Partner Notification for Syphilis in the United States 2005-2006: Data from the Performance Measures Database

Background:
Primary and secondary syphilis (P&S) rates have increased every year since 2000 in the United States. Partner notification can help control syphilis. Four performance measures related to partner notification have been reported to CDC twice each year since 2005 by project areas.

Objective:
Determine the extent of partner services for P&S, and factors associated with high performance.

Method:
We looked at partner services performance measures from all project areas that reported more than 20 cases of P&S each year. All measures used the total number of reported cases of P&S as the denominator. Data from 4 time periods were collapsed.

Result:
From 2005-2006, 41 project areas reported approximately 17,690 cases of P&S. 13 programs did not use the same denominator for all 4 measures. 68% of cases were interviewed about partners within 30 days of specimen collection (range 33-99%). 7,940 partners (0.55 per index case) were treated prophylactically or for diagnosed infections (range 0.09-1.0). 2,120 suspects and associates (0.14 per index case) were tested (range 0-.52); and 229 (0.016 per index case) were treated for diagnosed syphilis (range 0-0.14). Programs reporting high performance on one measure usually reported high performance on others. Performance was slightly worse in areas where the M:F ratio of reported infectious syphilis cases was >10.

Conclusion:
Performance measures data contains errors that were easy to recognize and probably others that are harder to detect. Only 68% of patients had been interviewed during the month after syphilis was suspected. Effectiveness of partner treatment is difficult to interpret because it combines prophylactic treatment (which may vary by program) with infections detected. Success depends partly on patient characteristics but variability suggests that some programs may be more successful than others.

Implications:
Performance measures data should be verified and used so that successful practices can be identified and replicated.