united south and eastern tribes: gonorrhea and chlamydia overview
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United South and Eastern Tribes: Gonorrhea and Chlamydia Overview
Chris Compher
Tribal Epidemiology CenterUnited South and Eastern Tribes
A Discussion on Gonorrhea Control in Region VI: Optimizing Strategies to Reduce Morbidity
October 14, 2009
2004 2005 2006 2007 2008
North 385 490 491 447 400
South 700 639 793 750 737
Total 1085 1129 1284 1197 1137
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Num
ber o
f Tes
ts
Number of Gonorrhea Tests Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
2004 2005 2006 2007 2008
North 0 0 0.2 0.45 0.25
South 0.43 0.94 0.76 0.53 0.27
Total 0.28 0.53 0.55 0.5 0.26
0.0
1.0
2.0
3.0
4.0
5.0
% o
f Pos
itive
Tes
ts
Percentage of + Gonorrhea TestsAmong Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
2004 2005 2006 2007 2008
North 0.0 46.0 55.0 37.2 18.3
South 167.6 146.0 104.0 135.2 99.2
Total 122.6 118.6 90.2 108.1 77.2
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
Num
ber o
f Cas
es/1
0000
0
Number of Gonorrhea CasesAmong Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
10-14 15-19 20-24 25-34 35-44 45-54 55-64 65+
North 0 23.53 17.65 23.53 11.76 5.88 0 17.65
South 1.1 30.77 32.42 24.73 7.69 2.2 0.55 0.55
Total 1.01 30.15 31.16 24.62 8.04 2.51 0.5 2.01
0
20
40
60
80
100
% o
f Cas
es
Age Distribution of Gonorrhea Cases Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
Female Male
North 76.47 23.53
South 75.14 24.86
Total 75.25 24.75
0
20
40
60
80
100
% o
f Ca
ses
Gender Distribution of Gonorrhea Cases Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
2004 2005 2006 2007 2008
North 478 561 519 471 430
South 765 2450 2634 2672 2459
Total 1243 3011 3153 3143 2889
0
1000
2000
3000
4000
Num
ber o
f Tes
ts
Number of Chlamydia Tests Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
2004 2005 2006 2007 2008
North 1.46 3.74 2.31 2.97 3.49
South 8.63 6.9 6.23 7.67 7.32
Total 5.87 6.31 5.58 6.97 6.75
0.0
2.0
4.0
6.0
8.0
10.0
% o
f Pos
itive
Tes
ts
Percentage of + Chlamydia TestsAmong Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
2004 2005 2006 2007 2008
North 87.3 211.6 137.6 167.2 155.8
South 231.8 490.2 491.3 626.2 526.6
Total 193.0 413.8 391.9 499.1 425.9
0.0
100.0
200.0
300.0
400.0
500.0
600.0
700.0
Num
ber o
f Cas
es/1
0000
0
Number of Chlamydia CasesAmong Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
10-14 15-19 20-24 25-34 35-44 45-54 55-64 65+
North 0 17.07 43.9 26.83 7.32 3.66 1.22 0
South 1.94 36.66 32.94 20.57 5.22 1.94 0.75 0
Total 1.73 34.53 34.13 21.25 5.44 2.12 0.8 0
0
20
40
60
80
100
% o
f Cas
es
Age Distribution of Chlamydia Cases Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
Female Male
North 80.49 19.51
South 87.37 12.63
Total 86.62 13.38
0
20
40
60
80
100
% o
f Ca
ses
Gender Distribution of Chlamydia Cases Among Nashville Area Tribes
2004-2008
Data Sources: Tribal electronic patient management system. Notes: North Region includes Maine, Massachusetts, New York, Rhode Island, Connecticut. South Region includes Alabama, Florida, Lousiana, Mississippi, North Carolina, South Carolina, Texas.
Small Numbers…make data analysis difficult
...make secondary data difficult to access
Racial Misclassification…deflates our actual numbers
What do you consider your race?
Lack of Data Sharing…makes it difficult to access Tribal figures
Tribal Nation Borders
…federal
…state
…county
do not mirror
Social Norms and Values
…can be inhibitive
Close Knit Communities
…can inflate social stigmas
Community Insulation
…makes us feel safe and protected
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