Sentinel surveillance, where selected jurisdictions follow standardized protocols to collect and report enhanced public health data not available through other routine surveillance efforts, is a key part of national surveillance of sexually transmitted diseases (STDs). Although four STDs are nationally notifiable conditions (chlamydia, gonorrhea, syphilis and chancroid), the burden of these conditions (over 2.3 million cases were reported in 2017) limits the amount of detailed clinical and demographic data available for all cases. Sentinel surveillance in clinical settings serving at-risk populations, such as STD clinics, provides an opportunity to collect enhanced data elements on persons seeking STD-related services, such as sex of sex partners and anatomic site of infection. However, there are challenges in combining data across jurisdictions as estimated effect measures may vary by jurisdiction (e.g., some may have higher observed burden of disease among certain populations) and the amount of data contributed by jurisdiction may vary; combined this could lead to biased estimates if heterogeneity is not taken into account.
Objective: To identify best practices for combining public health data for multi-jurisdiction surveillance projects.