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Syphilis

Description

Administrative data refers to data generated during the processes of health care. These data are a rich source of patient health information, including diagnoses and problem lists, laboratory and diagnostic tests, and medications. Established standards are used to code each data into the appropriate coding systems. The International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification (ICD-9-CM and ICD-10-CM) codes are the coding standard for diagnoses and have been frequently used to identify cases for the creation of cohorts in examining care delivery, screening, prevalence, and risk factors. However, while some studies have assessed the validity and reliability of ICD-CM codes to identify various conditions such as cerebral palsy and rheumatoid arthritis3,4, the evidence for using ICD codes to accurately identify sexually transmitted infection (STI) cases is largely unexamined. The purpose of this study is to review the extant literature for evidence on the validity of ICD codes for identifying cases of chlamydia, gonorrhea, and syphilis. Our findings will inform efforts to improve the use of administrative data for STI-related health service and surveillance researches.

Objective: The purpose of this study is to review the extant literature for evidence on the validity of ICD-9-CM and -10-CM codes for the purpose of identifying cases of chlamydia, gonorrhea, and syphilis.

Submitted by elamb on
Description

In 2003, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia estimated that approximately 1 million people in the United States were living with HIV/AIDS, and that approximately 25% these were undiagnosed and unaware of their HIV infection. For many such patients the emergency department may be the only part of the health care system that is utilized. In 2006, the CDC revised their recommendations for HIV testing in a variety of care settings including the emergency department (ED). Early identification and treatment improves survival for patients with HIV. Earlier testing programs including those provided in the ED may lead to earlier detection and further reduction in the transmission of HIV in the United States. (1,2,3,4,5) High risk patients should recieve screening for HIV and those patients who have a lab test for GC/chlamydia represent a high risk patient popualtion.(4) While the ED is a frequent health care access point for patients seeking evaluation for sexually transmitted diseases, ED providers may not be following guidlines for HIV testing in high risk patients.

Objective

To assess compliance with CDC and USPSTF guidelines for HIV testing in a regional cohort of emergency departments.

Submitted by elamb on
Description

The time series of syphilis cases has been studied at the country and state level at the yearly basis, and it has been found that syphilis has a periodicity of approximately 10 years. However, to inform prevention efforts, it is important to understand the short term dynamics of disease activity.

 

Objective

(i) To forecast syphilis cases per state in the US to support early containment of outbreaks. (ii) For each state, to determine which states are most correlated, to find "bellwether" states to inform surveillance efforts. (iii) To determine a small collection of states whose syphilis incidence patterns are most closely correlated with all the states.

Submitted by elamb on
Description

Time series data involving counts are frequently encountered in many biomedical and public health applications. For example, in disease surveillance, the occurrence of rare infections over time is often monitored by public health officials, and the time series data collected can be used for the purpose of monitoring changes in disease activity. For rare diseases with low infection rates, the observed counts typically contain a high frequency of zeros (zero-inflated), but the counts can also be very large (overdispersed) during an outbreak period. Failure to account for zero-inflation and overdispersion in the data may result in misleading inference and the detection of spurious associations.

 

Objective

The purpose of this study is to develop novel statistical methods to analyze zero-inflated and overdispersed time series consisting of count data.

Submitted by elamb on
Description

Public health officials and epidemiologists have been attempting to eradicate syphilis for decades, but national incidence rates are again on the rise. It has been suggested that the syphilis epidemic in the US is a "rare example of unforced, endogenous oscillations in disease incidence, with an 8-11-yr period that is predicted by the natural dynamics of syphilis infection, to which there is partially protective immunity." While the time series of aggregate case counts seems to support this claim, between 1990 and 2010 there seems to have been a significant change in the spatial distribution of the syphilis epidemic. It is unclear if this change can also be attributed to "endogenous" factors or whether it is due to exogenous factors such as behavioral changes (e.g., the widespread use of the internet for anonymous sexual encounters). For example, it is pointed out that levels of syphilis in 1989 were abnormally high in counties in North Carolina (NC) immediately adjacent to highways. The hypothesis was that this may be due truck drivers and prostitution, and/or the emerging cocaine market. Our results indicate that syphilis distribution in NC has changed since 1989, diffusing away from highway counties.

 

Objective

To study the spatial distribution of syphilis at the county level for specific states and nationally, and to determine how this might have changed over time in order to improve disease surveillance.

Submitted by elamb on
Description

Reports of infants born with congenital syphilis have increased in the United States every year since 2012. Prevention depends on high performing surveillance systems and compliance with the U.S. Centers for Disease Control and Prevention (CDC) recommendations to perform syphilis testing early in pregnancy, in the third trimester and at delivery if a woman is at high risk, and following a stillbirth delivery. These guidelines exist, because untreated syphilis is associated with adverse fetal outcomes including central nervous system infection and death. Surveillance of congenital syphilis and stillbirth is challenging because available data sources are limited. Assessment of compliance with testing guidelines is particularly challenging, since public health agencies often lack access to comprehensive cohorts of tested individuals as most public health laws only require reporting of positive disease case information.

Objective:

To measure stillbirth delivery rates and syphilis screening rates among women with a stillbirth delivery using electronic health record data available in a health information exchange.

Submitted by elamb on
Description

In 2012, Louisiana’s case rate for congenital syphilis was 49.2 cases per 100,000 live births, the highest in the nation and over six times the national average1. In Louisiana, case investigations for infants perinatally exposed to syphilis are initiated through two primary methods: SHP may receive a positive syphilis test on an infant or a syphilis-infected woman may be contacted and identified by Partner Services during pregnancy. This identification process is similar to perinatal HIV surveillance in Louisiana with one major exception: for perinatal HIV surveillance an annual birth match is completed. Through this match women known to be HIV-infected are matched to women who gave birth during the previous year. Over 90% of perinatal HIV exposures are identified prior to this match, but the match ensures that Louisiana’s HIV surveillance system identifies all infants perinatally exposed to HIV.

Objective

To identify infants perinatally exposed to syphilis in Louisiana that were missed by routine surveillance activities and to ensure that all infants perinatally exposed to syphilis are investigated.

 

Submitted by Magou on
Description

In 2012, Louisiana’s case rate for congenital syphilis was 49.2 cases per 100,000 live births, the highest in the nation and over six times the national average1. In Louisiana, case investigations for infants perinatally exposed to syphilis are initiated through two primary methods: SHP may receive a positive syphilis test on an infant or a syphilis-infected woman may be contacted and identified by Partner Services during pregnancy. This identification process is similar to perinatal HIV surveillance in Louisiana with one major exception: for perinatal HIV surveillance an annual birth match is completed. Through this match women known to be HIV-infected are matched to women who gave birth during the previous year. Over 90% of perinatal HIV exposures are identified prior to this match, but the match ensures that Louisiana’s HIV surveillance system identifies all infants perinatally exposed to HIV.

Objective

To identify infants perinatally exposed to syphilis in Louisiana that were missed by routine surveillance activities and to ensure that all infants perinatally exposed to syphilis are investigated.

 

Submitted by Magou on
Description

Every year nearly 12 million new cases of syphilis in the world are registered. Currently, in many countries of the world the stabilization or even reduction of the incidence of syphilis is marked, but this does not apply to Ukraine. The current stage of development of the syphilis problem in Ukraine is characterized by not only high morbidity, but also the fact that in the overwhelming number of cases, we are talking about the latent forms and atypical manifestations of the disease and resistance to therapy [1]. Preventive and prophylactic measures are important in maintaining the public health. Predicting the dynamics of disease spreading allows developing appropriate countermeasures and ensuring rational use of human and material resources. Qualitative forecast of syphilis spreading is possible to implement by means of mathematical modeling. 

 

Submitted by uysz on