/18, and cervical lesions among HIV negative women. However, their efficacy remains uncertain for people living with HIV (PLHIV).We systematically reviewed available evidence on HPV vaccine on immunological, virological, or other biological outcomes in PLHIV. Methods: We searched five electronic databases (PubMed, Medline and Embase, clinicaltrials.gov and the WHO clinical trial database) for longitudinal prospective studies reporting immunogenicity, virological, cytological, histological, clinical or safety endpoints following prophylactic HPV vaccination among PLHIV. We included studies published by February 11th, 2021. We summarized results, assessed study quality, and conducted meta-analysis and subgroup analyses, where possible. Findings: We identified 43 publications stemming from 18 independent studies (Ns =18), evaluating the quadrivalent (Ns =15), bivalent (Ns =4) and nonavalent (Ns =1) vaccines. A high proportion seroconverted for the HPV vaccine types. Pooled proportion seropositive by 28 weeks following 3 doses with the bivalent, quadrivalent, and nonavalent vaccines were 0.99 (95% confidence interval: 0.95-1.00, Ns =1), 0.99 (0.98-1.00, Ns =9), and 1.00 (0.99-1.00, Ns =1) for HPV-16 and 0.99 (0.96-1.00, Ns =1), 0.94 (0.91-0.96, Ns =9), and 1.00 (0.99-1.00, Ns =1) for HPV-18, respectively. Seropositivity remained high among people who received 3 doses despite some declines in antibody titers and lower seropositivity over time, especially for HPV-18, for the quadrivalent than the bivalent vaccine, and for HIV positive than negative individuals. Seropositivity for HPV-18 at 29-99 weeks among PLHIV was 0.72 (0.66-0.79, Ns =8) and 0.96 (0.92-0.99, Ns =2) after 3 doses of the quadrivalent and bivalent vaccine, respectively and 0.94 (0.90-0.98, Ns =3) among HIV-negative historical controls. Evidence suggests that the seropositivity aft

Journal article

Rönn MM, Menzies NA, Salomon JA, 2022, Time trends between vaccination coverage and voting patterns before and during the COVID-19 pandemic: analysis of COVID-19 and flu surveys in the United States

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>We assessed the relationship between vaccination coverage and voting patterns: how has the association between COVID-19 vaccination and voting patterns changed during the pandemic, how does it compare to the association between flu vaccination coverage and voting patterns, and what can the time trends between flu vaccination and voting patterns tell us about the broader relationship between vaccination coverage and voting patterns.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analyzed survey data on flu and COVID-19 vaccination coverage utilizing National Immunization Surveys for flu (NIS-FLU; years 2010-2021) and for COVID (NIS-ACM; 2021-2022), CDC surveillance of COVID-19 vaccination coverage (2021-2022) and US COVID-19 Trends and Impact Survey (CTIS; 2021-2022). We described the association between state-level COVID-19 and flu vaccination coverage and state-level voting patterns using Pearson correlation coefficient. We examined individual-level characteristics of people vaccinated for COVID-19 and for flu using logistic regression among responses in CTIS during April-June 2022. We analyzed flu vaccination coverage by age in NIS-FLU between 2010-2021, and its relationship with voting patterns to see whether there has been a departure from the secular pre-pandemic trend during the pandemic.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Between May 2021 – June 2022 there was a strong and consistent correlation between state-level COVID-19 vaccination coverage and voting patterns for the Democratic party in the 2020 presidential elections. Pearson correlation coefficient was around 0.8 in NIS-ACM, CTIS and CDC surveillance with a range of 0.76–0.92. COVID-19 vaccination coverage in June 2022 was higher than flu vac

Journal article

Salomon JA, Reinhart A, Bilinski A, Chua EJ, La Motte-Kerr W, Ronn MM, Reitsma MB, Morris KA, LaRocca S, Farag TH, Kreuter F, Rosenfeld R, Tibshirani RJet al., 2021, The US COVID-19 Trends and Impact Survey: Continuous real-time measurement of COVID-19 symptoms, risks, protective behaviors, testing, and vaccination, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, Vol: 118, ISSN: 0027-8424

Journal article

Earnest R, Ronn MM, Bellerose M, Menon-Johansson AS, Berruti AA, Chesson HW, Gift TL, Hsu KK, Testa C, Zhu L, Malyuta Y, Menzies NA, Salomon JAet al., 2021, Modeling the Cost-Effectiveness of Express Multisite Gonorrhea Screening Among Men Who Have Sex With Men in the United States, SEXUALLY TRANSMITTED DISEASES, Vol: 48, Pages: 805-812, ISSN: 0148-5717

Journal article

Silhol R, Geidelberg L, Mitchell K, Mishra S, Dimitrov D, Bowring A, Behanzin L, Guedou F, Diabate S, Schwartz S, Billong S, Mfochive Njindam I, Levitt D, Mukandavire C, Maheu-Giroux M, Rönn M, Dalal S, Vickerman P, Baral S, Alary M, Boily M-Cet al., 2021, Assessing the potential impact of disruptions due to COVID-19 on HIV among key and lower-risk populations in the largest cities of Cameroon and Benin, JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol: 87, Pages: 899-911, ISSN: 1525-4135

Background: The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID-19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men (MSM), and overall.Setting: Yaoundé (Cameroon) and Cotonou (Benin).Methods: We used mathematical models of HIV calibrated to city- and risk-population-specific demographic/behavioural/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared to a scenario without COVID-19.Results: A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31% and 23% among MSM, FSW, clients, and overall in Yaoundé respectively, and 69%, 49% and 23% among FSW, clients and overall respectively in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships.Conclusions: Reductions in condom use following COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritised to minimise short-term excess HIV-related deaths.

Journal article

Tuite AR, Testa C, Ronn M, Bellerose M, Gift T, Fridge J, Molotnikov L, Desmarais C, Berruti A, Menzies N, Malyuta Y, Hsu K, Salomon JAet al., 2020, Exploring How Epidemic Context Influences Syphilis Screening Impact: A Mathematical Modeling Study, SEXUALLY TRANSMITTED DISEASES, Vol: 47, Pages: 798-810, ISSN: 0148-5717

Journal article

Ronn MM, Dunville R, Wang LY, Bellerose M, Malyuta Y, Menzies NA, Aslam M, Lewis F, Walker-Baban C, Asbel L, Parchem S, Masinter L, Perez E, Gift TL, Hsu K, Barrios LC, Salomon JAet al., 2020, Mathematical modeling study of school-based chlamydia screening: potential impact on chlamydia prevalence in intervention schools and surrounding communities, BMC PUBLIC HEALTH, Vol: 20

Journal article

Earnest R, Ronn MM, Bellerose M, Gift TL, Berruti AA, Hsu KK, Testa C, Zhu L, Malyuta Y, Menzies NA, Salomon JAet al., 2020, Population-level Benefits of Extragenital Gonorrhea Screening Among Men Who Have Sex With Men: An Exploratory Modeling Analysis, SEXUALLY TRANSMITTED DISEASES, Vol: 47, Pages: 484-490, ISSN: 0148-5717

Journal article

Ronn MM, Menzies NA, Gift TL, Chesson HW, Trikalinos TA, Bellerose M, Malyuta Y, Berruti A, Gaydos CA, Hsu KK, Salomon JAet al., 2020, Potential for Point-of-Care Tests to Reduce Chlamydia-associated Burden in the United States: A Mathematical Modeling Analysis, CLINICAL INFECTIOUS DISEASES, Vol: 70, Pages: 1816-1823, ISSN: 1058-4838

Journal article

Ronn MM, Testa C, Tuite AR, Chesson HW, Gift TL, Schumacher C, Williford SL, Zhu L, Bellerose M, Earnest R, Malyuta Y, Hsu KK, Salomon JA, Menzies NAet al., 2020, The Potential Population-Level Impact of Different Gonorrhea Screening Strategies in Baltimore and San Francisco: An Exploratory Mathematical Modeling Analysis, SEXUALLY TRANSMITTED DISEASES, Vol: 47, Pages: 143-150, ISSN: 0148-5717

Journal article

Ronn M, Gift T, Chesson H, Malyuta Y, Hsu K, Salomon Jet al., 2019, OPTIMIZING SCREENING FOR CHLAMYDIA: IS THERE A ROLE FOR SCREENING HETEROSEXUAL MEN?, Publisher: BMJ PUBLISHING GROUP, Pages: A70-A70, ISSN: 1368-4973

Conference paper

Ronn MM, Tuite AR, Menzies NA, Wolf EE, Gift TL, Chesson HW, Torrone E, Berruti A, Mazzola E, Galer K, Hsu K, Salomon JAet al., 2019, The Impact of Screening and Partner Notification on Chlamydia Prevalence and Numbers of Infections Averted in the United States, 2000-2015: Evaluation of Epidemiologic Trends Using a Pair-Formation Transmission Model, AMERICAN JOURNAL OF EPIDEMIOLOGY, Vol: 188, Pages: 545-554, ISSN: 0002-9262

Journal article

Ronn M, Mc Grath-Lone L, Davies B, Wilson J, Ward Het al., 2019, Evaluation of the performance of nucleic acid amplification tests (NAATs) in detection of chlamydia and gonorrhoea infection in vaginal specimens relative to patient infection status: a systematic review, BMJ Open, Vol: 9, ISSN: 2044-6055

OBJECTIVE: We aimed to assess the performance of NAATs using vaginal specimens in comparison to other urogenital specimens in their ability to detect chlamydia and gonorrhea infection in women.DESIGN: Systematic review.DATA SOURCES: EMBASE and Ovid MEDLINE databases through 3 October 2017.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included studies that tested samples from the vagina and ≥1 other site (cervix and/or urine) with ≥2 NAATs for chlamydia and ≥2 NAATs or 1 NAAT and culture for gonorrhoea for each site.DATA EXTRACTION AND SYNTHESIS: We compared the performance of NAATs on specimens taken from the vagina to those from the cervix or urine in diagnosing chlamydia and gonorrhoea infection in women based on patient infection status (PIS). We analysed the performance using vaginal specimens compared to PIS. Performance is defined as the sensitivity of a NAAT using a specimen site and PIS status of the patient. We assessed risk of bias using modified QUADAS-2.RESULTS: Nine publications met the inclusion criteria (eight for chlamydia; six for gonorrhoea) and were narratively reviewed. Pooled summary estimates were not calculated due to the variable methodology and PIS definitions. Tests performed on vaginal specimens accomplished similar performance to cervical and urine specimens for chlamydia (range of performance estimates: vaginal 65-100%, cervical 59-97%, urine 57-100%) and gonorrhoea (vaginal 64-100%, cervical 85-100%, urine 67-94%). Vaginal specimens were estimated to have a performance >80% for chlamydia and gonorrhoea infections in all but one study.CONCLUSIONS: Performance of the NAATs for chlamydia and gonorrhea detection using vaginal specimens was similar to that of cervical and urine specimens relativeto PIS. As vaginal samples have a higher acceptability and lower cost, the study can support clinical testing guidelines by providing evidence that vaginal samples are a suitable alternative to traditional test sites.

Journal article

Tuite AR, Fisman DN, Ronn MM, 2018, The Epidemiology of Sexual Partnerships-It's Complicated, JAMA NETWORK OPEN, Vol: 1, ISSN: 2574-3805

Journal article

Tuite AR, Ronn MM, Wolf EE, Gift TL, Chesson HW, Berruti A, Galer K, Menzies NA, Hsu K, Salomon JAet al., 2018, Estimated Impact of Screening on Gonorrhea Epidemiology in the United States: Insights From a Mathematical Model, SEXUALLY TRANSMITTED DISEASES, Vol: 45, Pages: 713-722, ISSN: 0148-5717

Journal article

Looker K, Ronn M, Brock P, Brisson M, Drolet M, Mayaud P, Boily MCet al., 2018, Evidence of synergistic relationships between HIV and human papillomavirus (HPV): Systematic reviews and meta-analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status, Journal of the International AIDS Society, Vol: 21, ISSN: 1758-2652

Introduction:Observational studies suggest HIV and human papillomavirus (HPV) infections may have multiple interactions. We reviewed the strength of the evidence for the influence of HIV on HPV acquisition and clearance, and the influence of HPV on HIV acquisition. Methods:We performed meta-analytic systematic reviews of longitudinal studies of HPV incidence and clearance rate by HIV status (review 1) and of HIV incidence by HPV status (review 2). We pooled relative risk (RR) estimates across studies using random-effect models. I2 statistics and subgroup analyses were used to quantify heterogeneity across estimates and explore the influence of participant and study characteristics including study quality. Publication bias was examined quantitatively with funnel plots and subgroup analysis, as well as qualitatively. Results and discussion: Inreview 1, 37 publications (25 independent studies) were included in the meta-analysis. HPV incidence (pooled RR=1.55, 95%CI 1.29-1.88; heterosexual males: pooled RR=1.95, 95%CI 1.62, 2.34; females: pooled RR=1.63, 95%CI 1.26-2.11; men who have sex with men: pooled RR=1.36, 95%CI 1.01-1.82) and high-risk HPV incidence (pooled RR=2.20, 95%CI 1.90-2.54) was approximately doubled among people living with HIV (PLHIV) whereas HPV clearance rate (pooled RR=0.53, 95%CI 0.42-0.67) was approximately halved. Inreview 2, 14 publications (11 independent studies) were included in the meta-analysis. HIV incidence was almost doubled (pooled RR=1.91, 95%CI 1.38-2.65) in the presence of prevalent HPV infection. There was more evidence of publication bias in review 2, and somewhat greater risk of confounding in studies included in review 1. There was some evidence that adjustment for key confounders strengthened the associations for review 2. Misclassification bias by HIV/HPV exposure status could also have biased estimates toward the null. Conclusions:These results provide evidence for synergistic HIV and HPV interactions of clinical and public

Journal article

Ronn MM, Turner KME, 2018, The dawn of novel STI prevention methods: modelling potential unintended effects of changes in cervical cancer screening guidelines on trichomoniasis, SEXUALLY TRANSMITTED INFECTIONS, Vol: 94, Pages: 161-162, ISSN: 1368-4973

Journal article

Ronn MM, Tuite A, Menzies NA, Gift T, Chesson H, Torrone E, Wolf EE, Galer K, Hsu K, Salomon JAet al., 2017, EVALUATING CHLAMYDIA TRENDS IN THE UNITED STATES 2000-2015 USING A PAIR FORMATION TRANSMISSION MODEL, Publisher: BMJ PUBLISHING GROUP, Pages: A2-A3, ISSN: 1368-4973

Conference paper

Looker KJ, Ronn MM, Brock PM, Brisson M, Drolet M, Mayaud P, Boily M-Cet al., 2017, WHAT IS THE STRENGTH OF EVIDENCE FOR HIV AND HPV INTERACTIONS? RESULTS FROM SYSTEMATIC REVIEWS AND META-ANALYSES OF LONGITUDINAL STUDIES, Publisher: BMJ PUBLISHING GROUP, Pages: A41-A41, ISSN: 1368-4973

Conference paper

Ronn MM, Wolf EE, Chesson H, Menzies NA, Galer K, Gorwitz R, Gift T, Hsu K, Salomon JAet al., 2017, The Use of Mathematical Models of Chlamydia Transmission to Address Public Health Policy Questions: A Systematic Review, SEXUALLY TRANSMITTED DISEASES, Vol: 44, Pages: 278-283, ISSN: 0148-5717

Journal article

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