Поширеність сифілісу серед засуджених (аналіз сучасних наукових публікацій і власні дані)

Abstract

Introduction. According to the WHO, the highest incidence of STIs / HIV-infection, including syphilis, is in prisons, which currently have more than 10 million people worldwide. The objective. To assess the current state of the spread of syphilitic infection in prisons in the context of a holistic view of sexually transmitted diseases, taking into account our own pilot studies on the prevalence of sexually transmitted infections (STIs) and HIV, as well as risk factors infection. Materials and methods. The search was performed according to the recommendations of PRISMA 2008, 2021 (The Preferred Reporting Items for Systematic reviews and Meta-Analyzes). The data of own pilot studies of 160 prisoners (80 women and 80 men) from the key risk group for STIs / HIV-infection in Ukrainian prisons are also presented, as well as some social characteristics of convicts and risk factors for syphilis are analyzed. Results. It has been confirmed that convicts as a separate social group have an increased risk of syphilis infection in penitentiary institutions of the world. At the same time, the incidence is several times higher compared to the general population. According to pilot studies, 16.3% of the surveyed convicts were diagnosed with serological markers of Treponema pallidum, including women (12.5%) and men (20%), and markers of other STIs, namely Chlamydia trachomatis (women – 37.5%, men – 15%), Ureaplasma urealyticum (5 and 62% respectively), HSV­1 (97.5 and 95%), HSV­2 (72.5 and 50%), HCV (25 and 47.5%), HBV (12.5 and 7.5%), HIV (50 and 80%), as well as the pathogens Trichomonas vaginalis (35% – women) and Neisseria gonorrhoeae (17, 5 and 2.5%, respectively) and dermatological pathology (scabies (10%), allergodermatoses (15%) – in women; psoriasis (1.3%) – in men) and tuberculosis (7.5 and 5% respectively). Risk factors for contracting STIs, including syphilis, in particular, were latent forms of infection, risky sexual behavior, drug use (women – 47.5%, men – 88%) and alcoholism (52.5 and 8.4%, respectively), repeated and long-term imprisonment (42.5 and 82.5%), no family (73.5 and 90%), tattoos (27.5 and 95%), and neglect of condom use, including number of visits while incarcerated. Conclusions. The high concentration in the institutions of the penitentiary system of key groups at risk of contracting syphilis creates a unique opportunity for scientific further research and practical application of the implementation of a number of effective therapeutic, diagnostic, organizational and preventive public health measures.