Transcript Region V IPP PM UPdate

Region II
Infertility Prevention Project
Advisory Committee
May 31-June 1, 2006
CDC Update:
Personnel
Budget and Program Changes
Reorganization
Ongoing Projects
Azithromycin
Performance Measures
PDSB Personnel
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Catherine Lindsey Satterwhite
David Johnson
Sheldon Black
David Byrum
Tracey Hardy
Susan DeLisle
Kathryn Koski
Budget 2006
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Flat Funding for STD Prevention
– $161 Million FY 2006
» $106 million to grantees
– 50% funding awards
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FY 2006 Final Budget
– 2.97% reduction in funds
» CSPS and Infrastructure
» 1% Katrina Relief
Program Changes
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Internal– Infrastructure Performance Measure(s)
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External– However, new language in the
congressional committee report for FY06
indicates possible future directions for the
Infertility Prevention Project
109th Congress Committee
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The committee notes that CDC is charged legislatively with instituting
programs to help prevent infertility. CDC’s current program activities in
this matter are undertaken by the division of HIV/STD/TB and are
limited to the prevention of venereal diseases. The Committee
understands that there are numerous additional causes of infertility
beyond sexually transmitted disease, such as delayed child bearing,
smoking, low or excessive body weight, exposure to hazardous
environmental toxins, drug and alcohol abuse, and particularly for men,
exposure to high temperatures. The Committee encourages CDC to
consider expanding the scope of this program and provide greater
support to public education on the risks to fertility.
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Senate Report 109-103 Calendar #163
Reorganization
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CDC
CoCID
NCHHSTP
DSTDP
– PDSB and THCB merged into the Program and
Training Branch (PTB)
Ongoing Projects
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Male Screening Consultation
– Questions of Interest
» What is the effectiveness of screening men in various
venues to identify undiagnosed chlamydia infection?
» Can we identify behavioral or demographic
characteristics such as age that can be used to target
men at high risk for chlamydia infection?
» What do models and cost-effectiveness studies on male
chlamydia screening tell us?
» What data are there on partner management practices
for female partners of men found to have chlamydia?
Ongoing Projects
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Partner Management
– Expedited Partner Therapy
» Dear Colleague Letter
» Catalogue of state and local statutes, rules, and
regulations
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GC Screening
» National GC Screening guidelines using a
prevalence threshold should be established
» Localize efforts in a “geographic core”
» GISP/GASP
Ongoing Projects
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Infertility Prevention Workgroup Subcommittees
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Partner Services
Client Counseling and Behavioral Interventions
Diagnosis and Treatment
Surveillance and Monitoring
Screening
2 Page Outline
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Rationale for component
Describe Status Quo
Given existing evidence, what should we be doing?
Identify critical issues and recommend strategies
Ongoing Projects
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Broad Action Areas Identified
– Twenty-six prioritized to eleven
– Development of 3-5 page brief response
paper using a common template
– Discussion meeting June 16
– Subsequent Prioritization
» 3-5 presented to Dr. Douglas for consideration
Ongoing Projects
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Partnership for Prevention
» P4P is a national nonprofit dedicated to building
evidence for strong disease prevention policies
» Proposed Work Plan
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Promote the use of high-impact adolescent
preventive services, including chlamydia screening;
Develop an implementation guide to assist health
systems and clinicians establish systems that
encourage the delivery of chlamydia screening
services;
Promote delivery of the new HPV vaccine, especially
to vulnerable populations
Azithromycin
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FDA approval for generic AZ 11/11/05
» Greenstone (Pfizer)
» Teva
» Sandoz
– 340B sub-ceiling pricing for branded AZ
($95/10 doses) expires 6/30/06. Pfizer will
not renew this contract with 340B
– Kansas IPP Coordinator
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Jennifer Vandevelde 785-296-6544
Performance Measures
Activities
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PM Consultation January 2006
– Established PM evaluation criteria
– Reviewed current measures and evaluated
possible future measures
– Recommended guiding principles
PM Activities (2)
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PM Consultation (cont)
– Made recommendations for each “new” measure
» Tabled
» Needs further discussion
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Proportion of family planning clinics adhering to regional
chlamydia screening criteria (Infrastructure[?])
» Pilot-ready
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Timeliness of treatment for maternal syphilis during
pregnancy
Screening coverage estimate among sexually active 15-19
year old women in FP clinics (Infrastructure [?])
» Ready for Implementation
PM Activities (3)
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PM Consultation (cont)
– Made recommendations for each “new”
measure
» Ready for Implementation
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Gender of Sex Partner information
Timeliness of treatment for gonorrhea and chlamydia
in women who test positive in STD clinics
– Made recommendations for current
measures
PM Activities (4)
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Live Database March 6
– Continued development of Technical Assistance and Reports
section
– January-June 2005 data final β-est for data entry
– MOU and User ID requests
» Grantees
» IPP regional coordinators
– Three training Webinar for grantees
– Database available for aggregate July-December 2005 data
entry until April 30, 2006. Changes after 4-30-06 will be
reviewed, approved, and entered by project area consultant.
Performance Measure
IPP CS1
Among clients of IPP Family
Planning clinics, the proportion of
women with positive chlamydia
tests treated within 14 and 30
days of the date of specimen
collection.
IPP CS 1 (Chlamydia) Results
Site
2004 2005.1 2005.2
Region II- 14 Days (Average)
Region II- 30 Days (Average)
0.52
0.74
0.40
0.64
National- 14 Days (Average)
National- 30 Days (Average)
0.7
0.9
0.75
0.89
0.16
0.45
IPP-CS1
Proportion of positive chlamydia cases from family
Planning clinics treated within 14 and 30 days
U.S. and IPP median proportions (2005)
14 days
30 days
1.0
Proportion Treated
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
U. S.
I
II
III
IV
V
VI
VII
U.S. and IPP Regions
VIII
IX
X
Performance Measure
IPP CS2
Among clients of IPP Family
Planning clinics, the proportion of
women with positive gonorhea
tests treated within 14 and 30
days of the date of specimen
collection.
IPP CS 2 (Gonorrhea) Results
Site
2004 2005.1 2005.2
Region II- 14 Days (Average)
Region II- 30 Days (Average)
0.55
0.74
0.51
0.61
National- 14 Days (Average)
National- 30 Days (Average)
0.7
0.9
0.74
0.91
N/A
N/A
IPP-CS2
Proportion of positive gonorrhea cases from family
Planning clinics treated within 14 and 30 days
U.S. and IPP median proportions (2005)
14 days
30 days
1.0
Proportion Treated
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
U. S.
I
II
III
IV
V
VI
VII
U.S. and IPP Regions
VIII
IX
X
Performance Measure
CSPS MLS1
Proportion of female admittees to large
juvenile detention centers tested for
chlamydia.
CSPS MLS1 (JDC Screening) Results
Site
Region II (Average)
National (Average)
2004 2005.1 2005.2
0.69
0.63
0.87
0.60
0.54
CSPS-MLS1
Proportion of female juvenile detention center
admittees that are screened for chlamydia
Median proportions in U.S. and IPP regions (2005)
1.0
Proportion Tested
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
U. S.
I
II
III
IV
V
VI
VII
U.S. and IPP Regions
VIII
IX
X
Disclaimer
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"The findings and conclusions in this
presentation are those of the author and
do not necessarily represent the views
of the Centers for Disease Control and
Prevention."
Questions