Civilization & Peptic Civilization & Peptic UlcerUlcer
Indiana PacesettersIndiana Pacesetters
Also Known As:A Rooster, Three Hens & A Chick
Outline Outline
What is a peptic ulcer? What is a peptic ulcer? What are the characteristic symptoms of What are the characteristic symptoms of
an ulcer in the stomach or duodenum an ulcer in the stomach or duodenum (peptic ulcer)? (peptic ulcer)?
What are the causes of ulcer in the What are the causes of ulcer in the stomach?stomach?
Are genetic factors involved in the cause Are genetic factors involved in the cause of peptic ulcers (stomach ulcers)? of peptic ulcers (stomach ulcers)?
What is a Peptic UlcerWhat is a Peptic Ulcer
DefinitionDefinition
A A peptic ulcerpeptic ulcer is a circumscribed is a circumscribed erosionerosion in or loss of the in or loss of the mucous membranemucous membrane lining of the lining of the gastro-intestinal gastro-intestinal tracttract. . PepticPeptic ulcersulcers are are chronicchronic but may have but may have acute acute exacerbationsexacerbations..
Health Officer of Health Officer of Brahma CountyBrahma County
Dr. Foghorn Dr. Foghorn LeghornLeghorn
BackgroundBackground Determine OutbreakDetermine Outbreak ProcessProcess Communities EffectedCommunities Effected Action TakenAction Taken ResultsResults
Brahma County
Key PlayersKey Players
C am on a H ea lth C lin ic
B rah m a C ou n ty H ea lth D ep artm en t
M in orca S ta te D ep artm en t o f H ea lth
C D C
BackgroundBackground From 1996 to 1999, Brahma County went from
25th to 1st nationally.
Syphilis cases reported in
Brahma County during 1999
represented a 160% increase
over cases reported in 1998.
Determining The OutbreakDetermining The Outbreak
What were existing problems?What were existing problems? How can we rectify them?How can we rectify them?
At the time, there was no official CDC At the time, there was no official CDC criteria to eliminate syphilis .criteria to eliminate syphilis .
ProcessProcess
FundingFunding TestingTesting Reporting & NotificationReporting & Notification SurveillanceSurveillance
FundingFunding
Redirected fundsRedirected funds reduced dollars for syphilis screening,
testing, and treatment lack of visits by Disease Intervention
Specialists (DIS) delays in partner notification
Reporting & NotificationReporting & Notification
Reporting in a timely fashionReporting in a timely fashion
Created delays in partner notification,Created delays in partner notification,
education, and risk reduction of education, and risk reduction of syphilissyphilis
cases by DIScases by DIS
SurveillanceSurveillance
BCHD staff was not conducting BCHD staff was not conducting effective surveillance effective surveillance
Surveillance reports from Surveillance reports from physicians were not being physicians were not being reported.reported.
CDC comes into playCDC comes into play
Communities EffectedCommunities Effected African Americans African Americans
made up a large made up a large percentpercent
87% of Syphilis 87% of Syphilis CasesCases
Syphilis Cases in Brahma County, 1999
416
39
362
15
0 50 100 150 200 250 300 350 400 450
Total
White
Black
Hispanic
Number of Cases Reported
Factors Contributing to Factors Contributing to Communities EffectedCommunities Effected
Poverty Lack of access to
quality health care Recreational drug
use High-risk sexual
behaviors Jails
Action TakenAction Taken
An assessment of the MSDH syphilis program An assessment of the MSDH syphilis program by CDC in 1999 was satisfactory, but CDC by CDC in 1999 was satisfactory, but CDC indicated it could be improved. Among the indicated it could be improved. Among the items suggested by CDC were to:items suggested by CDC were to:
Increase surveillance; Provide access to testing and treatment; Implement a jail program to diagnosis and treat syphilis
cases, and; Identify areas as high morbidity areas to obtain financial
support for staff/programs to combat syphilis.
Action Taken Cont....Action Taken Cont....
FundingFunding StaffingStaffing Testing,Reporting, and NotificationTesting,Reporting, and Notification Community InvolvementCommunity Involvement
Pluck Out SyphilisPluck Out Syphilis
The coalition was formed in late 1999 to The coalition was formed in late 1999 to address the epidemic of syphilis address the epidemic of syphilis occurring in Brahma Countyoccurring in Brahma County
BCHD’s health officer was instrumental BCHD’s health officer was instrumental in bringing community groups together in bringing community groups together around the issue.around the issue.
Pluck Out Syphilis Cont.….Pluck Out Syphilis Cont.….
Community members and organizations Community members and organizations were notified when the BCHD would be were notified when the BCHD would be coming out to test, screen and educate coming out to test, screen and educate residents about syphilisresidents about syphilis
Four committees:Four committees: faith & outreach, faith & outreach, communications, men having sex with communications, men having sex with men, and evaluationmen, and evaluation
Pluck Out Syphilis Cont....Pluck Out Syphilis Cont....
Member organizations reached out to the
community, identifying risks for contracting
syphilis, and attempting to remediate the
problems that were occurring in thiscommunity.
Billboards, bus placard,brochures,posters,community forumsand radio ads.
ResultsResults
Contributory factors leading to a decline increases in funding as well as staffing better testing reporting and partner notification collaboration between the community
organizations resulting in an increase in community awareness and knowledge.