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Response to White and Lewis: Letter to editor in response to Has Chlamydia trachomatis prevalence in young women in England, Scotland and Wales changed? Evidence from national probability surveys. Epidemiology and Infection. 2019

Published online by Cambridge University Press:  20 September 2019

D. Z. Kounali Open the ORCID record for D. Z. Kounali [Opens in a new window] ,
A. E. Ades ,
K. Soldan  and
P. Horner
D. Z. Kounali*
Affiliation:
Population Health Sciences, Bristol Medical School, 38 Whatley Road Bristol BS2 8PS, UK National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK
A. E. Ades
Affiliation:
Population Health Sciences, Bristol Medical School, 38 Whatley Road Bristol BS2 8PS, UK
K. Soldan
Affiliation:
National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
P. Horner
Affiliation:
Population Health Sciences, Bristol Medical School, 38 Whatley Road Bristol BS2 8PS, UK National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK
*
Author for correspondence: D. Z. Kounali, E-mail: daphne.kounali@bristol.ac.uk
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Abstract

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Type
Letter to the Editor
Information
Epidemiology & Infection , Volume 147 , 2019 , e272
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s) 2019

White and Lewis [Reference White and Lewis1] comment on our article [Reference Kounali2] highlighting the methodological issues arising when attempting to use the National survey of Attitudes and Sexual Lifestyles (NATSAL) to calibrate estimates of seroprevalence derived from data available by sources such as the PHE Seroepidemiology Unit [Reference Horner3] and Health Survey for England [Reference Mindell4]. White and Lewis [Reference White and Lewis1] do not challenge our observations. We agree with White and Lewis [Reference White and Lewis1] on the importance of data on health-seeking behaviour. It is not possible to use data on individuals who are tested for CT to make inferences about CT prevalence, or changes in CT prevalence over time, without information on how the CT prevalence relates to the probability of being tested, and how that changes over time [Reference Soldan, Dunbar and Gill5–Reference Miller7]. Individuals may be tested for a number of reasons: following an ad hoc offer of opportunistic testing; as a result of symptoms; or concern about recent sexual encounters. Each of these factors may impact on CT prevalence among those tested in GP surgeries or GUM clinics.

Acknowledgements

This work was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol in partnership with Public Health England (PHE). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England.

References

1.White, PJ and Lewis, J (2019) Letter to editor in response to Has Chlamydia trachomatis prevalence in young women in England, Scotland and Wales changed? Evidence from national probability surveys. Epidemiology and Infection 147, e271. Cambridge University Press.Google Scholar
2.Kounali, DZ et al. (2019) Has Chlamydia trachomatis prevalence in young women in England, Scotland and Wales changed? Evidence from national probability surveys. Epidemiology and Infection 147, e107, 1–7.Google Scholar
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