enhanced perinatal surveillance (eps)
DESCRIPTION
Enhanced Perinatal Surveillance System in Texas Presenter: Elvia Ledezma May 30, 2007 Texas Department of State Health Services. Enhanced Perinatal Surveillance (EPS). Purpose: Monitor and reduce perinatal HIV transmission in Texas. How is EPS data used?. - PowerPoint PPT PresentationTRANSCRIPT
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Enhanced Perinatal Surveillance System in Texas
Presenter: Elvia LedezmaMay 30, 2007
Texas Department of State Health Services
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Enhanced Perinatal Surveillance (EPS)
Purpose: Monitor and reduce perinatal HIV
transmission in Texas.
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How is EPS data used?
Determine effectiveness of perinatal transmission efforts
Determine effectiveness of antiretroviral therapy (ART)
Determine reasons for prevention failures
Evaluate adverse outcomes from ART use
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Enhanced Perinatal Surveillance (EPS) Project Sites, 1999-2007
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EPS Data Collection
Instrument Basic demographics for both mother and
child Maternal information
Prenatal care HIV testing ARV therapy Substance use Clinical information
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EPS Data Collection, cont.
Child information Birth history Pediatric history
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Who Collects Texas EPS Data?
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Personnel
12 satellite surveillance sites5 regional public health offices4 city/county health departments3 county health departments
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Arlington - Valerie Carson
Austin - Sherry Lyles
Beaumont - Sylvia Mazique
Cactus - George Ragsdale
Corpus Christi - Carmen Villarreal
Dallas - Lucy Betancourt
El Paso - Raul Tellez
Fort Worth - Bobby Jones
Galveston - Jim Hilton
Houston - Dawn Meade/Jerry Harms
Lubbock - Gabriel Cruz
San Antonio - Alma Mead
Tyler - Della Mendez
1
8
79/10
2/3
11
4/5N
6/5S
Regional Public Health Department
City/County Health Department
County Health Department
Texas HARS Sites
Arlington
Austin
Beaumont
Cactus
Corpus Christi
Dallas
El Paso
Fort Worth
Galveston
Houston
Lubbock
San Antonio
Tyler
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Where is EPS Data Collected?
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Texas EPS Target AreaBased on 1999-2005 Data
Residence of HIV+ women at time of delivery108 counties223 cities
201 hospitals where HIV+ moms gave birth
350 infants born annually to HIV+ moms
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Based on births from 1999-2005
45.54
5.7
3.51
2.93
17.75
Babies born to HIV Mothers(by County of Residence)
Greater than 2%1 - 2 %Less than 1%No Data
Source:Texas Department of State Health Services, HIV STD Epidemiology Group, May 2007Projection: NAD 1983 Texas Centric Mapping System Lambert
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Based on births from 1999-2005
Number of Hospitalswhere HIV+ Women Gave Birth
18 - 29
6 - 173 - 51 - 2
Source:Texas Department of State Health Services, HIV STD Epidemiology Group, May 2007Projection: NAD 1983 Texas Centric Mapping System Lambert
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What is the Process of Data Collection?
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EPS Case Identification
Review of medical records Provider/HARS staff communication Lab reports Birth certificate matching
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EPS Data Collection
Medical chart abstraction at provider officesBirth facilitiesHIV clinical care providerPrenatal care providerPediatric provider officesBirth/death certificates
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EPS Data Collection, cont.
Follow-up of the child6 months12 months18 months
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What are the Data Collection Challenges that are Encountered?
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Types of Challenges
Geography Personnel Data sources Identification and follow-up of children
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Geographical Challenges
Sheer size of Texas :261,797 square miles 660 miles long by 790 miles long 254 counties550 licensed hospitals
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Personnel Challenges
Multiple tasksEnhanced perinatal surveillance is
added to the long list of tasks they already perform
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Data Collection Challenges
Multiple record abstractions Availability of prenatal care provider
recordsPrenatal care and pediatric care
provider identification
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Identification and Follow-up Challenges
Identification of infected infants
Children lost to follow-upIndeterminate HIV status
• Lack of medical care• Negative PCR Tests
Foster care and adoptionChange in residency
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What is the Importance in Collecting EPS data?
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Comments/Questions
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Contact Information
Elvia Ledezma, MPH
Epidemiologist
Texas Department of State Health Services
(512)-533-2045