Laboratory Surveillance of Sexually Transmitted Disease

1
Laboratory Surveillance of Sexually Transmitted
Disease
LA County Dept. of Health Services Sexually
Transmitted Disease Program Laboratory
Surveillance Unit Chandra Higgins,
MPH chiggins_at_ladhs.org
2
Reportable STDs in LA County

• Reporting requirements
• Dual reporting system
• Forms

3
Legal STD Reporting Requirements in California

• Health Provider
• Syphilis
• Chlamydia
• Gonorrhea
• Chancroid
• PID (Pelvic Inflammatory Disease)
• NGU (Non-Gonococcal Urethritis)

• Laboratory
• Syphilis
• Chlamydia
• Gonorrhea

4
Reporting Responsibilities

• Health Provider
• Known or suspect
• Report syphilis within one working day of
  identification. All others within 7 calendar days.

• Laboratory
• All positives
• Report within one working day of identification

5
Reporting Responsibilities

• Laboratory
• Patient name limited demographics
• Provider name, address, phone
• Specimen accession, dates, test type results

• Health Provider
• Patient name full demographics
• Diagnosis, date of diagnosis onset
• Name, address, phone of reporter

6
Medical Providers STD Reporting Form (p.1)
7
Medical Providers STD Reporting Form (p.1,
continued)
8
Medical Providers STD Reporting Form (p.2)
9
Medical Providers STD Reporting Form (p.2,
continued)
10
Reports to LA County STD Program Chlamydia,
Gonorrhea, and Syphilis 2004
Both ESy 51 CT 70 GC 66
Laboratory Only ESy 49 CT 27 GC 29
Provider Only ESy 0.3 CT 3.5 GC 4.8
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Reporting Issues

• Improved enforcement of reporting laws
• State investigations non-compliance can result
  in loss of lab license
• Identification of non-reporters is difficult
• Dual reporting requirement facilitates
  identification
• Annual laboratory survey identifies laboratories
  with deficient reporting practices

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Reporting Issues(continued)

• Heaviest burden on laboratories
• Often sole reporting source
• Rely on providers for patient information
• Referring laboratories withhold patient /
  provider information from testing facilities
• Increased interstate testing has accompanied
  growth of managed care core laboratories
• Reporting requirements vary by state

13
Annual Laboratory Survey

• Monitor compliance with reporting guidelines
• Monitor trends in test utilization laboratory
  practice
• Provide information on STD testing trends and
  recommendations
• Inform laboratories about STD Program function

14
2004 STD Testing Laboratories
N163
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Test Volume by Lab-Type 2004 Syphilis, Chlamydia,
Gonorrhea
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L.A. County STD Testing 1995 2004
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Syphilis Testing, 2004
N1,629,500
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Growth In Amplified Tests Chlamydia, 1995 - 2004
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Amplified Methods 2003 2004 Chlamydia Tests
2003
2004
20
Growth in Amplified Testing Gonorrhea, 1995 - 2004
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L.A. County STD Testing All 2004 Testing