Conference Abstract Compendium Examples from the ... - CityMatCH

More documents

Recommendations

Info

2009 CityMatCH Urban MCH Leadership ConferenceEnhanced surveillance, analysis of, and rapid response to simultaneous outbreaks ofsyphilis among heterosexuals and men-who-have-sex-with-men(MSM)/bisexual inCuyahoga County, OhioPRIMARY CONTACT:David Bruckman, MS, MT(ASCP)Chief Systems Analyst/BiostatisticianCleveland Department of Public Health75 Erieview Plaza, 3rd FloorCleveland, OH, 44114-1839Phone: (216) 664-4353Fax: (216) 440-7741Email: dbruckman@city.cleveland.oh.usWebsite: www.clevelandhealth.orgCATEGORYInfectious disease and MCHFOCUSProgram Policy FocusISSUEA nationwide increase in syphilis incidence heightens the risk of congenital syphilis. The index ofsuspicion among perinatal care organizations, medical care centers and clinics to recognize syphilissymptoms and screen for syphilis may be very low. Conversely, surveillance information, includingcongenital cases occurring or prevented, do not diffuse to caregivers. Our objective was to circumvent thisdisconnect, obtain syphilis surveillance data from state officials and disseminate outbreak information toclinicians and the public.SETTINGCity of Cleveland and Cuyahoga County (pop. 1.37 million); A consortium of city, county and statepublic health officials and public health agency medical directors having affiliation to local medicalcenters.PROJECTCleveland Department of Public Health twice obtained syphilis surveillance data, in July 2008 andJanuary 2009, from the Ohio Department of Health in Columbus. Data were analyzed and shared with aconsortium of local and state public health agencies and representatives from school districts, Ryan Whitefunding and child and maternal health (CMH) offices. The outbreak of early syphilis (primary, secondary,and early latent) began in July 2007 and has accelerated through November 2008. Two populations wereidentified: heterosexuals males and females (88% African American) and men who have sex with menand male and bisexual males (across all races/ethnicities). Since the latter group is more often identified inoutbreaks, an outbreak among heterosexuals alarmed public health officials. Two-thirds of heterosexuals20
2009 CityMatCH Urban MCH Leadership Conferenceinfected with syphilis were under age 35, among whom Chlamydia and gonorrhea rates are highest; thenumber of female cases equaled males. Two females were pregnant when found positive for syphilis andtreated. No congenital cases have been reported to date. Medical directors of the three local and countypublic health offices informed the public and clinical community through a press briefing and an alertletter for general circulation. PowerPoint slide presentations for medical and prevention education weredisseminated.BARRIERSSyphilis surveillance data reported by state offices does not provide orientation or behavior of cases at thecounty or city level. Had local health officials relied solely on these reports, the outbreak amongheterosexuals may have gone undetected entirely, or at least delayed for months. Swift action by DiseaseIntervention Specialists to warn local health officials of the overall increase was key to initial recognition.Obtaining surveillance data for analysis was critical to uncover the outbreak among heterosexuals andbegin prevention activities. Because of previous surveillance cooperation with state STD prevention units,CDPH was able to obtain local syphilis data.LESSONS LEARNEDAll cases of congenital syphilis are preventable. MCH offices and prevention programs should monitortrends in STDs that impact CMH and develop stronger ties to epidemiology and surveillance offices atlocal and state levels. MCH programs should encourage LHDs (local health departments) to develop andmaintain analytical capacity to routinely analyze vital statistics and STD surveillance data and providecurrent findings that impact CMH activities. If analytical resources are few to review surveillance data indepth,LHDs can partner with local universities to leverage resources.INFORMATION FOR REPLICATION• Share FTE of a data analyst for surveillance capacity.• Analysis: use of SAS software or similar. Can be done in Excel using pivot tables and queries.• Basic epidemiology knowledge (e.g. incidence rate) and use of census data for denominators areneeded.• Joint consortium of local and state public health officials is suggested.• Open communication of surveillance results between public health officials and disease interventionspecialists (who perform patient/partner notification of HIV, syphilis and other STDs) with CMH offices,emergency rooms, hospitals, clinics and subspecialty providers.21
Page 1: 2009 CityMatCH Urban Maternal andCh
Page 5: 2009 CityMatCH Urban MCH Leadership
Page 8 and 9: Work it out: Engaging public health
Page 10 and 11: 2009 CityMatCH Urban MCH Leadership
Page 18 and 19: 122009 CityMatCH Urban MCH Leadersh
Page 60 and 61: 542009 CityMatCH Urban MCH Leadersh
Page 76 and 77:
2009 CityMatCH Urban MCH Leadership
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
• Create new points of contact fo
Page 122 and 123:
Page 124 and 125:
satisfaction with the treatment and
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
show all

Conference Abstract Compendium Examples from the ... - CityMatCH

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?