Online Program

Enhancing STD Practitioners' Understanding of Syphilis Staging: An Interactive Case-Conference Training Module

Tuesday, November 3, 2015 : 10:45 a.m. - 11:00 a.m.

Michael Thomas, BS Microbiology; MPH Public Health, Bureau of Nursing Services, Houston Department of Health and Human Services, Houston, TX
Carolyn Mitchell, RN, BSN, Chief Nurse, HDHHS Community Health Services, Houston Department of Health and Human Services, Houston, TX
Lupita Thornton, STD Program Manager, Bureau of HIV/STD and Viral Hepatitis Prevention, Houston Department of Health and Human Services, Houston, TX
Algia Hickenbotham, MEd, RN-BC, Area Operations Support, City of Houston, Department of Health and Human Services, Houston, TX
Marlene McNeese-Ward, Bureau of HIV/STD and Viral Hepatitis Prevention, Houston Department of Health and Human Services, Houston, TX

In 2000, syphilis was on the verge of elimination in the United States; however, from 2005-2013 rates of primary and secondary syphilis steadily increased and health jurisdictions across the nation experienced outbreaks of early syphilis.  As a result, the number of clients infected with syphilis and reporting to public health clinics also increased. However, previous years of declines in syphilis morbidity resulted in a clinical workforce that is deficient in staging syphilis cases appropriately, leading to patient misdiagnosis and inaccurate morbidity rates.


The Houston Department of Health and Human Services (HDHHS) developed a customized training module, “Syphilis Case Conference” that provides STD clinicians with didactic and applied knowledge of syphilis and the staging process. The module presents information on syphilis epidemiology, local morbidity trends and true clinical cases for staging syphilis. The   training is interactive and clinicians and health investigator trainees combine their medical and epidemiology knowledge base for an increased comprehension of the staging process.     

Lessons Learned

In 2013 as syphilis morbidity levels increased in Houston, all STD clinic practitioners were required to attend Syphilis Case-Conference training, which has since become an annual, mandatory course.  Pre-test and post-test assessments revealed that only 22% of attendees passed syphilis staging competency prior to training while 95% of attendees received a passing score after training.  


The customized Syphilis Case-Conference training greatly enhances clinicians’ knowledge of syphilis and how to stage the disease, which facilitates improved patient diagnosis and accurate enumeration of disease morbidity.

Learning Areas:

Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related education

Learning Objectives:
Describe how to design an effective training program that enables STD clinical practitioners to gain a practical working knowledge of how to stage syphilis cases. Discuss the importance of STD clinician's role, as the initial provider of service, in being able to correctly diagnose syphilis staging.

Keyword(s): STDs/STI, Training

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health adviser, providing technical expertise on public health prevention, interventions and control practices to health department personnel on national, state and local levels. I have a BS in microbiology and a masters of Public Health in the area of Epidemiology. I have 31 years of experience in working in public health programs. I have presented the results of evidence-base, STD interventions at various conferences on national and state levels.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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