Implementation of Extra-Genital Gonorrhea (GC) and Chlamydia (CT) Screening at Louisiana Parish (County) Health Units

Rahman, Mohammad

Wednesday, September 21, 2016

Galleria Exhibit Hall

Mohammad Rahman, PhD, MBBS, MPH¹, Connie Bouligny, MN, APRN, FNP-BC², Stephanie N. Taylor, MD³, Danielle Haydel, MT (AAB)⁴, Stephen Martin, PhD⁵, Teri Anderson, MT, (ASCP)⁶, Cornelis Rietmeijer, MD, PhD⁷, Chaquetta Johnson, DNP, MPH¹ and DeAnn Gruber, PhD, LCSW⁸, 1STD/HIV Program, Louisiana Office of Public Health, New Orleans, LA, 2STD/HIV, Louisiana Office of Public Health, New Orleans, LA, 3Section of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, LA, 4OPH Central Lab, DHH - Louisiana Office of Public Health Central Lab, Baton Rouge, LA, 5OPH Laboratory, DHH - Louisiana Office of Public Health Laboratory, Baton Rouge, LA, 6Denver STD/HIV Prevention Training Center, Denver Public Health Department, Denver, CO, 7Denver STD Prevention Training Center, Denver Public Health, Denver, CO, 8Louisiana Office of Public Health STD/HIV Program, New Orleans, LA

Background:

Louisiana ranks at or near the top in the nation for GC and CT case rates with 25–28% of cases identified at parish health units (PHU). Louisiana’s Targeted Evaluation Plan was developed to evaluate extra-genital (rectal and pharyngeal) positivity rates at PHUs.

Methods:

The Louisiana Office of Public Health STD/HIV Program, Laboratory, Bureau of Family Health, and Denver Prevention Training Center (DPTC) collaborated to implement an extra-genital testing pilot at four PHUs in three regions with high GC/CT morbidity. Steps taken to accomplish this included: laboratory validation of anal and pharyngeal GC/CT NAAT testing; extra-genital testing protocol development; multi-language instruction sheets for nurses and patients; and training on the importance of extra-genital testing, specimen collection and project implementation by the SHP STD Medical Director and Nurse Consultant with DPTC assistance. Testing began in February 2016.

Results: In first six weeks of the pilot, 220 patients (241 samples) had extra-genital testing. The prevalence of rectal GC was 21% (7 of 34), pharyngeal 8% (17 of 207), and urogenital 6% (81 of 1344), while the prevalence of rectal CT was 21% (7 of 34), pharyngeal 1.5% (3 of 207), and urogenital 13% (176 of 1344). Thirty patients had urogenital and rectal testing. Of these, 5 (17%) CT infections and 4 (13%) GC infections would have been missed with urogenital testing alone. One hundred ninety-four patients had urogenital and pharyngeal testing. Of these 12 (6%) CT infections and 9 GC infections would have been missed.

Conclusions:

The project was implemented after internal collaboration of the OPH Programs and partnership with DPTC. This is an example of a public health department fulfilling a specific public health need. There is strong preliminary evidence that extra-genital testing will identify a significant number of cases that would have been missed testing urogenital sites alone.

WP 39 Implementation of Extra-Genital Gonorrhea (GC) and Chlamydia (CT) Screening at Louisiana Parish (County) Health Units