Office of HIV, STD, and Hepatitis C Services

CDRs (Communicable Disease Reports)

How and Why?STATEWIDE STD MEETING

September 2, 2009

Arshad AzizADHS/STD Epidemiologist

OLD CDR FORM

NEW CDR FORM

NEW CDR FORM

NEW CDR FORM

• New Communicable Disease Reports– http://www.azdhs.gov/phs/hvstdhpc/CDRRep

ortFinal_fill3.pdf

• It is ‘pdf’ file and fill able but you can not save data.

Reporting

• Updated Administrative Rules for Provider Reporting (R9-6-202)– http://www.azdhs.gov/phs/oids/code.htm

Reporting• All providers should submit a report within

five working days after a case or suspect case is diagnosed, treated, or detected.

• All laboratories should submit a report within five working days after obtaining a positive test result or a test result specified on this page.

Reporting (Cont’d)

Reporting (Cont’d)

• So Who Reports to Whom?– Administrative Code requires Health Care

Providers to report STDs to the Local Health Agency.

"Local health agency" means a county health department, a public health services district, a tribal health unit, or a U.S. Public Health Service Indian Health Service Unit.

– Administrative Code requires Local Health Agencies to report to the State STD Program.

Reporting (Cont’d)

• What Do We Want?– Providers report directly to their county health

department– Other local health agencies receiving reports

forward the report to the county health department

– County health departments report to the STD Program and also to other local health agencies (i.e., tribal health units, IHS health units)

Why?----- Importance of Reporting

• Effective public health surveillance and disease control

• To ensure effective treatment and follow-up of cases

• Early detection and prevention

• To monitor disease trends over time

Why?----- Importance of Reporting

• To identify high risk groups• To allocate resources- Racial disparity

issues In February of 2009, ADHS staff developed a “missing race” letter to be

sent to providers that have reported chlamydia and gonorrhea cases as

required but not included the race/ethnicity. These “missing race” letters were sent to approximately 700 providers in March 2009 and we received race/ethnicity information for 1160 cases. This information was entered into

central database.

• To develop policy and design prevention programs

Why?----- Importance of Reporting• To support grant application and CDC performance measures• CDC Required Performance Measures beginning with

2005 grant cycle– Medical and Lab Services (1 measure)– Partner Services (6 measures)– Surveillance and Data Management (3 Measures)– Clinical Services (4 Measures)– Syphilis Elimination - Enhanced Surveillance (1Measure)

• STD Program staff may call on County STD staff to request information necessary to respond to the CDC performance measures

ChlamydiaJan-June

2008Male

Jan-June 2008

Female

Jan-June 2008Total

Jan-June 2009

Male

Jan-June 2009

Female

Jan-June 2009Total

White, Non-Hispanic

641 1853 2494  615  1582 2207

Black, Non-Hispanic

 362 586  948  417  502 923

Hispanic 910 2817  3728 833 2535  3379

Asian/PI  12  77  89 22  57  79

American Indian/ Alaska Native

250 1081 1333 157 807 964

Mixed 5 26 31 13 20 33

Other (Unknown)

 26(899)  63(2771)  89(3671)  20(1136)  55(3726)  76(4871)

Total  3105 9274 12383 3213 9284 12532

Arizona Department of Health Services2010 Comprehensive Sexually Transmitted Disease (STD) Prevention Systems

Cooperative Agreement No. 1 H25 PS0013852009 Interim Progress Report

APPENDIX A: Required Data Tables

CDR RECEIVED, Arizona 2006-2008

CDR Received 2006-8, Arizona

300803182932033

21993

2513726981

0

5000

10000

15000

20000

25000

30000

35000

2006 2007 2008

Year

To

tal N

um

be

r o

f C

as

es

Total Number of Cases

CDR Received

Note: Syphilis cases are not included

%CDR Received, Arizona 2006-2008

% CDR Received, Arizona 2006-2008

73%79%

84%

0

20

40

60

80

100

2006 2007 2008

Year

% C

DR

Rec

eive

d

Note: Syphilis cases are not included

Syphilis Cases Lag Time Between Collection and CDRs Received Dates, Arizona 2006-8

Syphilis Cases Lag Time Between Collection and CDRs Received Dates, Arizona 2006-8

39%

32%

16%13%

31%

21%

12%

36%

14%12%11%

63%

0

10

20

30

40

50

60

70

0-15 16-30 31-60 >60

Lag Time (Days)

% o

f C

ases 2006

2007

2008

Gonorrhea Cases- Lag Time Between Collection and CDRs Received Dates, Arizona

2006-8Gonorrhea cases- Lag Time Between Collection and

CDRs Received Dates, Arizona 2006-8

22% 21%24%

33%

57%

18%

11%14%

63%

17%12%

8%0

10

20

30

40

50

60

70

0-15 16-30 31-60 >60

Lag Time (Days)

% o

f C

ases

2006

2007

2008

Chlamydia Cases- Lag Time Between Collection and CDRs Received Dates, Arizona

2006-8Chlamydia Cases- Lag Time Between Collection and

CDRs Received Dates, Arizona 2006-8

19%21%

25%

35%

47%

21%

16% 16%

52%

21%

16%

11%

0

10

20

30

40

50

60

0-15 16-30 31-60 >60

Lag Time (Days)

% o

f C

ases

2006

2007

2008

Violation of reporting rules • Under

Arizona Administrative Code (AAC) R9-6-202, 203, 204, and 205, a health care provider, an administrator of a health care facility or correctional facility, an administrator of a school, child care establishment, or shelter, or their authorized representatives shall submit a communicable disease report to the local health agency.

Violation of reporting rules

• Violation of reporting rules is a class III misdemeanor and is subject to referral to the facility's licensing agency or provider's state licensing board.

Contact InformationArshad Aziz Epidemiologist IIArizona STD Control Program150 N.18th Ave Phoenix AZ 85007P (602)364-4759F (602)364-2119Email: aziza@azdhs.gov

Kerry M. KenneySr. Public Health AdvisorArizona STD Control Program150 North 18th Avenue, Suite 140Phoenix, Arizona 85007Phone: (602) 364-2124Fax: (602) 364-2119E-Mail: kenneyk@azdhs.gov

ADHS STD WEBSITE

• http://wwW.azdhs.gov/phs/oids/std/index.htm