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State of Alaska

Health Indicator Report of Chlamydia Cases (HA2020 Leading Health Indicator: 18)

Chlamydia trachomatis (CT) infection is the most commonly reported bacterial sexually transmitted disease in the US and in Alaska. Chlamydia is known as a 'silent' infection because most infected people have no symptoms. Untreated CT infection can cause pre-term labor, pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women; epididymitis and Reiter's syndrome in men; and eye infection and pneumonia in newborns. Alaska has consistently had the first or second highest (CT) infection rate in the nation since 2000.^1^[[br]] [[br]] {{class .SmallerFont 1. Centers for Disease Control and Prevention. ''Sexually Transmitted Disease Surveillance 2015''. Atlanta: U.S. Department of Health and Human Services; 2016. [https://www.cdc.gov/std/stats15/]. Accessed January 25, 2017. }}

Notes

Rates are not age-adjusted.   ** = Data not available

Data Sources

  • Sexually Transmitted Disease Program, Section of Epidemiology, Alaska Department of Health and Social Services
  • National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention

Definition

Rate of newly reported cases of Chlamydia trachomatis by date of diagnosis per 100,000 population.

Numerator

Number of newly reported cases of chlamydia by date of diagnosis for a specific time period.

Denominator

Mid-year resident population for the specific time period.

Healthy People Objective: Reduce the proportion of adolescents and young adults with Chlamydia trachomatis infections

U.S. Target: Not applicable, see subobjectives in this category
State Target: Healthy Alaskans 2020 Target: 705.2 per 100,000

Other Objectives

Healthy Alaskans 2020 Indicator 18: Reduce the incidence rate of Chlamydia trachomatis to 705.2 per 100,000 by 2020.

How Are We Doing?

Chlamydia rates in Alaska have increased since 2000. In addition to an increase in disease prevalence, reasons for this increase can include: increased screening efforts, use of increasingly sensitive diagnostic testing, efforts to increase reporting by providers and laboratories, and improved information systems for reporting. Such increased rates can be interpreted as an advancement in chlamydia infection control as more infections are identified and treated, providing opportunity to intervene in the spread of infection. Chlamydia infections in both men and women are commonly asymptomatic, yet screenings occurring mostly among females produce higher rates of reported infections. However, with the increased availability of urine testing, men are increasingly being tested for Chlamydial infection.^1^ In 2016, the Chlamydia rate in Alaska was 771.6 per 100,000.^2^ Of total cases in 2016, 79% of cases were in persons aged 29 years and under and 67% of all cases were in females. Non-Hispanic American Indian/Alaska Native, Native Hawaiian/Pacific Islander and Black persons accounted for the highest rates. Rates were highest in Southwest and Northern regions of the state.^3^ [[br]] [[br]] {{class .SmallerFont 1. Centers for Disease Control and Prevention. ''Sexually Transmitted Disease Surveillance 2015''. Atlanta: U.S. Department of Health and Human Services; 2016. [https://www.cdc.gov/std/stats15/]. Accessed January 25, 2017. 2. Centers for Disease Control and Prevention (CDC). Chlamydia - 2016 STD Surveillance Report. [https://www.cdc.gov/std/stats16/chalmydia.htm]. Accessed August 3, 2018. 3. Alaska Department of Health and Social Services, Section of Epidemiology. Chlamydia infection update - Alaska, 2016. Epidemiology Bulletin. July 19, 2017. [http://epibulletins.dhss.alaska.gov/Document/Display?DocumentId=1944]. Accessed August 3, 2018. }}

How Do We Compare With the U.S.?

In 2016, Chlamydia rates in Alaska at 771.6 per 100,000 were significantly higher than rates in the U.S. at 497.3 per 100,000.^2^[[br]] [[br]] {{class .SmallerFont 2. Centers for Disease Control and Prevention (CDC). Chlamydia - 2016 STD Surveillance Report. [https://www.cdc.gov/std/stats16/chalmydia.htm]. Accessed August 3, 2018.}}

What Is Being Done?

Persons who test positive for chlamydia are confidentially interviewed by a local public health nurse to educate the patient, ensure proper treatment, and to obtain sexual partner information for follow up. This process helps prevent reported cases from spreading disease and the patient from becoming reinfected.

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaskan subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. '''Strategy 1:''' [[br]]Increase awareness of sexually transmitted diseases (STDs) and demand for STD testing. '''Evidence Base:''' [[br]]Alaska's Chlamydia trachomatis (CT) case reports and rates have increased since reporting began in 1996. Alaska has ranked first or second in the nation for CT rates since 2000. Chlamydia is the most commonly reported notifiable disease in the U. S. In 2012, CDC reported the highest ever number of reported chlamydial infections. Cases and rates of chlamydial infections in females have increased each year. Overall rates in males are about one-half of the rates in females. CDC reports that lower rates in men may suggest that many of the sex partners of women with chlamydia are not receiving a diagnosis of chlamydia or being reported as having CT. '''Source:''' [[br]]Chlamydia - 2016 STD Surveillance. [http://www.cdc.gov/std/stats16/chlamydia.htm]. '''Strategy 2:''' [[br]]Increase the identification, testing, and treatment of sexual partners of individuals infected with Chlamydia trachomatis. '''Evidence Base:''' [[br]]Partner Services, the elicitation and confidential notification of sexual partners, is essential in preventing and controlling sexually transmitted disease, including CT. The use of public health resources to identify infected persons, elicit and notify their partners of their possible exposure, and provide infected persons and their partners linkage to medical care and STD prevention series results in the following: 1) prevention of clinical disease; 2) decreased complication from infection; and 3) reduced STD/HIV transmission. '''Sources:''' [[br]]CDC - Partner Services. [http://www.cdc.gov/std/program/partners.htm] [[br]] [[br]]CDC - MMWR RecommendationsHow these recommendations differ from previous partner services guidelines. [http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5709a1.htm#How_These_Recommendations_Differ_from_Previous_Partner_Services_Guidelines]. '''Strategy 3:''' [[br]]Increase annual Chlamydia screening of sexually active women age 25 years and younger and older women with risk factors. '''Evidence Base:''' [[br]]The Centers for Disease Control and Prevention recommends routine Chlamydia screening for all sexually active females age 25 and younger annually, and for older females who report risk factors for STD, as one of the top Chlamydia prevention and control strategies. Screening programs reduce both the prevalence of chlamydia infection and rates of pelvic inflammatory disease. This screening recommendation follows published federal agency and medical professional organizations' clinical guidelines. '''Source:''' [[br]] CDC - Sexually Transmitted Disease Treatment Guidelines[http://www.cdc.gov/std/treatment/2010/specialpops.htm]. A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_18_Chlamydia.pdf]

Available Services

Federallly Qualified Health Centers have STD clinics where adolescents can be tested and treated for STDs at minimal or no cost. Planned Parenthood has locations throughout Alaska that also provide STD services at minimal cost. Condoms are available at these locations.

Health Program Information

The Alaska Sexually Transmitted Disease (STD) Program components include:[[br]] -STD case surveillance to monitor trends in syphilis, gonorrhea, and chlamydia, and detect potential outbreaks [[br]] -Consultation on laboratory and medical aspects of diagnosis and treatment [[br]] -Direct assistance to providers in outbreak situations; [[br]] assistance to affected individuals and their sexual partners, as well as to their health care providers, with partner notification and access to STD treatment[[br]] -Sponsoring, with the Northwest STD Prevention Training Center and other agencies, continuing medical education opportunities related to STD [[br]] -Funding for laboratory services related to infertility prevention [[br]] -Training for health care providers in partner interviewing, follow up, notification, and referral techniques[[br]] -Provision of information, technical assistance, and other capacity building services to medical and other health service providers, as well as educators and members of the public. Clinical services for STD are delivered through public and private providers in communities statewide, including Public Health Nursing Health Centers. The Municipality of Anchorage is also funded by the HIV/STD Program to assist Anchorage medical providers and patients with interviewing for sexual partners and partner follow up services.
Page Content Updated On 11/16/2018, Published on 11/16/2018
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 20 November 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Fri, 16 Nov 2018 13:23:15 AKST
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 20 November 2018 16:23:23 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Fri, 16 Nov 2018 13:23:15 AKST