摘要：We used an electronic medical records system retrospectively to evaluate how frequently, in a public hospital and its clinics, combined gonorrhea/chlamydia tests were accompanied by a syphilis test before and during a syphilis outbreak. Among 70 330 gonorrhea/chlamydia tests (1996–2000), the proportion with a syphilis test increased from 13% (preoutbreak) to 50% (intervention period) for men and from 6% to 13% for nonpregnant women. The increased syphilis testing coincided with a multifaceted public health intervention. In 1998, as the Centers for Disease Control and Prevention called for eliminating syphilis from the United States, 1 an outbreak was beginning in Indianapolis, Ind (Marion County). The reported annual case rate in the county peaked in 1999 at 50 per 100 000, 2 whereas the national rate was 2.5 per 100 000. 3 Because symptoms can be minimal or absent in the early stages of syphilis, screening is central to elimination efforts; inadequate screening has been implicated in syphilis outbreaks. 4– 6 In response to the Indianapolis outbreak, the Marion County Health Department and the community implemented a multifaceted program, designed primarily to increase early case detection. Some interventions involved encouraging clinicians who suspected other sexually transmitted diseases (STDs) to test for syphilis also. We report a longitudinal, descriptive analysis of syphilis tests performed in association with gonorrhea/chlamydia tests before and during the public health response in Indianapolis.
