Public health funding and chlamydia and gonorrhea rates among adolescents during the COVID-19 pandemic in Ontario, Canada: An interrupted time series study
Bibliographic record
Abstract
OBJECTIVES: We estimated the association between local public health infectious and communicable diseases (ICD) funding and chlamydia and gonorrhea trends before and during the COVID-19 pandemic among adolescents aged 13-19 in Ontario, Canada. STUDY DESIGN: Quasi-experimental, interrupted time series. METHODS: We conducted a population-based analysis using repeated cross-sectional data of chlamydia and gonorrhea incidence among adolescents across Ontario's 34 regional public health units from January 2015 to October 2022. We used negative binomial-regression to estimate changes in chlamydia and gonorrhea incidence before and during the COVID-19 pandemic, and whether these changes differed by 2019 ICD per capita public health funding. RESULTS: During the study period, there were 51,230 adolescent cases of chlamydia and 5256 of gonorrhea with most cases in females and older adolescents (age 18-19). Pre-pandemic, chlamydia rates increased over time (Risk ratio (RR) = 1.01, 95 % confidence interval (CI): 1.01-1.01, per month). There was an immediate decrease in chlamydia rates post-pandemic onset (RR = 0.26, 95 % CI: 0.12-0.53) though higher rates were observed with increasing 2019 ICD per capita funding (RR = 1.11, 95 % CI: 1.05-1.17, per dollar of ICD per capita funding, post-pandemic onset). Similar trends were observed for gonorrhea, but estimates had lower precision. CONCLUSION: Higher pre-pandemic 2019 ICD per capita funding may have allowed greater sexual health screening services during the COVID-19 pandemic, potentially mitigating a larger drop in STI detection. Results suggest that higher public health funding may allow for greater resilience of sexual health services during public health emergencies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".