Decline in reported GC morbidity in NYC Preeti Pathela [email protected].

Decline in reported GC morbidity in NYC

Preeti Pathela

[email protected]

Where do we stand?

105

110

115

120

125

130

135

140

Overall Male Female

NYCNYCNYC

USUS US

GonorrheaC

as

es p

er 1

00,

000

po

p.

Gonorrhea Rates:

United States, 1970-2004

and the Healthy People 2010 target

-74%

-12%

Gonorrhea Rates by Sex:

United States, 1981-2004

and the Healthy People 2010 target

Gonorrhea Rates by Sex

New York City, 1995-2005

0

50

100

150

200

250

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

Year

Cas

e R

ate

per

100

,000

p

op

ula

tio

n

malefemaleoverall

Data based on cases reported to the NYC DOHMH

Gonorrhea Rates by Provider Type:

United States, 1984-2004

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

14 13 10 13 10 10

43 43 40 4135

30

0

10

20

30

40

50

60

70

80

90

100

2000 2001 2002 2003 2004 2005

Year

% G

C c

ase

s re

po

rted

fro

m

NY

C S

TD

cli

nic

s

0

20

40

60

80

100

120

140

160

180

200

GC

case ra

te per 1

00

,00

0

Females% males% Malesrate Femalerate

HIV Counseling & Testing

STD Clinic

Drug Treatment

Family Planning

Prenatal

Other Clinic

Private Physician

Hospital

Correctional Facility

Laboratory

Other

Unknown

Provider types in NYC BSTDC Surveillance Database

NYC DOHMHReported male gonorrhea cases, by provider type

2002 - 2005

0

500

1000

1500

2000

2500

3000

3500

2002 2003 2004 2005

Calendar Year

Num

ber o

f Cas

es

STD Clinic Private Physician Hospital Correctional Facility Other / Unknown

N=5507N=5286

N=6720N=6330

0500

1000150020002500300035004000

2002 2003 2004 2005

Calendar year

No

. o

f ca

ses

STD Clinic Private Provider Hospital Correctional Facility Other / Unknow n

NYC DOHMHReported female gonorrhea cases, by provider type

2002 - 2005

N=5048N=5544

N=6691N=6646

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)

MalesN=5286

FemalesN=5544

Gonorrhea reported to the NYC DOHMH. Case rates (per 100,000 population) by age and sex*, full year 2004

* Excludes persons for whom age or sex information is missing.

600 400 200 0 200 400 600 800

Case rate /100,000 population

Male GC positivity by age BSTDC clinics, 2003-2005

0

2

4

6

8

10

12

2003 2004 2005

Year

% p

os

itiv

e

15-19

20-24

25-29

30-34

35-39

40-44

45+

all ages

0

1

2

3

4

5

6

7

2003 2004 2005

Year

% p

os

itiv

e

15-19

20-24

25-29

30-34

35-39

40-44

45+

all ages

Female GC positivity by age BSTDC clinics, 2003-2005

• A true decline in GC

• Changes in screening practices • Use of diagnostic tests with different sensitivities

• Changes in reporting practices

What is leading to the apparent decline in GC cases?

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?

Thanks!