Applying capture recapture methods to estimate the burden of chlamydial and gonococcal infections using Indian Health Service Medical Records, 2016-2021.

American Indian and Alaska Native persons in the United States experience high rates of chlamydia and gonorrhea (CT/GC) infections, but the burden among persons receiving healthcare through the Indian Health Service (IHS) has not been recently described. Currently, there is no surveillance system to...

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Published in:American Journal of Epidemiology Vol. 196; no. 7; pp. 1984 - 1993
Main Authors: Haberling, Dana L, Ge, Lin, Pondo, Tracy, Taylor, Melanie M, Nuorti, J Pekka, Apostolou, Andria
Format: research tables/charts Journal Article
Published: Oxford University Press / USA Jul2026
Online Access:View this record in EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Applying capture recapture methods to estimate the burden of chlamydial and gonococcal infections using Indian Health Service Medical Records, 2016-2021.
      aug:
        au:
          Haberling, Dana L
          Ge, Lin
          Pondo, Tracy
          Taylor, Melanie M
          Nuorti, J Pekka
          Apostolou, Andria
        affil: Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United StatesHealth Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
      sug:
        subj:
          Chlamydia Infections Epidemiology
          Gonorrhea Epidemiology
          Chlamydia Infections Trends
          Gonorrhea Trends
          Medical Records Utilization
          Health Services, Indigenous
          Native Americans
          Alaska Natives
          United States
          Human
          Female
          Male
          Adolescence
          Adult
          Middle Age
          Descriptive Statistics
          Confidence Intervals
          Health Facilities
          Random Sample
          International Classification of Diseases
          Data Analysis Software
          Diagnostic Tests, Routine
          Diagnosis, Laboratory
          Medical Record Linkage
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: American Indian and Alaska Native persons in the United States experience high rates of chlamydia and gonorrhea (CT/GC) infections, but the burden among persons receiving healthcare through the Indian Health Service (IHS) has not been recently described. Currently, there is no surveillance system to regularly monitor IHS-specific CT/GC burden and trends. We used two capture recapture (CRC) methods with two IHS medical records sources: diagnostic codes and laboratory test results linked by person within 30 days among persons ≥15 years during 2016 to 2021. Capture recapture estimates were used with the IHS population to create prevalence rates and compared to the medical records counts. CRC estimated 88 680 (1189 per 100 000) and 83 884 CT infections (1125) and 36 713 (492) and 35 930 GC infections (482). Diagnostic codes were 60% and 63% of CT and 54% and 56% of GC CRC estimates and combined with laboratory test results were 88% and 94% of CT and 86% and 88% of GC CRC estimates. These findings underscore the value of IHS medical records for estimating CT/GC infections and measuring undercounting of single source CT/GC medical records. These sources can be leveraged to provide surveillance estimates for monitoring trends; strategic outreach; and supporting testing, treatment, and staffing needs.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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