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Background: Reported gonorrhea (GC) in Philadelphia has remained relatively stable since 2003.Recently, CDC has encouraged local areas to examine GC data elements to better target resources and therefore affect a decline in case numbers.
Objectives: To identify unrealized trends or clusters of GC.
Methods: GC morbidity data for 2008 was analyzed by race, gender, age, provider type, zip code of residence, and census tract. Geomapping was utilized to overlay morbidity and proximity to venues participating in the City-wide GC and Chlamydia screening program.
Results: During recent years, GC has affected males and females virtually equally (1:1 ratio). In 2008, females ages 15-19 (1839.3/100,000) and males ages 20-24 (1,267.2/100,000) had the highest rates. Three of the 47 zip codes in Philadelphia had the highest case counts and case rates. Further analysis revealed one zip code with high morbidity (>400 cases/100,000) in every census tract. Furthermore, there are no screening sites located within the zip code. Analysis by provider type showed cases from this region were diagnosed at either the City STD clinic, or at local hospital Emergency Departments (EDs). One ED located in the high morbidity zip code diagnosed nearly as many cases from that zip code as did the STD Clinic (77 vs. 86 cases). This ED agreed to participate in the City-wide GC and Chlamydia screening program by screening all asymptomatic individuals between 14-29 years of age utilizing the ED. Preliminary results show high positivity (11.1%).
Conclusions: Geomapping provides a valuable tool for identifying areas with high morbidity allowing programs to better focus screening activities. The STD Control Program will continue to utilize this tool in the era of expanding need and declining resources.
Implications for Programs, Policy, and/or Research: Targeting resources to this community should affect the disparate number of cases and case rates among those who reside there.