Residential mobility impacts relative risk estimates of space-time clusters of chlamydia in Kalamazoo County, Michigan

We determine the impact of residential mobility in the prevalence and transmission dynamics of sexually transmitted infections. We illustrate our approach on reported chlamydia infections obtained from the Michigan Disease Surveillance System for Kalamazoo County, USA, from 2006 to 2014. We develop two scenarios, one with fixed residential addresses and one considering residential mobility. We then compare the resulting space-time clusters and relative risk (RR) of infection. The space-time scan statistics showed increased RR in an area with previously low risk of sexually transmitted infections. In addition, even though the spatial extent of the three clusters identified did not change significantly at the scale we conducted our analysis at, the temporal extent (duration) did exhibit significant changes and could be considered for unique interventions. The results indicate that residential mobility has some dependency on the prevalence and transmission dynamics of sexually transmitted infections to new areas. We suggest that strategies adopted to reduce the burden of sexually transmitted infections take into consideration the relatively high residential mobility of at-risk populations to reduce spreading the infections to new areas.