THISIS FAQ – Congenital Syphilis

Entering data for a congenital syphilis investigation in which the mom was diagnosed with secondary syphilis during pregnancy. The doctor opted to treat the mom with 4.8 BIC. Mom was treated greater than 30 days before delivery. In the clinical question package of her THISIS event it says that she was adequately treated; however, in the baby’s related congenital event, the ‘Congenital syphilis case classification’ field (in the Administration section of the Congenital Syphilis question package), it automatically populates as ‘Probable Case’ when it should be ‘Not a Case.’ What should I do?

This is an issue that has been identified before go-live. To avoid this, change the mom’s treatment to DOSE 2.4 BIC and FREQUENCY as x2 Only in the Clinical question package in the mom's syphilis event, and that should update the congenital case to ‘Not a Case’.

We are working on two possible solutions. One is to hide the options of 4.8 and 7.2 BIC. This forces the user to select 2.4 with the opportunity to select how many doses the patient received, The second option is to have the system recognize that 4.8 is a sufficient treatment.

***Remember: the congenital case classification field in the congenital syphilis question package will only generate correctly when all required fields in the QP are entered and saved***
 

Concern Generating for an interview when an infected dispo is selected for a person under the age of 10.

• Question: Was this person interviewed? Select No
• Question: Reason not interviewed, Select Other
• Other field type: Person younger than 10

For probable cases of congenital syphilis, the following concern is generated "Symptoms must be entered" even if symptoms exist in the 126 or the person is asymptomatic"- We are attempting to resolve this issue so that the concern will clear.
 

Interview iteration is triggered for Congenital Syphilis (CS) Events

This issue has been reported. The user should state that the interview was not conducted and to justify, select Other. In the Specify box, enter that the patient was under the age of 10.

Central Office has notified the developer. This will be considered an improvement to the model, so it will not clear out until approved by the Program Improvement Team.
 

Do I have to cut a field record for an infant or can I just create a congenital investigation?

You have to do both. 

1. Initiate field records for all infants. 
   1. If the infant’s labs are positive: Initiate a Reactor field record or else the labs will remain in the “New Syphilis Initial Assignment” Workflow.
   2. If the infant’s labs are negative or if a mother has delivered and a CS report is needed but labs on the infant have not been performed and/or received yet: Initiate a F1-Congenital Follow-up Field Record. This will help you track the follow-up, ensuring the collection and entry of labs for the infant.
2. Create a “Congenital Investigation” in the Case Assignment/Field Record QP at the same time you initiate a field record.
    

What is the most up to date information about congenital case classification?

There has been a reported issue with the processor for determining case classification for Congenital Syphilis cases. This is being addressed. Sites can enter their CS investigations and once the processor has been updated, the cases should return to the proper case classification.