{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T15:08:22Z","timestamp":1771340902521,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Australian National Health and Medical Research Council early career fellowship","award":["GNT1104781"],"award-info":[{"award-number":["GNT1104781"]}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"crossref","award":["xjh012019055 xzy032020026"],"award-info":[{"award-number":["xjh012019055 xzy032020026"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Xi\u2019an Jiaotong University Young Scholar Support Grant","award":["YX6J004"],"award-info":[{"award-number":["YX6J004"]}]},{"name":"Epidemiology modeling and risk assessment","award":["20200344"],"award-info":[{"award-number":["20200344"]}]},{"name":"Outstanding Young Scholars Support Program","award":["3111500001"],"award-info":[{"award-number":["3111500001"]}]},{"name":"Australian National Health and Medical Research Council Leadership Investigator Grant","award":["GNT1172900"],"award-info":[{"award-number":["GNT1172900"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["11801435"],"award-info":[{"award-number":["11801435"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81950410639"],"award-info":[{"award-number":["81950410639"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2018M631134"],"award-info":[{"award-number":["2018M631134"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Xi\u2019an Jiaotong University Basic Research and Profession Grant","award":["xtr022019003 xzy032020032"],"award-info":[{"award-number":["xtr022019003 xzy032020032"]}]},{"DOI":"10.13039\/501100017596","name":"Natural Science Basic Research Program of Shaanxi Province","doi-asserted-by":"crossref","award":["2019JQ-187"],"award-info":[{"award-number":["2019JQ-187"]}],"id":[{"id":"10.13039\/501100017596","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian National Health and Medical Research Council Emerging Leadership Investigator Grant","award":["GNT1172873"],"award-info":[{"award-number":["GNT1172873"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,9,14]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The incidence of\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      and its antimicrobial resistance is increasing in many countries. Antibacterial mouthwash may reduce gonorrhoea transmission without using antibiotics. We modelled the effect that antiseptic mouthwash may have on the incidence of gonorrhoea.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We developed a mathematical model of the transmission of gonorrhoea between each anatomical site (oropharynx, urethra and anorectum) in men who have sex with men (MSM). We constructed four scenarios: (1) mouthwash had no effect; (2) mouthwash increased the susceptibility of the oropharynx; (3) mouthwash reduced the transmissibility from the oropharynx; (4) the combined effect of mouthwash from scenarios 2 and 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We used data at three anatomical sites from 4873 MSM attending Melbourne Sexual Health Centre in 2018 and 2019 to calibrate our models and data from the USA, Netherlands and Thailand for sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Published available data on MSM with multisite infections of gonorrhoea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Incidence of gonorrhoea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall incidence of gonorrhoea was 44 (95% CI 37 to 50)\/100 person-years (PY) in scenario 1. Under scenario 2 (20%\u201380%\u2009mouthwash coverage), the total incidence increased (47\u201360\/100 PY) and at all three anatomical sites by between 7.4% (5.9%\u201360.8%) and 136.6% (108.1%\u2013177.5%). Under scenario 3, with the same coverage, the total incidence decreased (20\u201339\/100 PY) and at all anatomical sites by between 11.6% (10.2%\u201313.5%) and 99.8% (99.2%\u2013100%). Under scenario 4, changes in the incidence depended on the efficacy of mouthwash on the susceptibility or transmissibility. The effect on the total incidence varied (22\u201355\/100 PY), and at all anatomical sites, there were increases of nearly 130% and large declines of almost 100%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The effect of mouthwash on gonorrhoea incidence is largely predictable depending on whether it increases susceptibility to or reduces the transmissibility of gonorrhoea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-052823","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T20:31:01Z","timestamp":1633725061000},"page":"e052823","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Potential effect of antiseptic mouthwash on the incidence of\n                    <i>Neisseria gonorrhoeae<\/i>\n                    among men who have sex with men: a mathematical modelling study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-4734","authenticated-orcid":false,"given":"Xianglong","family":"Xu","sequence":"first","affiliation":[{"name":"China-Australia Joint Research Center for Infectious Diseases,School of Public Health, Xi\u2019an Jiaotong University Health Science Centre, Xi an, Shanxi, People\u2019s Republic of China"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingwang","family":"Shen","sequence":"additional","affiliation":[{"name":"China-Australia Joint Research Center for Infectious Diseases,School of Public Health, Xi\u2019an Jiaotong University Health Science Centre, Xi an, Shanxi, People\u2019s Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuoru","family":"Zou","sequence":"additional","affiliation":[{"name":"China-Australia Joint Research Center for Infectious Diseases,School of Public Health, Xi\u2019an Jiaotong University Health Science Centre, Xi an, Shanxi, People\u2019s Republic of 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