1. STOP CHLAMYDIA PROGRAM
Gloria Jones, BSN, Public Health Nurse
550 S. Peoria Avenue, Tulsa, OK 74120

2. Initiating & Integrating CT Screening Activities into:
Tulsa metro area: 86,000 Indian people
Clinic patients: 15,000 per year
Tulsa Public Schools has largest Indian pupil population in U.S.
Comprehensive health services:
Medical
Dental
Optometry
Behavioral Health
Health Education

3. Chlamydia Program Challenges
.1% of patients lost to follow-up, due to unreliable phone number or address
PHN makes three attempts for tracking & treating STIs
Phone call
Certified letter
Home visit, leaving business card and need for follow-up appointment
Uncooperative condom use by partners
2006 prior STI = 14 (averaging 2 to 5 re-exposures per qtr)
2007 prior STI = 17 (averaging 2 to 5 re-exposures per qtr)
Anonymous and multiple partner encounters
Contacts ineligibility for IHS services PHN refers partners to their closest health department

4. Chlamydia Program Enhancements
To promote timely treatments of STI’s a systemized approach is established
PHN enters daily all pap results in a Stop Chlamydia & STI log book
Lab ensures all positive Chlamydia results are sent to the PHN for patient tracking, DOT treatment, partner management & PHIDDO reporting
Intensive case management resulted in 99.9% of cases tracked & treated within 10 days of STI lab collection
Quarterly PHN checks with pharmacy’s Azithromycin distribution list & performs chart audits for missed reported cases

5. Stop Chlamydia! Data
Newly developed Stop Chlamydia Project Quarterly Reports
Provide routine analysis of project-level screening outcomes
Can be used to evaluate and better target screening efforts

6. Chlamydia Positivity Among Females by Age Group, Indian Health Care Resource Center of Tulsa, Inc. 2006
High positivity among youth
No positivity found in older age groups
Data could inform more effective targeting of services
Shift resources currently used to screen older groups to then screen increased numbers of at-risk groups

7. Chlamydia Positivity Among Females by Age Group, Indian Health Care Resource Center of Tulsa, Inc. 2007
Increase in high positivity among year olds (8.8 to 20.2)s
Slight increase in positivity found in year olds (10.5 to 12.0)
Slight decrease in positivity of year olds (4.8 to 3.5)
Slight increase in positivity in 30 to 65+ age groups due to improved screening efforts

11. Practical, Consistent & Efficient Keys to Preventing Chlamydia in Indian Country:
Intensive case management
Networking with health care providers, lab personnel, local & State Health Departments
Continuous demographic updating of patient’s phone & address each visit
Accessible screening & treatment services targeting the at risk age groups
Distribution of STI/Prophylactic education

12. Q&A