STD Program - Google Drive


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4	Goal Increase the percent of infectious syphilis cases receiving CDC-approved treatment. Description Percent of infectious syphilis cases that received CDC-approved treatment. Formula Primary, Secondary and Early Non-Primary, Non-Secondary syphilis cases in the performance period that received CDC-approved syphilis treatment, divided by all confirmed and probable Iowa PSE syphilis cases. Remove 'Not a Case'. Remove 'Not infected'. Remove non-Iowa cases. Include as approved treatment: Bicillin, benzathine penicillin, ceftriaxone, doxy, gentamicin, cefixime, ceftriaxone, aqueous crystalline penicillin G, procain penicillin G, and probenecid. For this purpose, count treatment with any of these drugs regardless of dosage. Data Source IDSS Data Query Tool.	Goal Increase the percent of infectious gonorrhea cases receiving CDC-approved treatment. Description Percent of gonorrhea cases that received CDC-approved treatment. Formula Gonorrhea cases treated with ceftriaxone, cefixime, gentamicin, Cefotetan, gemifloxacin, or erythromicin divided by the total number of confirmed and probable gonorrhea cases for the given time period. Remove 'Not a Case'. Remove 'Not infected'. Remove non-Iowa cases. Data Source IDSS data query tool.	Goal We strive for a minimum of 8% positivity for chlamydia at our Community-Based Screening Services (CBSS) sites. This high benchmark is indicative that the program is effectively reaching individuals at increased risk of infection. Description The STD Program at IDPH works in partnership with the State Hygienic Laboratory (SHL) and the Family Planning Council of Iowa (FPCI) to maintain a network of safety net sites where patients may be tested and treated for certain STIs at free or reduced cost. Patients who are uninsured, underinsured, or seeking confidential services are prioritized for testing at these sites. One marker of whether we are reaching the correct populations is positivity rate. A high positivity rate indicates that the program is adequately reaching populations at increased risk of infection. This is particularly important for an infection like chlamydia, which is often asymptomatic. A high positivity rate is also indicative of cost effectiveness of the program. Previously, CDC had set a threshhold of 3% positivity to determine whether a chlamydia screening program was cost effective. Formula Positivity rate is determined by dividing the number of positive tests (numerator) by the number of tests conducted overall (denominator) during the time period. Data Source Data are made available via customized reports from SHL and the Polk County Health Department.	Goal We strive for a minimum of 3% positivity for gonorrhea at our Community-Based Screening Services (CBSS) sites. This high benchmark is indicative that the program is effectively reaching individuals at increased risk of infection. Description The STD Program at IDPH works in partnership with the State Hygienic Laboratory (SHL) and the Family Planning Council of Iowa (FPCI) to maintain a network of safety net sites where patients may be tested and treated for certain STIs at free or reduced cost. Patients who are uninsured, underinsured, or seeking confidential services are prioritized for testing at these sites. One marker of whether we are reaching the correct populations is positivity rate. A high positivity rate indicates that the program is adequately reaching populations at increased risk of infection. As the number of gonorrhea diagnoses have increased over the past several years, it is increasingly important that we are utilizing our limited resources for the populations at greatest risk of acquiring the infection. A high positivity rate is also indicative of cost effectiveness of the program. Formula Positivity rate is determined by dividing the number of positive tests (numerator) by the number of tests conducted overall (denominator) during the time period. Data Source Data are made available via customized reports from SHL and the Polk County Health Department.	Goal A high treatment index for infectious syphilis leads to decreased transmission. Challenges with locating contacts and making arrangements for them to receive treatment are commonplace. Our goal is a treatment index of 0.75. Description This performance measure tracks the average number of contacts treated per index patient diagnosed with infectious syphilis. In this measure, all index patients with infectious syphilis (primary, secondary or early non-primary, non-secondary stage) are included. All contacts who receive treatment are included (i.e., contacts who test positive and those without a positive result are preventively treated). Formula Average number of contacts who were treated per index patient is obtained directly from a report in IDSS (the treatment index from the STD case management report). The number of infectious syphilis cases investigated is also obtained from the STD case management report (stated as Cases Closed). The only formula needed is to calculate the number of contacts who were treated for syphilis, which is obtained by multiplying the above two numbers. Data Source STD Case Management Report (CMR) in IDSS.	Goal Prevention of congenital syphilis is a top priority. It can have lethal consequences yet with early diagnosis and treatment of pregnant women, it is wholly preventable. Our goal is that 100% of congenital syphilis cases be averted. Description This performance measure is two-fold. First, it tracks the number of congenital syphilis cases averted (i.e., pregnant women who completed treatment for syphilis in a timely manner). Since congenital syphilis cases can be avoided if pregnant women are diagnosed and treated appropriately for syphilis early, it is essential for pregnant women to have adequate and timely prenatal care. Second, it tracks the percent of cases where a congenital syphilis outcome had been possible, but averted. Since syphilis cases overall have been increasing dramatically in recent years, it is important for context to look not only at raw numbers of cases, but also as a percent of total. Note that in this measure all stages of syphilis are counted since any stage of syphilis can be passed to the fetus. Formula First, the number of pregnant women with any stage of syphilis minus the number of congenital syphilis cases. For cases averted, the numerator is number of pregnant women diagnosed with any stage of syphilis minus the number of congenital syphilis cases for the period. The denominator is the number of pregnant women diagnosed with any stage of syphilis. Data Source Congenital cases are tracked on an internal spreadsheet and reported to CDC. Pregnant women with syphilis data are extracted from IDSS via the IDSS Data Query Tool.