1. Gonorrhea Epidemiology and Prevention Program Efforts in Iowa
Karen Thompson
STD Program Manager
Iowa Department of Public Health

2. GC Testing in Iowa
1972: GC Control Program was successful in decreasing the prevalence of disease in Iowa.
1986: Chlamydia Control Project was modeled after the GC Program when CT became reportable.
State funding was used until federal funds became available.
1998: A change from GC culture and CT Syva Micro Trak to Abbott Lcx Amplified DNA probe dual test occurred.
GC testing was merged with CT Control Project and renamed IPP.
Separate screening criteria for each disease existed.
2003: Lack of availability of the Abbott Lcx prompted a switch to the BD Probe Tec by the University Hygienic Laboratory.
Still a dual test, but there was now only one screening criteria.
2006: The UHL made a move to the Gen-probe Aptima Combo 2.
Still being used and one criteria is in place for both CT and GC.

3. Diagnoses of Gonorrhea Infections in Iowa 1990-2008

4. Reported Cases of Gonorrhea: 1997
Legend
0 to 4
5 to 9
10 to 19
20 to 49
50 or More
Reported Cases of Gonorrhea: 1997
Linn
142
Sac 1
Lee 10
Sioux 6
Ida
Polk
352
Tama 3
Clay
Lyon
Iowa
Kossuth
Cass
Jasper 4
Adair
Page
Story
Clayton
Benton
Clinton 30
Cedar
Jones
Fayette 2
Dallas 7
Butler
Mills
Floyd
Davis
Plymouth
Boone
Wright
Monona
Woodbury
125
Shelby
Webster 24
Scott
213
Taylor
Hardin
Marion
Carroll
Harrison
Wayne
Guthrie
Warren
Greene
O'Brien
Crawford
Jackson
Keokuk
Johnson 17
Union
Henry
Lucas
Franklin
Dubuque 11
Calhoun
Grundy
Worth
Decatur
Madison
Marshall
Clarke
Pottawattamie
Hancock
Mahaska
Hamilton
Louisa
Palo Alto
Allamakee
Adams
Fremont
Ringgold
Howard
Delaware
Cherokee
Bremer
Winneshiek
Mitchell
Monroe
Buchanan 5
Emmet
Wapello
Poweshiek
Audubon
Pocahontas
Osceola
Washington
Buena Vista
Black Hawk
206
Van Buren
Cerro Gordo
Appanoose
Chickasaw
Jefferson
Humboldt
Dickinson
Winnebago
Montgomery
Muscatine
Des Moines 43
Maps are of 2007 data

5. Reported Cases of Gonorrhea: 2007
Linn
229
Sac 1
Lee 18
Sioux 2
Ida
Polk
481
Tama 5
Clay 3
Lyon
Iowa
Kossuth
Cass
Jasper 4
Adair
Page
Story 30
Clayton
Benton
Clinton 19
Cedar
Jones
Fayette 9
Dallas 12
Butler
Mills
Floyd
Davis
Plymouth
Boone
Wright
Monona
Woodbury
109
Shelby
Webster 54
Scott
306
Taylor
Hardin
Marion 8
Carroll
Harrison
Wayne
Guthrie
Warren
Greene
O'Brien
Crawford
Jackson
Keokuk
Johnson 62
Union
Henry 14
Lucas
Franklin
Dubuque 72
Calhoun
Grundy
Worth
Decatur
Madison
Marshall
Clarke 7
Pottawattamie 42
Hancock
Mahaska
Hamilton
Louisa
Palo Alto
Allamakee
Adams
Fremont
Ringgold
Howard
Delaware
Cherokee
Bremer
Winneshiek
Mitchell
Monroe
Buchanan
Emmet
Wapello
Poweshiek
Audubon
Pocahontas
Osceola
Washington
Buena Vista
Black Hawk
233
Van Buren
Cerro Gordo
Appanoose
Chickasaw
Jefferson
Humboldt
Dickinson
Winnebago
Montgomery
Muscatine 6
Des Moines 64
Reported Cases of Gonorrhea: 2007
Legend
0 to 4
5 to 9
10 to 19
20 to 49
50 or More
Maps are of 2007 data

6. GC Cases by Race and Ethnicity Compared to Iowa’s Population
2008 Estimated Population
2008 GC Cases, n = 1,700

7. 2008: Reported Cases of Gonorrhea by Race, Ethnicity and Gender
Number of Cases
Male
Female
Total Cases = 1,700
Source: Iowa Department of Public Health STD Prevention Program

8. Will insert Rates by race, ethnicity, and gender slide here

9. GC Prevalence by Age Compared to Iowa’s Population
2008 Estimated Population
2008 GC Cases, n = 1,700

10. 2008: Statewide reported Cases of Gonorrhea by Age and Gender
Total Cases = 1,700
Source: Iowa Department of Public Health STD Prevention Program

11. Will insert rate by gender and age slide here

12. Iowa Infertility Prevention Project 2008 Gonorrhea Prevalence Monitoring Data
Clinic Type
Total Tests
GC Positives
Positivity Rate
Family Planning
43,105
252
0.6%
STD Clinics
5,404
278
5.1%
Integrated
3,940
128
3.2%
Student Health
2,807 18
Corrections
2,612 23
0.9%
CHC
916 3
0.3%
Other
392
0.8%
Indian Health
123 4
3.3%
Total
59,299
709
1.2%
Data Source: UHL and Polk Co. Health Dept.

13. MLS2b and 3b: Timeliness to GC Treatment in IPP and STD Settings
GC/IPP
Jan-Jun 07
Jul-Dec 07
Jan-Jun 08
Jul-Dec 08
Jan-Jun 09 14
90/104=.87
124/144=.86
50/95=.53
99/110=.90
91/117=.78 30
100/104=.96
140/144=.97
84/95=.88
109/110=.99
111/117=.95
GC/STD
67/68=.99
70/72=.97
61/66=.92
54/61=.89
58/59=.98
68/68=1
71/72=.99
63/66=.95
61/61=1
59/59=1.0
IPP Goals are .85 (14 Days) and .95 (30 Days)
STD Goals are .95 (14 Days) and .98 (30 Days)

14. PS3: Timeliness to GC Interview
Jan-Jun 06
Jul-Dec 06
Jan-Jun 07
Jul-Dec 07
Jan-Jun 08
Jul-Dec 08
7 Days
82/111=.74
100/136=.74
132/193=.68
61/165=.37
22/129=.17
129/198=.65
14 Days
96/111=.86
116/136=.85
168/193=.87
93/165=.56
34/129=.26
141/198=.71
30 Days
97/111=.87
135/136=.99
114/165=.69
41/129=.32
161/198=.81
Jan – Jun 2009
7 days: 434/834 = goal .5
14 days: 511/834 = goal .7
30 days: 571/834 = .68 goal .9
258 or 30.9% Not Interviewed

15. Programmatic Response:
Iowa Disease Surveillance System (IDSS)
EPT
IPP Criteria
Pregnancy Testing Only Clinics
School Screening
Performance Measure Monitoring
Chlamydia Toolkit Revision
Funding for Social Marketing
PCSI Opportunity with HIV Prevention