Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114855

Anne F. McIntyre, MPH¹, Rachel N. Plotinsky, MD², Irina L. Tabidze, MD, MPH³, Alice Studzinski⁴, Jennifer M. Broad, MPH³, Charlie Rabins, MPH⁴, Thad Zajdowicz, MD, MPH, FACP³, and Mark S. Dworkin, MD, MPH&TM⁵. (1) School of Public Health, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, 2121 West Taylor Street, MC 923, Chicago, IL 60612, (708)386-6002, amcint1@uic.edu, (2) CDC-Epidemiologic Investigation Officer, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301, (3) STD/HIV Prevention and Care Program, Chicago Department of Public Health, 530 East 31st Street, Chicago, IL 60616, (4) STD Section, Illinois Department of Public Health, 525 West Jefferson, Springfield, IL 62761, (5) Division of Infectious Diseases, Illinois Department of Public Health, 160 N. LaSalle, #7 South, Chicago, IL 60601

Background: Congenital syphilis represents a failure to prevent syphilis in sexually active women of childbearing age. Methods: Possible congenital syphilis cases are reported to health departments based on the infant's and/or mother's characteristics and/or test results. Health departments further investigate reports to verify case classification according to the CDC case definition. The Illinois and Chicago Departments of Public Health 1994-2002 congenital syphilis surveillance databases were merged. Cases were analyzed to assess factors associated with congenital syphilis. Results: Of the 2,650 reports, 901 (34.0%) were identified as cases and 1,749 (66.0%) were not cases. Of the 901 cases, one (0.1%) was confirmed, 820 (91.0%) were probable, and 80 (8.9%) were syphilitic stillbirths. Cases declined from 253 in 1994 to 41 in 2002 (p<0.0001). The median maternal age at delivery was 26 years (range, 13-44 years). Of the mothers, 777 (86.2%) were black, 606 (67.3%) were single, and 245 (27.2%) did not have prenatal care. Prenatal care status was unknown in an additional 177 (19.6%) cases. Low birthweight (<2500 g) was reported in 284 (31.5%) cases. Geographically, 745 (82.7%) mothers were from Cook County (Chicago/surrounding area). Of the 150 reported zip codes of residence, only 10% (all in Chicago) accounted for 503 (55.8%) cases. Conclusions: In Illinois, congenital syphilis exemplifies a health disparity with a predominance of diagnoses documented in infants born to young, black, single, urban women. Prevention of congenital syphilis should focus on geographic areas with the highest prevalence to enhance access to and utilization of prenatal care.

Learning Objectives:

• Describe methods of matching public health surveillance databases. Discuss the process of case classification using medical records. Identify risk factors associated with congenital syphilis in a high morbidity area. Develop strategies to enhance access to and utilization of prenatal care.

Keywords: Health Disparities, Maternal and Child Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.