Gonorrhea Gonorrhea Epidemiology and Epidemiology and Control Efforts in Control Efforts in MichiganMichigan

Kathryn Macomber, MPHKathryn Macomber, MPHMichigan Department of Community HealthMichigan Department of Community Health

Bureau of EpidemiologyBureau of EpidemiologyFebruary 2, 2010February 2, 2010

Introduction to the Introduction to the Michigan STD ProgramMichigan STD Program Decentralized: few administrative staff, Decentralized: few administrative staff,

resources largely used for direct serviceresources largely used for direct service DIS in areas of high morbidityDIS in areas of high morbidity State $ purchases Rocephin and Cefixime.State $ purchases Rocephin and Cefixime. Interviews for GC are locally prioritizedInterviews for GC are locally prioritized FDT recommended – MDCH guidelines FDT recommended – MDCH guidelines

disseminated in April, 2009; EPT illegaldisseminated in April, 2009; EPT illegal 2009 new initiatives resulted in additional 2009 new initiatives resulted in additional

case finding and tools for partner referralcase finding and tools for partner referral Working toward more integration with HIVWorking toward more integration with HIV

Reported Gonorrhea Cases by Reported Gonorrhea Cases by Region 1986-2009Region 1986-2009

0

5000

10000

15000

20000

25000

30000

35000

40000

Michigan 37780 37284 37444 33993 31232 26559 21467 18014 18215 18220 15244 15582 16319 15906 18182 17121 14770 13965 17376 17684 16591 17330 17905 14465

Detroit 17563 19166 20454 17440 15809 12647 10924 9275 8637 8553 7090 7381 8413 7900 9610 8220 6846 5535 6763 8363 6839 7912 8851 6769

Outstate 20217 18118 16990 16553 15423 13912 10543 8739 9578 9667 8154 8201 7906 8006 8572 8901 7924 8430 10613 9321 9752 9418 9054 7696

1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

# of

cas

es

Reported Cases of Gonorrhea and Reported Cases of Gonorrhea and Rate, 2000-2009Rate, 2000-2009

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

20000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Cases

020406080

100120140160180200

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Rate per 100,000

HP 2010 Goal

Trends in Rates by Trends in Rates by CountyCounty

0

100

200

300

400

500

600

700

800

900

1000

2005 2006 2007 2008 2009

Berrien

Genesee

Kalamazoo

Muskegon

Detroit City

Rates by Sex, 2000-Rates by Sex, 2000-20092009

0

50

100

150

200

250

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Male Rate

Female Rate

Racial Disparity by Age GroupRacial Disparity by Age GroupRate per 100,000Rate per 100,000

0 500 1000 1500 2000 2500 3000

10-14 yrs

15-19 yrs

20-24 yrs

25-29 yrs

30-34 yrs

35-39 yrs

40-44 yrs

45-49 yrs

50-54 yrs

WhiteBlack

GC/CT Reduction Plan GC/CT Reduction Plan Pilot ProjectsPilot Projects

SiteSite GC TestsGC Tests GCPOSGCPOS GC%GC%    CT%CT%

Expanded Screening Expanded Screening Initiative Initiative 19141914 4848 2.5%2.5% 8.7%8.7%

Healthy Teen Adolescent Healthy Teen Adolescent Site Site 784784 3737 4.7%4.7%

16.516.5%%

Finney Blitz Finney Blitz 306306 22 0.7%0.7% 8.8%8.8%

Wayne County Jail Pilot Wayne County Jail Pilot (604)(604) 604604 2020 3.3%3.3%

11.311.3%%

Pregnancy Test OnlyPregnancy Test Only 617617 88 1.3%1.3% 9.9%9.9%

Advantage Health Centers Advantage Health Centers (FQHC - Homeless)(FQHC - Homeless) 12751275 5757 4.5%4.5% 6.7%6.7%

Retest InitiativeRetest Initiative 641641 2424 3.4%3.4%   17.317.3

%%

TotalTotal 61416141 196196 3.2%3.2%10.610.6

%%

2008 Statewide average - all sites except 2008 Statewide average - all sites except STDSTD 1.7%1.7% 7.6%7.6%

2009 Repeater Burden2009 Repeater Burden

6.8

14

20

02468

101214161820

% of Total Cases that are Repeaters

DetroitMuskegon Genesee

Thank you for your Thank you for your time….time….

Katie MacomberKatie Macomber

macomberk@michigan.govmacomberk@michigan.gov

517-335-9807517-335-9807