gonorrhea morbidity, missouri, 2008
DESCRIPTION
Gonorrhea Morbidity, Missouri, 2008. In 2008, there were 8,014 reported gonorrhea cases. Of these, 57% were in females, 65% were among Black, non-Hispanic persons, and 63% were in persons aged 15-24 years. Rates among Black, non-Hispanic persons were 26 times those in White, non-Hispanics. - PowerPoint PPT PresentationTRANSCRIPT
Gonorrhea Morbidity, Missouri, 2008
• In 2008, there were 8,014 reported gonorrhea cases.
• Of these, 57% were in females, 65% were among Black, non-Hispanic persons, and 63% were in persons aged 15-24 years.
• Rates among Black, non-Hispanic persons were 26 times those in White, non-Hispanics.
Race Cases % Rate** Cases % Rate** Cases Rate**White 356 10.3% 14.9 1052 23.2% 42.2 1408 28.8Black 2567 73.9% 787.8 2630 57.9% 717.2 5197 750.4Other/Unknown 549 15.8% -- 860 18.9% -- 1409 --Total Cases 3472 100.0% 120.9 4542 100.0% 151.0 8014 136.3
Male Female Total
White Male (n=356) White Female (n=1052) Black Male (n=2567) Black Female (n=2630)0
200
400
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1,000
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0 8 12
5744
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538
962
116
405
813 92
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85
191
528
412
38 64
256
134
24 47
136
7549 37
284
68
10–14 yrs 15–19 yrs 20–24 yrs 25–29 yrs 30–34 yrs 35–39 yrs 40+ yrsRace and Sex
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Gonorrhea Morbidity, Missouri, 2008
• The greatest number of cases (962) was reported among Black Females aged 15-19 years.
• The case rate in this group was 3,047 per 100,000. 22 times greater than the overall case rate.
• Among Black Females 20-24 years of age, the rate was 3,380 per 100,000. 25 times greater than the overall case rate.
Gonorrhea Morbidity, Missouri, 2008
In 2008, St. Louis City, St. Louis County, and Jackson County reported 5,966 gonorrhea cases. This represented 74.4% of all reported cases.
National Rankings by Cases2007
Missouri: #8St. Louis City: #20
Jackson County: #21St. Louis County: #28
Unofficial National Rankings by Rates2007
St. Louis City: easily #1 (742.3)Jackson County: (385.2)St. Louis County: (230.6)
The second highest rate among counties/independent cities ranked by cases was Orleans County, LA at 684.5
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Missouri
St. Louis Region
Kansas City Region
Gonorrhea Morbidity, Missouri, 2008
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Missouri Population Estimates, 2007HIV Region Male Female TotalSt. Louis Region 1,007,557 1,080,388 2,087,945 Kansas City Region 598,787 628,058 1,226,845 Northwest Region 120,644 121,136 241,780 North Central Region 365,437 372,508 737,945 Southwest Region 539,008 557,750 1,096,758 Southeast Region 239,589 247,553 487,142 Missouri Total 2,871,022 3,007,393 5,878,415
GC in MOEpi Investigations
In Missouri, priority has been given to syphilis and HIV for Partner Services.
In 2008, there were 369 cases reported of early syphilis and 588 cases of newly reported HIV Disease.When time permits or as 700/900 morbidity goes down (never), it is expected that GC follow up would increase.
GC in MOEpi Investigations
Four DIS jurisdictions (agencies) perform GC investigations:
• Kansas City Health Department• St. Louis City Health Department• St. Louis County Department of Health• Missouri Department of Health & Senior Services (DHSS)
GC in MOEpi Investigations
Missouri has a total of 43 staff that spend a percentage of their time as a STD/HIV DIS.
• 15 in KC (also work other communicable diseases)• 4 in STL Co• 9 in STL City (mostly HIV and CD focused, minimal
STD)• 15 DHSS (Outstate & STL City)
GC in MOEpi Investigations
KCHD Interview CriteriaSTD clinic:
• GS positive males• positives returning for treatment
Epi Impact in 2008Cases interviewed 955Contact index 0.7
GC in MOEpi Investigations
St. Louis City Interview CriteriaConnectCare clients
• GS positive males• Positives returning for treatment
Epi Impact in 2008Cases interviewed 132Contact index 1.2
GC in MOEpi Investigations
St. Louis County Interview Criteria• Select circumstances
Epi Impact in 2008Cases interviewed 9Contact index 0.8
GC in MOEpi Investigations
DHSS Outstate MO Interview Criteria• Co-infected with 700 and/or 900• provider request
Epi Impact in 2008Cases interviewed 46Contact index 1.5
GC Screeing in MOSTD and IPP Providers
~80 IPP Providers114 Local Public Health Agencies3 dedicated full time STD clinics
Use dual screening test (Gen Probe Aptima)85,000 tests per year (55% IPP)IPP MOA Requires provision of Partner Services to GC/CT positive clients:
• Partner elicitation• Partner notification
– Three phone calls– Letter– Referral to DIS for assistance
GC in MOTreatment Verification
KC, St. Louis County, and DHSS conducts follow-up for all inadequate treatment reported
• Cipro – FR assigned to DIS • Other inadequate treatment – phone follow-up to
provider• No treatment – select follow-up
