Implementing a Gonorrhea and Chlamydia Screening Program in Philadelphia Public High Schools

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Implementing a Gonorrhea and Chlamydia Screening
Program in Philadelphia Public High Schools

• Melinda Salmon
• Philadelphia Department of Public Health

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• Why?
• How?

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Reported Cases of Chlamydia Philadelphia,
1991-2003 (2003 data are provisional)
Number of cases
Year
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Chlamydia - Case Rates by Age and Sex, 2003
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CY 2000

• Report Card 2000 issued Phila. Coalition For
  Kids
• STDs given a failing grade
• School District Legal Opinion (8/21)
• No Screening in schools
• Safe and Sound Initiative addresses all Report
  Card issues
• Various Organizations on Committee
• STD Program states key to control is
  school-based screening
• School District Legal Opinion (12/19)
• Screening in school-based HRCs OK

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CY 2001

• Meetings with PDPH/FPC/School District
• November Screening initiated in 1st Health
  Resource Center
• December Screening initiated in 2nd Health
  Resource Center

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Health Resource Center STD Screening (2
schools)2001-2002
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CY 2002

• January Commissioners Forum on STDs Held
• Adolescent STDs described as EPIDEMIC
• February New Health Commissioner Appointed
• Mr. John Domzalski
• February-June HRC data presented to Commissioner
  and others

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CY 2002 Contd.

• October New CEO _at_ School District (Mr. Paul
  Vallas) PDPH Commissioner Meet
• Commissioner proposes screening in 10 schools
  Mr. Vallas counters with 44 Mr. Domzalski
  accepts. (54,000 Students)
• November Television and Newspaper Press
  Coverage
• Generally positive issue of no parental
  consent raised
• December Meeting with All Principals
• Letter Given to Principals
• STD Program Presentation to Principals
• Parent Letter Developed w. Joint Signatures

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CY 2003

• January 7th Testing Begins
• Meetings with
• Home School Council Presidents
• Individual School Councils
• Scheduling of Individual High Schools for
  Screening Days and Treatment Clinics Ongoing

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Philadelphia Department of Public HealthSTD
Control Program 2002-2003 High School Screening
Program Summary Data
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How it all works
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Pre-meeting with the School

• Usually involves the assistant principal, nurse,
  roster chair
• Informational folder distributed
• Explanation by health department staff of what
  occurs

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Pre-meeting with the School (contd)

• Communicate our needs to make screening work
• Commitment to see at least 300 students per day
  in classes of approximately 60
• A presentation room in proximity to rest rooms
• Space to process specimens Tentative dates for
  screening set, as well as dates for the delivery
  of supplies, brochures, etc.
• Explanation of our need return to treat and see
  additional students and identification of a
  process and tentative date(s)

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Screening Begins

• Presentation
• Bags
• Explanation of the process
• All students receive a bag
• All students complete the paperwork
• All students go the bathroom
• All bags must be returned
• Based upon the information in the presentation,
  each student makes a decision, on their own,
  whether or not to be screened

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During Screening

• Specimens processed in separate room
• Sort out empty specimen cups from those with
  urine
• If time permits, aliquot specimens and create lab
  slips
• Deal with other issues as they arise

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At the close of the day

• Return to the Health Department with specimens
• Any remaining specimens are aliquoted and/or lab
  slips created
• Specimens are submitted to the lab
• Information form with a copy of lab slip attached
  are submitted for data entry

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In the days following

• Data entry of information slips with pending
  results indicated
• As lab results are received, pending results
  changed to positive or negative
• Test results given to students by telephone

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Treatment

• List of students to be seen submitted to nurse 1
  day prior to the arrival of medical staff
• Students issued call slips or called from class
• Oral medications administered
• Counseling, instructions for follow-up exams and
  partner referral cards given

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Treatment

• For students not treated at school, we continue
  to work through school nurse to refer for
  treatment
• Use the best way to contact information

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In summary.

• Process takes a solid commitment from many,
  including
• School personnel
• Health Department screening staff
• All other staff for data entry
• Staff giving results
• Clinical staff to give treatment
• Laboratory staff to process tests
• Administrative staff
• But, most importantlyit takes the political will
  of those who have the power to make it happen