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Sexually Transmitted Disease (STD)

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.

Submitted by elamb on

Although U.S. Mother to Child transmission (MCT) rates of HIV have been reduced from approximately 25% to less than 2%, transmissions continue to occur.1 This reduction comes in a large part from treating pregnant mothers with antiretroviral medications.2 Despite these efforts, Louisiana has one of the highest rates of MCT of HIV in the U.S.3 Real-time identification of pregnancy status would allow high risk HIV-infected pregnant women to be targeted for follow-up. In Louisiana, laboratories are required to report positive HIV tests to SHP, most of which are received in electronic lab reporting (ELR) format. Although pregnancy status is not a variable provided on lab reports, some reports do contain information that is useful in identifying pregnancy status.

Objective

To identify, in real-time, pregnancy status of HIV-infected women through information found in laboratory reports received by the STD/HIV Program (SHP) at the Louisiana Office of Public Health. This identification will be used for targeted follow-up.

Submitted by knowledge_repo… on
  • Objective: To monitor clinical encounters for gonorrhea infection and disease
  • Syndromic surveillance system: ESSENCE
  • Data Sources: Emergency department visits, primary and urgent care visits 
  • Fields used to query the data: Chief Complaint History, Discharge Diagnosis
Submitted by adylina on
  • Objective: To monitor clinical encounters for chlamydia infection and disease
  • Syndromic surveillance system: ESSENCE
  • Data Sources: Emergency department visits, primary and urgent care visits 
  • Fields used to query the data: Chief Complaint History, Discharge Diagnosis

 

Submitted by adylina on

The increasing use of the Internet to arrange sexual encounters presents challenges to public health agencies formulating STD interventions, particularly in the context of anonymous encounters. These encounters complicate or break traditional interventions. In previous work [1], we examined a corpus of anonymous personal ads seeking sexual encounters from the classifieds website Craigslist and presented a way of linking multiple ads posted across time to a single author. The key observation of our approach is that some ads are simply reposts of older ads, often updated with only minor textual changes. Under the presumption that these ads, when not spam, originate from the same author, we can use efficient near-duplicate detection techniques to cluster ads within some threshold similarity. Linking ads in this way allows us to preserve the anonymity of authors while still extracting useful information on the frequency with which authors post ads, as well as the geographic regions in which they seek encounters. While this process detects many clusters, the lack of a true corpus of authorship-linked ads makes it difficult to validate and tune the parameters of our system. Fortunately, many ad authors provide an obfuscated telephone number in ad text (e.g., 867-5309 becomes 8sixseven5three oh nine) to bypass Craigslist filters, which prohibit including phone numbers in personal ads. By matching phone numbers of this type across all ads, we can create a corpus of ad clusters known to be written by a single author. This authorship corpus can then be used to evaluate and tune our existing near-duplicate detection system, and in the future identify features for more robust authorship attribution techniques.

Objective:

This paper constructs an authorship-linked collection or corpus of anonymous, sex-seeking ads found on the classifieds website Craigslist. This corpus is then used to validate an authorship attribution approach based on identifying near duplicate text in ad clusters, providing insight into how often anonymous individuals post sexseeking ads and where they meet for encounters.

Submitted by Magou on

Under the CDC STD Surveillance Network (SSuN) Part B grant, WA DOH is testing eICR of sexually transmitted infections (STI) with a clinical partner. Existing standard vocabulary codes were identified to represent previously-identified information gaps, or the need for new codes or concepts was identified.

Objective:

Previous research identified data gaps between traditional paper-based STI notifiable condition reporting and pilot electronic initial case reporting (eICR) relying on Continuity of Care Documents (CCDs) exported from our clinical partner’s electronic health record (EHR) software. Structured data capture is needed for automatic processing of eICR data imported into public health repositories and surveillance systems, similar to electronic laboratory reporting (ELR). Coding data gaps (between paper and electronic case reports) using standardized vocabularies will allow integration of additional questions into EHR or other data collection systems and may allow creation of standard Clinical Data Architecture (CDA) templates, Logical Observation Identifiers Names and Codes (LOINC) panels, or Fast Healthcare Interoperability Resources (FHIR) resources. Furthermore, identifying data gaps can inform improvements to other standards including nationwide standardization efforts for notifiable conditions.

Submitted by elamb on

Sexually transmitted disease treatment guidelines have incrementally added repeat testing recommendations for Chlamydia trachomatis infections over time, including test-of-cure 3 to 4 weeks following completion of treatment for pregnant women and test-of-reinfection for all patients approximately 3 months after infection. However, few studies have investigated adherence to these recommendations and whether the evolution of guidelines have led to changes in repeat testing patterns over time.

Objective:

To evaluate current rates and temporal trends in adherence with national guidelines recommending chlamydia test-of-cure for pregnant females and test-of-reinfection for all patients.

Submitted by elamb on

Utilization of local surveillance data has been shown to help risk stratify patients presenting to the emergency department presenting with GAS pharyngitis or meningitis. (1, 2) Adolescents frequently present to the emergency department (ED) with symptoms that may be associated with a sexually transmitted infection (STI). (3) When ED providers perceive high local rates of STI and low rates of follow-up, empiric treatment is considered. This strategy may result in unnecessary treatment. Knowledge of the local spatial distribution of adolescents with STIs diagnosed in local pediatric emergency departments EDs may enhance risk stratification and allow targeted testing and/or treatment among future ED patients in whom STI is considered.

Objective

(1) To describe the spatial distribution of adolescents with EDdiagnosed STIs in a large urban area with a high prevalence of STI

(2) To compare census block groups and identify “hot spots” of STI.

 

Submitted by Magou on

Surveillance for STD in the United States (US) relies primarily on case reports from clinicians and laboratories and sentinel surveillance; however, nationwide reporting is not required for viral STD and clinical sequelae of STD.

Objective

To evaluate the potential usefulness of 3 sources of administrative health care data for sexually transmitted disease (STD) surveillance.

Submitted by teresa.hamby@d… on
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