Exploring causal mechanisms and essential factors in the prevention and control of chlamydia in Guangdong, Southern China: a study protocol

• Published in: BMC infectious diseases Vol. 23; no. 1; p. 628
• Main Authors: He, Wenjun, Zhao, Peizhen, Yang, Tao, Wan, Yuting, Wu, Dadong, Chen, Xiaoshan, Huang, Zizhen, Luo, Huanyuan, Xu, Dong Roman, Huang, Shujie, Wang, Cheng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25-09-2023; BioMed Central; BMC
• Subjects: Analysis; Causal loop diagram; Causality; China - epidemiology; Chlamydia; Chlamydia infections; Chlamydia Infections - epidemiology; Chlamydia Infections - prevention & control; Chlamydia prevention and control; Chlamydia trachomatis; Consensus; Decisions; Developing countries; Disease prevention; Disease transmission; Dynamic characteristics; Evaluation; Feedback; Feedback mechanisms; Female; Health aspects; Humans; Infection; Infections; Infectious diseases; International organizations; Intervention development; LDCs; Literature reviews; Mathematical analysis; Medical research; Medicine, Experimental; Metronidazole; Perinatal exposure; Pilot projects; Population; Pregnancy; Prevention; Quantitative analysis; Research design; Risk factors; Sexual behavior; Sexually transmitted diseases; Social aspects; STD; Study Protocol; System dynamics; System dynamics modeling; Women; Womens health; China; Guangdong China; Chlamydia prevention and control; Feedback mechanisms; Causal loop diagram; System dynamics modeling; Intervention development
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08597-y

Chlamydia Trachomatis (CT) is among the most prevalent sexually transmitted diseases (STDs) globally. According to the World Health Organization, more than 131 million people get infected with CT annually. CT is usually transmitted via sexual contact or perinatal exposure and can result in severe long-term complications. In developing nations, particularly, the prevention and control of CT is challenging. Hence, this study will explore the feedback mechanisms of chlamydia prevention and control, as well as identify the essential factors affecting the control and prevention of this infection in China.
Our study will employ a mixed-methods research design that encompasses both qualitative and quantitative methods. Firstly, we will develop a causal loop diagram (CLD) based on the literature review and optimize it via in-depth interviews with stakeholders. Additionally, we will utilize a quantitative method called MICMAC(Impact Matrix Cross-Reference Multiplication Applied to a Classification tool) to obtain consensus among different stakeholders and pinpoint the key information. Next, the CLD will be transformed into a system dynamics model (SDM) to evaluate the feedback mechanisms within the CLD. The causality in the CLD will be modeled using mathematical equations, which facilitate the transformation into an SDM. As such, we will be able to analyze the dynamic behavior of the system and its response to different decisions.
Our study offers a systematic perspective on the control and prevention of chlamydia infection through system dynamics modeling, examining the dynamic properties and background factors of the system. The creation of the CLD affords stakeholders the chance to comprehend the functionality of their relationships and improve cooperation. Consequently, by evaluating the outcomes of these simulations, it will be possible to analyze and determine potential interventions and their effects on chlamydia infections. This modeling approach can help us gain insight into the dynamic characteristics of the system, evaluate the potential outcomes of different decisions, and design control strategies to either stabilize the system or adjust its behavior.