Identifying likely syphilis transmitters

Implications for control and evaluation

Richard H. Kahn, Thomas A. Peterman, Janet Arno, Emmett John Coursey, Stuart M. Berman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND/OBJECTIVES: Persistence of syphilis in communities may be maintained by relatively small groups of high-risk persons centrally placed among a larger group with low to moderately risky behavior. We sought to determine which control strategies identified particularly high-risk, early-stage syphilis cases considered to have high prevention value. METHODS: In 2 cities with recent heterosexual outbreaks, data were abstracted for early syphilis cases from 1997 through 2002. Disease stage and number of sex partners were used to create an index to estimate the relative likelihood and magnitude of future transmission had the case not been treated. We estimated the relative transmission potential for each stage of syphilis (primary = 4.3, secondary = 2.5, and early-latent = 1.0) and multiplied by the number of reported partners to determine a prevention value score. Cases scoring >10 were considered high prevention value. Cases were stratified by the method used to detect the case. RESULTS: Of 1700 female early syphilis cases, 174 (10%) were high value. Cases were identified by private physicians (28% of all female cases and 16% of high-value cases), jails (19% of all, 40% of high-value cases), partner notification (16% of all, 10% of high-value cases), sexually transmitted disease (STD) clinic (9% of all, 13% of high-value cases), and the emergency room (8% of all, 4% of high-value cases). Of 1851 male cases, 228 (12%) were high value. Cases were identified by jails (27% of all male cases and 14% of high-value cases), STD clinic (21% of all, 47% of high-value), private physicians (17% of all, 17% of high-value), partner notification (14% of all, 11% of high-value), and the emergency room (6% of all, 14% of high-value). CONCLUSIONS: Private physicians identified the most female cases; however, jail screening identified the most high-prevention-value female cases. Jail screening identified the most male cases; however, the STD clinic (self-referred) identified the most high-prevention-value cases. Partner notification identified relatively few high-value cases.

Original languageEnglish (US)
Pages (from-to)630-635
Number of pages6
JournalSexually Transmitted Diseases
Volume33
Issue number10
DOIs
StatePublished - Oct 2006

Fingerprint

Syphilis
Contact Tracing
Sexually Transmitted Diseases
Physicians
Hospital Emergency Service
Heterosexuality
Disease Outbreaks

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)

Cite this

Identifying likely syphilis transmitters : Implications for control and evaluation. / Kahn, Richard H.; Peterman, Thomas A.; Arno, Janet; Coursey, Emmett John; Berman, Stuart M.

In: Sexually Transmitted Diseases, Vol. 33, No. 10, 10.2006, p. 630-635.

Research output: Contribution to journalArticle

Kahn, Richard H. ; Peterman, Thomas A. ; Arno, Janet ; Coursey, Emmett John ; Berman, Stuart M. / Identifying likely syphilis transmitters : Implications for control and evaluation. In: Sexually Transmitted Diseases. 2006 ; Vol. 33, No. 10. pp. 630-635.
@article{8e73f14d1c4d43dcae31ccacf9966c98,
title = "Identifying likely syphilis transmitters: Implications for control and evaluation",
abstract = "BACKGROUND/OBJECTIVES: Persistence of syphilis in communities may be maintained by relatively small groups of high-risk persons centrally placed among a larger group with low to moderately risky behavior. We sought to determine which control strategies identified particularly high-risk, early-stage syphilis cases considered to have high prevention value. METHODS: In 2 cities with recent heterosexual outbreaks, data were abstracted for early syphilis cases from 1997 through 2002. Disease stage and number of sex partners were used to create an index to estimate the relative likelihood and magnitude of future transmission had the case not been treated. We estimated the relative transmission potential for each stage of syphilis (primary = 4.3, secondary = 2.5, and early-latent = 1.0) and multiplied by the number of reported partners to determine a prevention value score. Cases scoring >10 were considered high prevention value. Cases were stratified by the method used to detect the case. RESULTS: Of 1700 female early syphilis cases, 174 (10{\%}) were high value. Cases were identified by private physicians (28{\%} of all female cases and 16{\%} of high-value cases), jails (19{\%} of all, 40{\%} of high-value cases), partner notification (16{\%} of all, 10{\%} of high-value cases), sexually transmitted disease (STD) clinic (9{\%} of all, 13{\%} of high-value cases), and the emergency room (8{\%} of all, 4{\%} of high-value cases). Of 1851 male cases, 228 (12{\%}) were high value. Cases were identified by jails (27{\%} of all male cases and 14{\%} of high-value cases), STD clinic (21{\%} of all, 47{\%} of high-value), private physicians (17{\%} of all, 17{\%} of high-value), partner notification (14{\%} of all, 11{\%} of high-value), and the emergency room (6{\%} of all, 14{\%} of high-value). CONCLUSIONS: Private physicians identified the most female cases; however, jail screening identified the most high-prevention-value female cases. Jail screening identified the most male cases; however, the STD clinic (self-referred) identified the most high-prevention-value cases. Partner notification identified relatively few high-value cases.",
author = "Kahn, {Richard H.} and Peterman, {Thomas A.} and Janet Arno and Coursey, {Emmett John} and Berman, {Stuart M.}",
year = "2006",
month = "10",
doi = "10.1097/01.olq.0000216063.75575.f8",
language = "English (US)",
volume = "33",
pages = "630--635",
journal = "Sexually Transmitted Diseases",
issn = "0148-5717",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Identifying likely syphilis transmitters

T2 - Implications for control and evaluation

AU - Kahn, Richard H.

AU - Peterman, Thomas A.

AU - Arno, Janet

AU - Coursey, Emmett John

AU - Berman, Stuart M.

PY - 2006/10

Y1 - 2006/10

N2 - BACKGROUND/OBJECTIVES: Persistence of syphilis in communities may be maintained by relatively small groups of high-risk persons centrally placed among a larger group with low to moderately risky behavior. We sought to determine which control strategies identified particularly high-risk, early-stage syphilis cases considered to have high prevention value. METHODS: In 2 cities with recent heterosexual outbreaks, data were abstracted for early syphilis cases from 1997 through 2002. Disease stage and number of sex partners were used to create an index to estimate the relative likelihood and magnitude of future transmission had the case not been treated. We estimated the relative transmission potential for each stage of syphilis (primary = 4.3, secondary = 2.5, and early-latent = 1.0) and multiplied by the number of reported partners to determine a prevention value score. Cases scoring >10 were considered high prevention value. Cases were stratified by the method used to detect the case. RESULTS: Of 1700 female early syphilis cases, 174 (10%) were high value. Cases were identified by private physicians (28% of all female cases and 16% of high-value cases), jails (19% of all, 40% of high-value cases), partner notification (16% of all, 10% of high-value cases), sexually transmitted disease (STD) clinic (9% of all, 13% of high-value cases), and the emergency room (8% of all, 4% of high-value cases). Of 1851 male cases, 228 (12%) were high value. Cases were identified by jails (27% of all male cases and 14% of high-value cases), STD clinic (21% of all, 47% of high-value), private physicians (17% of all, 17% of high-value), partner notification (14% of all, 11% of high-value), and the emergency room (6% of all, 14% of high-value). CONCLUSIONS: Private physicians identified the most female cases; however, jail screening identified the most high-prevention-value female cases. Jail screening identified the most male cases; however, the STD clinic (self-referred) identified the most high-prevention-value cases. Partner notification identified relatively few high-value cases.

AB - BACKGROUND/OBJECTIVES: Persistence of syphilis in communities may be maintained by relatively small groups of high-risk persons centrally placed among a larger group with low to moderately risky behavior. We sought to determine which control strategies identified particularly high-risk, early-stage syphilis cases considered to have high prevention value. METHODS: In 2 cities with recent heterosexual outbreaks, data were abstracted for early syphilis cases from 1997 through 2002. Disease stage and number of sex partners were used to create an index to estimate the relative likelihood and magnitude of future transmission had the case not been treated. We estimated the relative transmission potential for each stage of syphilis (primary = 4.3, secondary = 2.5, and early-latent = 1.0) and multiplied by the number of reported partners to determine a prevention value score. Cases scoring >10 were considered high prevention value. Cases were stratified by the method used to detect the case. RESULTS: Of 1700 female early syphilis cases, 174 (10%) were high value. Cases were identified by private physicians (28% of all female cases and 16% of high-value cases), jails (19% of all, 40% of high-value cases), partner notification (16% of all, 10% of high-value cases), sexually transmitted disease (STD) clinic (9% of all, 13% of high-value cases), and the emergency room (8% of all, 4% of high-value cases). Of 1851 male cases, 228 (12%) were high value. Cases were identified by jails (27% of all male cases and 14% of high-value cases), STD clinic (21% of all, 47% of high-value), private physicians (17% of all, 17% of high-value), partner notification (14% of all, 11% of high-value), and the emergency room (6% of all, 14% of high-value). CONCLUSIONS: Private physicians identified the most female cases; however, jail screening identified the most high-prevention-value female cases. Jail screening identified the most male cases; however, the STD clinic (self-referred) identified the most high-prevention-value cases. Partner notification identified relatively few high-value cases.

UR - http://www.scopus.com/inward/record.url?scp=33748987617&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748987617&partnerID=8YFLogxK

U2 - 10.1097/01.olq.0000216063.75575.f8

DO - 10.1097/01.olq.0000216063.75575.f8

M3 - Article

VL - 33

SP - 630

EP - 635

JO - Sexually Transmitted Diseases

JF - Sexually Transmitted Diseases

SN - 0148-5717

IS - 10

ER -