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Enhanced Syphilis Surveillance in Baltimore

Enhanced Syphilis Surveillance in Baltimore. Scott Tulloch Maryland State Department of Health and Mental Hygiene. Comprehensive Evaluation of the Syphilis Surveillance System. Over period of 1999-2000, the SEP performed evaluation of surveillance system following CDC guidelines

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Enhanced Syphilis Surveillance in Baltimore

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  1. Enhanced Syphilis Surveillance in Baltimore Scott Tulloch Maryland State Department of Health and Mental Hygiene

  2. Comprehensive Evaluation of the Syphilis Surveillance System • Over period of 1999-2000, the SEP performed evaluation of surveillance system following CDC guidelines • 18 recommendations generated • Most have been implemented, others are in process of implementation

  3. Elements of Enhanced Syphilis Surveillance in Baltimore • Expanded data collection (especially behavioral risks) • Enhanced syphilis interview • Jail Stat Lab project • Cross-jurisdictional data sharing • Expanded community screening

  4. Behavioral Risk (Local Use) Variables • Collected on all syphilis cases as part of Original Patient Interview • Immediately indicates membership in suspected high prevalence networks • People who in engage in these behaviors are considered integral to spread of syphilis

  5. Local Use Variables

  6. Local Use Variables from InterviewsApr. 2001 – Jan. 2002 (n=120)

  7. Congenital Syphilis Supplemental Data Collection • CDC 126 form can be limited for diagnosing CS risks • Designed supplemental data collection form to be used with CS investigations • Presently collect detailed data on: • Prenatal care during each trimester • If no prenatal care, reason(s) why • Drug screen information • Risk history of mother

  8. Modified Interview: The Syphilis Assessment • Since December 2000, syphilis cases have been asked to identify locations where they met their sex partner(s) • Cases also report on risk behaviors occurring at these meeting places

  9. Assessment Form -Focuses on where cases met their sex partners -Scanned into a database -Places and risks are mapped using GIS software

  10. Sex Partner Meeting Places (n=55)

  11. Stat Lab Project • Jail-based rapid disease intervention initiative • Prevalence monitoring of high-risk population • Partnering with local SE activities

  12. Syphilis Reactor Prevalence (in%) At Baltimore City Jail By Sex and Quarter, 1998-2001

  13. Percentage of Baltimore City P&S Syphilis Identified By Jail-Based Screening By Year (1999-2001)

  14. Associated Risk Factors for P&S Syphilis Cases Identified by Jail-Based Screening (2001)

  15. Cross-Jurisdictional Data Sharing • Assessment forms used by Baltimore are also used in surrounding counties, including jails. • Jail screening data (under jurisdiction of MD state), can now be shared for more complete syphilis histories

  16. Enhanced Community Screening • “Piggyback” syphilis screening at sites where blood is being drawn for HIV test • Create leadership through funding key CBO partners • Partner with community clinics • Rapid Response Team outreach screening

  17. Conclusion • Creating an effective “tool” • Multi-pronged approached • Representative • Data supported interventions • Community Involvement • Community • Community • Community

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