Abstract
BackgroundGuangzhou is the economic center of South China, which is currently suffering an insidious re-emergence of syphilis. Syphilis epidemic in this area is a matter of serious concern, because of the special economic position of Guangzhou and its large migrant population. Therefore, a comprehensive analysis of surveillance data is needed to provide further information for developing targeted control programs.MethodCase-based surveillance data obtained from a real-time, web-based system were analyzed. A hierarchical clustering method was applied to classify the 12 districts of Guangzhou into several epidemiological regions. The district-level annual incidence and clustering results were displayed on the same map to show the spatial patterns of syphilis in Guangzhou.ResultsA total of 60,178 syphilis cases were reported during the period from 2005 to 2013, among which primary/secondary syphilis accounted for 15,864 cases (26.36 %), latent syphilis for 41,078 cases (68.26 %) and congenital syphilis for 2,090 cases (3.47 %). Moreover, primary/secondary syphilis burden slightly decreased from 17.5-18.0 cases per 100,000 people in the first years to 10.6 cases per 100,000 in 2013, with latent syphilis largely increasing from 18.5 cases per 100,000 to 43.4 cases per 100,000. Districts of Guangzhou could be classified into 3 epidemiological regions according to the syphilis burden over the last 3 years of the study period.ConclusionsThe burden of primary/secondary syphilis appears to be decreasing in recent years, whereas that of latent syphilis is increasing. Given the epidemiological features and the annual changes found in this study, it is suggested that future control programs should be more population-specific and spatially targeted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1072-z) contains supplementary material, which is available to authorized users.
Highlights
Guangzhou is the economic center of South China, which is currently suffering an insidious re-emergence of syphilis
Given the epidemiological features and the annual changes found in this study, it is suggested that future control programs should be more population-specific and spatially targeted
Given its specific position as the capital city of Guangdong Province and the de facto economic center of South China, as well as the large population involved, syphilis epidemics in Guangzhou are of great concern [10, 11]
Summary
A total of 60,178 cases of syphilis infections were reported to the CBSS during the past nine years, from 2005 to 2013 (Fig. 1). Primary/secondary syphilis burden decreased slightly, from 17.5-18.0 cases per 100,000 people in earlier years of the study period to 10.6 cases per 100,000 in 2013. Congenital syphilis burden increased slightly from 1.7 cases per 100,000 in 2005 to 2.9 cases per 100,000 in 2007, and decreased annually to 0.7 cases per 100,000 in 2013 (Additional file 1: Figure S1). Education and the most probable acquisition route was collected as part of CBSS These characteristics were similar for primary/secondary and latent syphilis cases, among which married individuals and individuals with middle school, or high school education represented a large proportion (Table 1). According to the results of district-level analyses (Fig. 4), in the last 3 years of the study period, Baiyun District (926 cases) reported the highest number of primary/secondary syphilis cases, followed by Huadu District (799 cases) and Panyu District (606 cases). All the other districts were classified as Region 3 with an average incidence of 56.26 cases per 100,000
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