Elevated risk for congenital syphilis

Using predictive modeling and a risk scoring system

Geographic concentration of congenital syphilis

"Congenital syphilis cases have been highly geographically concentrated in that only 5% of all counties in the United States reported at least one case of CS in 2015... Given that CS is not geographically widespread, identification of county-level characteristics associated with the presence of CS in affected areas could help identify and target areas for enhanced CS prevention efforts, maximizing limited resources. We examined the association between CS and several county-level socioeconomic and health demographics. In addition, we developed risk scores to predict areas at elevated risk for CS where enhanced CS prevention efforts should be targeted (Cuffe et al., 2020)." 

Social determinants for the elevated county-level risks  

"The model identified 973 (31.0% of all US counties) counties at elevated risk for CS (sensitivity, 88.1%; specificity, 74.0%). County factors that were predictive of CS included metropolitan area, income inequality, primary and secondary syphilis rates among women and men who have sex with men, and population proportions of those who are non-Hispanic black, Hispanic, living in urban areas, and uninsured. The predictive model using 2014–2015 CS outcome data was predictive of 2016–2017 CS cases (area under the curve value, 89.2%) (Cuffe et al., 2020)."

  1. Sources. This is based on a secondary analysis data of reported county congenital syphilis cases to the National Notifiable Diseases Surveillance System during the periods 2014-2015 and 2016-2017. Cuffe et al., 2020 developed a predictive model to identify county-level factors associated with congenital syphilis and use these to predict counties at elevated risk for future congenital syphilis in the region (Cuffe KM, Kang JDY, Dorji T, Bowen VB, Leichliter JS, Torrone E, Bernstein KT. Identification of US Counties at Elevated Risk for Congenital Syphilis Using Predictive Modeling and a Risk Scoring System. Sex Transm Dis. 2020 May;47(5):290-295. PMID: 32044864).  Link to the source! 
  2. Processing. County-level risk factors for congenital syphilis in the modeling included metropolitan area, income inequality, primary and secondary syphilis rates among women and men who have sex with men, and population proportions of those who are non-Hispanic black, Hispanic, living in urban areas, and uninsured. The data is available as .docx format and it is transformed to .csv format for further analysis in Tableau.   
  3. Presentation. The 10-point risk scores for county-level risks for congenital syphilis are presented in the heat map. Tableau Public Edition (2020.4.1) - Map layout is used to present the regional distribution of congenital syphilis risk on a national level.

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