The document summarizes Hamilton County's ongoing syphilis epidemic. It finds that 80% of syphilis cases are among African Americans, with the majority of cases being young people ages 15-34. Despite efforts to increase syphilis screening and testing, as well as community outreach campaigns, the county continues to see congenital syphilis cases. Moving forward, the health department aims to further coordinate with healthcare providers, evaluate the root causes of congenital cases, and continue community education efforts with the goals of reducing overall syphilis rates and achieving zero congenital syphilis cases by 2014.
Healthy Communities: Multnomah county is one of the 36 counties in the state of Oregon, located with Portland as its county seat. Portland is the second largest city in Oregon and the most populous metropolitan area in the state (U.S. Census Bureau [USCB], 2008, p. 1). As of 2007, Multnomah County's population is 681,454 people (Sperling, 2008). For the purpose of this study, the community focus will be primarily on the sector of Multnomah County in the 97212 area code, which will be called the Rose Sector.
Healthy Communities: Multnomah county is one of the 36 counties in the state of Oregon, located with Portland as its county seat. Portland is the second largest city in Oregon and the most populous metropolitan area in the state (U.S. Census Bureau [USCB], 2008, p. 1). As of 2007, Multnomah County's population is 681,454 people (Sperling, 2008). For the purpose of this study, the community focus will be primarily on the sector of Multnomah County in the 97212 area code, which will be called the Rose Sector.
Michael Lynskey - Big Data in Mental Health - 23rd July 2014kclcompbio
Organised by the Bioinformatics group at the BRCMH, IoP, SLaM and Maudsley Digital, this symposium showcased talks regarding the important roles of big data in mental health biomedical research and treatments.
Pat Cota, Executive Director
Georgia Obstetrics and Gynecology Society
Presentation to the Georgia Senate Women's Adequate Healthcare Study Committee
November 9, 2015
Comparing local epidemiology of Chlamydia in Miami- Dade County to that of State of Florida and the United States. Highlighting basic description of the disease, surveillance methods, reporting, control measures, epidemiology of the disease and comparison of 5 year trends/incident rates in Miami Dade County to that of State of Florida and the United States.
Nevada profile 2015 stda re'port for cdc#GOMOJO, INC.
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
Cash transfers have positive impacts on consumption, food security, education and productive activities. But can social protection also reduce intimate partner violence?
Amber Peterman presented the findings of her study at Western Economic Association International's annual meeting in June 2018.
Michael Lynskey - Big Data in Mental Health - 23rd July 2014kclcompbio
Organised by the Bioinformatics group at the BRCMH, IoP, SLaM and Maudsley Digital, this symposium showcased talks regarding the important roles of big data in mental health biomedical research and treatments.
Pat Cota, Executive Director
Georgia Obstetrics and Gynecology Society
Presentation to the Georgia Senate Women's Adequate Healthcare Study Committee
November 9, 2015
Comparing local epidemiology of Chlamydia in Miami- Dade County to that of State of Florida and the United States. Highlighting basic description of the disease, surveillance methods, reporting, control measures, epidemiology of the disease and comparison of 5 year trends/incident rates in Miami Dade County to that of State of Florida and the United States.
Nevada profile 2015 stda re'port for cdc#GOMOJO, INC.
Core practices that are moving from a pilot state to implementation at scale: Many of the
barriers facing HIV programs are common across countries. PEPFAR’s ECTs (described below in
Sections 2.3.2 and 2.3.3) identified common issues affecting countries at various levels of
epidemic control and then developed a compendium of evidence-based solutions, approaches
and case-studies that highlight successful means of addressing common barriers. Additional
evidence-based approaches and case-studies will be incorporated into this living compendium
over time. As highlighted in this PEPFAR Solutions Platform, these practices can be rapidly
adapted and scaled to move countries forward.
Key considerations for all PEPFAR programs include:
• Bringing Interventions to Scale with Fidelity: Getting to HIV epidemic control is dependent on
several factors; not the least of which is the ability to rapidly scale successful interventions with
fidelity and demonstrated impact. However, the logistics of cost- effective programmatic scale
have proven challenging, with several implementation barriers. Implementation science
defines scalability as the capacity to expand or extend an intervention to account for a growth
factor that aims to fill a gap or address unmet need in a defined population group/geographic
area.
• Data and Information Technology: The enabling environment for data and information
technology is rapidly maturing across countries, creating space, opportunity, and needed
political will to harness the Data Revolution for epidemic control. OUs should consider
innovative ways to use data and information technology to improve efficiency and
sustainability in achieving epidemic control, beyond immediate PEPFAR indicator data
collection needs. As highlighted in the Data Revolution Innovation Toolkit, available on the
PEPFAR SharePoint, OUs are encouraged to explore, adapt, and scale these and other data
driven approaches to move country epidemic control forward.
Cash transfers have positive impacts on consumption, food security, education and productive activities. But can social protection also reduce intimate partner violence?
Amber Peterman presented the findings of her study at Western Economic Association International's annual meeting in June 2018.
Dynamic Integration of Semantic Metadata in Biomedical CommunicationsPistoia Alliance
Tim Clark of Harvard Medical School & Massachusetts General Hospital and chair of the W3C's scientific discourse task, gave a thorough look at applications for web 3.0, semantic metadata, and an application ontology and annotation framework for use in curing complex disorders.
How do Anti-Friction Coatings based on Binder Systems eliminate noise in auto...molykotetl
Presented at the 20th International Colloquium Tribology at the TAE, Esslingden in January 2016, Dr Manfred Jungk describes how antifriction coatings can eliminate noise in automotive interiors. Recently appointed to the board of the German Tribology Society, Molykote’s Dr Manfred Jungk has a passion for creative thinking that provides effective lubrication solutions to the automotive industry. His latest presentation demonstrates the innovative use of antifriction coatings to eliminate noise in automotive interiors with dry-film, plastic binding, high resistance, non-stick-slip coatings.
Today more than ever consumers are looking to be entertained, engaged and amused. And no other channel has the means to connect with a consumer on so many levels. In fact, it can engage with all five senses. Touch, taste, sound, sight, and smell. By leveraging new printing technology and the power of digital innovations, Direct Mail will continue to be a powerful tool in any marketers’ toolbox.
The Philadelphia Department of Public Health's Kathleen Brady presented on Philadelphia's Fetal Infant Mortality Rate (FIMR) process at the January 2015 meeting of the Philadelphia Ryan White Part A Planning Council.
Community Health Improvement Plan, Clermont County Ohio, Major Themes: obesity, tobacco use, drug use, mental health, infant mortality, breastfeeding, homelessness, secondary education for healthcare professionals, chronic disease issues, access to healthcare, inujury prevention, suicide, teen pregnancy, infectious diseases, alcohol abuse and aging population.
Hi52Hlth: Using Mobile Technology to Access Healthcare for TeensYTH
Hi52Hlth is a mobile application (app) created to engage adolescents and young adults in the search for resources in the Houston area. The app allows the user to search for locations of clinics and community organizations with directions, articles and videos on HIV/AIDS, ability to ask questions directly to health avatars ("Tiff" and "Ty"), PEP (Post-Exposure Prophylaxis) and PrEP (Pre-Exposure Prophylaxis) information, and a frequently asked questions section.
Ambassador-at-Large Deborah L. Birx, MD is the Coordinator of the US Government Activities to Combat HIV/AIDS. She discusses the importance of the faith community in addressing HIV/AIDS.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
Our Healthy Jackson County Presentation - HIT Jan 2023KC Digital Drive
In our first presentation, Jannette Berkley-Patton, PhD., of University of Missouri - Kansa City's School of Medicine will describe Our Healthy Kansas City Eastside, a set of projects organized by Dr. Berkley-Patton and UMKC and funded by Jackson County (MO) to improve health status in some of the most challenging neighborhoods in Kansas City. An initial round of funding was dedicated to improving the coverage of vaccinations in these same neighborhoods. Based on the success of that effort, this current round of funding expands into key health screenings, initiatives in maternal health, chronic disease prevention, and digital inclusion. A number of research projects are included in the program. The County grant is for $5 million and is expected to be followed up with another $5 million to expand further.
The success of the program is based on strong sector-led support (health care, education, faith communities, business) directly in the community through networking and events, as well as participation by multiple relevant community entities, like KC Digital Drive. KCDD will be active in both the chronic disease prevention and digital inclusion aspects of the program.
Dr. Berkley-Patton is a professor in the departments of Biomedical and Health Informatics at the School of Medicine. A fuller biography is available here.
Sydney Sexual Health Centre Journal Club presentation by Cherie Desreaux on the British Medical Journal and the Medical Journal of Australia editions published between November 2015 and March 2016.
The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.
Join us as we discuss best practices for integrating HIV prevention (e.g. HIV testing, PrEP and linkage to care) into primary care within the context of enhancing clinical workforce development.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
This workshop is designed to talk about the impact of STDs on youth under the age of 25. This workshop will discuss the importance of sexual health screenings, partner management, and current data around STD morbidity rates. We will also talk about current STD clinical recommendations for the treatment of gonorrhea, chlamydia, and syphilis. Participants will engage in an interactive activity where they will sharpen their skills on effective partner management strategies.
September 2013 Clean Kitchen Award Winners from Hamilton County Public Health. These are the winners who were present at the Board of Health meeting on October 14, 2013. A complete list of winners is available on our Website at www.hcph.org and then click "Clean Kitchen Awards."
August 2013 Clean Kitchen Award Winners from Hamilton County Public Health. These are the winners who were present at the Board of Health meeting in September. A complete list of winners is available on our Website at www.hcph.org and then click "Clean Kitchen Awards."
Preparedness is a year round activity. However, September is the month for recognizing national preparedness. The overall goal is to engage the public to make preparedness a part of their daily lives and just not for one single month. National Preparedness Month (NPM) is geared towards building awareness and encouraging Americans to take steps to prepare for emergencies in their homes, schools, organizations, businesses, and places of worship. NPM is managed and sponsored by FEMA’s Ready Campaign. The Ready Campaign works closely with Citizen Corps and National Preparedness Community (NPC) members to increase emergency preparedness awareness and activities across the nation and to ensure the rollout of NPM events.
Eric Kepf and Mandy Bartel recently hosted two Farmers' Markets Food Safety Training courses. Check out this valuable tool for #FoodSafety and safe food handling.
Hamilton County Public Health's Emergency Response Coordinator provides a detailed reivew of how Points of Dispensing will be managed during a public health emergency.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. P&S Syphilis Rates in the
United States by County in 2011
Baltimore
#4 (37.5)
San
Francisco
#2 (48.2)
Washington
D.C. #5 (27.4)
Fulton County,
GA #3 (39.3)
Caddo County, LA
#1 (59.2)
11. Syphilis Demographics: Age
Age Group
Sum (#)
%
<1
1-14
19
4
1.9%
0.4%
15-24
403
39.6%
25-34
313
30.7%
35-44
147
14.4%
45-54
97
9.5%
55-64
32
3.1%
>65
3
0.3%
12. Syphilis Demographics:
Behavioral Risk Factors
Target Prevention Efforts using these Risk Factors:
• Men having sex with men (MSM)
• Injection Drug Use (IDU) or sex with IDU
• Having sex with someone of the opposite
gender who is HIV+ or at risk of being HIV+
• Women having sex with MSM
• Women having sex in exchange for
money/drugs
• IDU or having sex with IDU
19. Congenital Syphilis Recent Trends
2011-2013
Cuyahoga
County is #3
with 3
cases
Franklin
County is #2
with 11
cases
20. Congenital Syphilis Recent Trends
2011-2013
Ohio Total: 42
Franklin
County is #2
with 11
cases
Cuyahoga
County is #3
with 3
cases
21. Congenital Syphilis
There is a 75-95% vertical transmission rate between
infected mother and fetus
Pregnant women with
untreated syphilis suffer a
40% fetal death rate
22. Congenital Syphilis – Prenatal Stats
• There were 22 cases of congenital syphilis reported in
Hamilton County from 2010-2012. Of these cases:
– 5 mothers (22.7%) were under the age of 19.
– 12 mothers (54.5%) received prenatal care from
hospital clinics, 4 mothers ( 18.2%) received prenatal
care from private physicians, and 1 mother (4.5%)
received prenatal care from an FQHC.
– 21 mothers (95.5%) had less than the 3
recommended RPR screenings during prenatal care.
– 18 mothers (81.8%) had less than 8 prenatal visits.
23. Congenital Syphilis
• Congenital syphilis serves as a key indicator of
community health, as it is an easily preventable
disease when proper healthcare is present.
• The Healthy People 2020 goal for congenital syphilis
is 9.1 per 100,000 live births; much lower than the
rate for Hamilton County in 2012 (54.6 per 100,000
live births).
• To meet the HP2020 goal, Hamilton County can
have 1 case of congenital syphilis.
• There have been 5 cases of congenital syphilis
reported within Hamilton County so far in 2013 (JanAug 2013).
25. Reporting Process
• Syphilis is a Class B1 disease in the Ohio
Infectious Disease Control Manual.
• Cases are to be reported to the local public
health department by the close of the next
business day after the case or suspected case
presents and/or there is a positive laboratory
result.
• These cases are usually submitted via fax or
by electronic lab reporting (ELR).
• Cases are prioritized.
26. Patient and Partner Follow-up
• HCPH staff offer partner services
• Persons infected with syphilis are interviewed
to:
– Elicit information about partners
– Notify the partners of possible exposure
– Ensure partners receive appropriate services
– Examination, treatment and referrals
– Provide prevention and risk reduction counseling
29. Hamilton County Syphilis Elimination
Healthcare Coalition Members
•
•
•
•
•
•
•
Cincinnati Children’s Hospital Medical Center
TriHealth
The Christ Hospital
Mercy Health
University of Cincinnati Medical Center
Public Health Depts—HCPH, CHD, N.KY Health
FQHC’s-Crossroads, WinMED, LHHC, NHC
30. HCPH Syphilis Elimination Strategy
• Enhanced Surveillance
• Health Care Mobilization-Targeted Screening
and Treatment @EDs and clinics
• HCPH Case and Partner Follow-up
• Community Outreach/Education
• Monitoring and Evaluation---Communication
31. Syphilis Testing: 2011 vs. 2012
Number of Screening Tests
Syphilis Testing by Hospital System, Hamilton
County, 2011-2012
Hospital System
2011
2012
35. Syphilis HotSpots: Healthy Moms & Babes
• HCPH contracted Healthy Moms and Babes
for syphilis testing in 10 Cincinnati
neighborhoods.
• In 2012, 141 tests were completed resulting in
the identification of 8 positive tests; 5.7 %
positivity.
• Health educators delivered
risk reduction messages
to 350 people
within the targeted neighborhoods.
36. Radio1
• HCPH supported testing program with
intensive radio and online campaign. The
campaign ran from October – December,
2012.
• Online survey, gauging knowledge of STIs
along with questions on STI testing.
• The campaign used well-known DJ for radio
spots. Theme: “Get real. Get tested. I did.”
38. Outreach in Schools
“Why are you telling us about this now...it’s too
late? We are seniors and getting ready to graduate.
You should have told us about this 4 years ago,
then we would have probably made different
decisions..” – several students in a local high school
“I’m addicted to sex and have had over 50 partners.
I only perform oral sex now because my mother
told me about getting HIV and she works at the
health clinic” – 15-year-old Colerain Twp female
39. Outreach in Faith-Based Organizations
“We have too many young girls who are
pregnant by the young boys sitting in our pews.
The message of waiting until marriage is not
working. We need another message.” – Head
Deacon in local church
“I don’t understand anything you are talking
about but I don’t want to get any diseases. I am
going to be smart and learn more about it.
Where can I get more information?” – 12-year-old
girl
40. Accomplishments and Progress
• 10% increase in syphilis screening and testing
from 2011 - 2012
• Healthcare awareness increased
• Community awareness and engagement
increased
• Accessible treatment sites
41. Moving Forward
• Further the education, communication and
care coordination among healthcare providers
• Develop a medical committee to determine
root cause of congenital cases
• Continue the community and school
education and engagement
• Evaluate and report results
42. Conclusions
• The syphilis epidemic continues
• Still seeing congenital cases
• More work to do by all of us
Healthcare providers -- please continue to:
– Treat syphilis cases presumptively upon clinical
manifestation
– Test for syphilis if person shows any STI symptoms
43. Our Goals
• To reduce the rate of syphilis to pre-epidemic
levels in Hamilton County by 2016
• Zero cases of congenital syphilis in 2014
Syphilis is 100% Preventable and
100% Treatable – It’s Up To Us!
44. Thank You!
Visit us online at www.HCPH.org
Find us on Social Media @HamCoHealth
Editor's Notes
Assist HCPH using a Five-Prong ApproachMultiple/Accessible Test &Treatment Referral Sites for Partners
Organizing people around the cause first takes research and understanding where people congregate. Locating people takes a multi-prong approach.Where do they live, go to school, church, play or recreate, work or volunteer. As I work to connect with people I ask them where should this message be shared. They almost always have someone else to connect with or talk to.
These comments are representative of what we’re hearing when visiting with high school students in the area.
This is typical of what I am hearing in the field.
Here is a quote that was in my Summit file from Obstetrics & Gynecology, 2012 Oct; 120(4): 882-8, Patel et al: “CONCLUSION: Providers missed well-defined opportunities to prevent congenital syphilis for the majority of cases. Combined efforts to prevent future cases include provider education and better integration of care between obstetricians and pediatricians.”