The Role of Geography, Marginalization, and Testing on Observed Chlamydia Rates in Peel Region, Ontario, Canada
Chlamydia rates in Canada and in the province of Ontario have continued to climb in recent years despite widespread screening programs. This thesis aims to untangle the variability that exists in the reported rates of chlamydia in Peel region, Ontario, Canada and the variation across both age and sex groups, and geography. The first study investigated chlamydia rates in Peel region, Ontario using geospatial analysis methods. Rates across Peel region were found to display geographic heterogeneity and clusters of increased risk were identified. Rates in Peel region at the census tract-level were found to be associated with dimensions of the Ontario Marginalization Index. The second study examined differential testing across age and sex groups and estimated test-adjusted incidence. Males aged 15–19 and 30–39 years were estimated to have increased incidence rates if tested at the same rate as the maximally tested group. The results of these studies identify groups that may be driving the transmission of chlamydia within the region. Targeting resources towards these groups could be important for curbing chlamydia rates.