Decline in reported GC morbidity in NYC

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Decline in reported GC morbidity in NYC

• Preeti Pathela
• ppathela_at_health.nyc.gov

2
Gonorrhea
Where do we stand?
NYC
NYC
NYC
US
US
Cases per 100,000 pop.
US
3
Gonorrhea Rates United States, 1970-2004 and
the Healthy People 2010 target
-74
-12
4
Gonorrhea Rates by Sex United States, 1981-2004
and the Healthy People 2010 target
5
Gonorrhea Rates by Sex New York City, 1995-2005
Data based on cases reported to the NYC DOHMH
6
Gonorrhea Rates by Provider Type United States,
1984-2004
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Case rate (per 100,000 population) of Neisseria
gonorrhea reported to the New York City DOHMH,
with percent reported from Bureau of STD clinics,
2000-2005, by sex
Data based on cases reported to the NYC DOHMH
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Provider types in NYC BSTDC Surveillance Database
HIV Counseling Testing STD Clinic Drug
Treatment Family Planning Prenatal Other
Clinic Private Physician Hospital Correctional
Facility Laboratory Other Unknown
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N6720
N6330
N5507
N5286
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NYC DOHMH Reported female gonorrhea cases, by
provider type 2002 - 2005
N6691
N6646
N5048
N5544
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Gonorrhea reported to the NYC DOHMH. Case rates
(per 100,000 population) by age and sex, full
year 2004
Males
Females
N5286
N5544
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50
-54 55-59 60-64 65
Age (years)
Case rate /100,000 population
Excludes persons for whom age or sex
information is missing.
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Male GC positivity by age BSTDC clinics,
2003-2005
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Female GC positivity by age BSTDC clinics,
2003-2005
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What is leading to the apparent decline in GC
cases?

• A true decline in GC
• Changes in screening practices
• Use of diagnostic tests with different
  sensitivities
• Changes in reporting practices

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If decreases are true decreases

• How would this impact targeting of GC screening?
• Could this impact manufacturers of tests
• (provision of Ct-only tests) for low GC
  prevalence areas?

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• Thanks!