P30 "Striking Back" Miami – Dade County Health Department "Syphilis Strike Team”

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Lori Jordahl, MBA-HA1, Jeanne Pinal1, Tom Burns, MPH2 and Toye Brewer, MD3, 1STD Program, Miami Dade County Health Department, Miami, FL, 2CDC, Miami Dade County Health Department STD Program, Miami, FL, 3CDC, Florida Bureau of STD Prevention and Control, Miami, FL

Background: A substantial  increase in the number of infectious syphilis cases in Miami-Dade County from 2000-2008 (192%) has stressed Disease Intervention Specialist (DIS) staff also responsible for managing HIV, gonorrhea and Chlamydia cases. Therefore, a Syphilis Strike Team (consisting of a coordinator, 2 DIS and a part-time surveillance DIS) devoted solely to syphilis cases with an RPR titer of ≥1:8 and above was formed to improve key performance outcomes related to infectious syphilis.

Objectives:To describe the impact of the Syphilis Strike Team  in Miami-Dade County

Methods: Review of key performance indicators of DIS efforts in syphilis from the year before the  Syphilis Strike Team was formed, (March 2007- February 2008), compared with the following 12-month period (March 2008-February 2009) after  its formation

Results: Infectious syphilis cases increased 19% in the twelve months after formation of the Syphilis Strike Team (from 228 to 271). Despite this increase in the number of cases major performance indicators improved.  The percent of patients interviewed within 14 days increased from 54% pre-Strike Team to 68% in the year after its formation (p<0.001). The percent treated within 14 days for persons diagnosed with infectious syphilis increased from 74% to 82% (p<0.05) and  the percent of partners/contacts of persons diagnosed with infectious syphilis that were treated within 14 days increased from 43% to 59% (p=<0.01).  The percent of cases with a titer of ≥1:8 or higher with a dispositions  within 14 days increased from 78% to 87% (p=<0.01). Unfavorable dispositions (refusals, unable to locate) decreased from 19% to 7% (P<0.001).

Conclusions: Despite increasing syphilis cases in Miami-Dade, a simple cost-neutral reorganization of DIS efforts has led to significant improvements in key performance indicators.

Implications for Programs, Policy, and/or Research: The Syphilis Strike Team approach can be adapted to other high morbidity areas seeking to improve performance outcomes.

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