enhanced perinatal surveillance (eps)
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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
Enhanced Perinatal Surveillance System in Texas
Presenter: Elvia LedezmaMay 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?
Determine effectiveness of perinatal transmission efforts
Determine effectiveness of antiretroviral therapy (ART)
Determine reasons for prevention failures
Evaluate adverse outcomes from ART use
Enhanced Perinatal Surveillance (EPS) Project Sites, 1999-2007
EPS Data Collection
Instrument Basic demographics for both mother and
child Maternal information
Prenatal care HIV testing ARV therapy Substance use Clinical information
EPS Data Collection, cont.
Child information Birth history Pediatric history
Who Collects Texas EPS Data?
Personnel
12 satellite surveillance sites5 regional public health offices4 city/county health departments3 county health departments
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
Where is EPS Data Collected?
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
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
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
What is the Process of Data Collection?
EPS Case Identification
Review of medical records Provider/HARS staff communication Lab reports Birth certificate matching
EPS Data Collection
Medical chart abstraction at provider officesBirth facilitiesHIV clinical care providerPrenatal care providerPediatric provider officesBirth/death certificates
EPS Data Collection, cont.
Follow-up of the child6 months12 months18 months
What are the Data Collection Challenges that are Encountered?
Types of Challenges
Geography Personnel Data sources Identification and follow-up of children
Geographical Challenges
Sheer size of Texas :261,797 square miles 660 miles long by 790 miles long 254 counties550 licensed hospitals
Personnel Challenges
Multiple tasksEnhanced perinatal surveillance is
added to the long list of tasks they already perform
Data Collection Challenges
Multiple record abstractions Availability of prenatal care provider
recordsPrenatal care and pediatric care
provider identification
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
What is the Importance in Collecting EPS data?
Comments/Questions
Contact Information
Elvia Ledezma, MPH
Epidemiologist
Texas Department of State Health Services
(512)-533-2045