The Prevalence of Syphilis Infection and Its Associated Factors in the General Population of Rwanda: A National Household-Based Survey.

Mwumvaneza Mutagoma,David J Riedel,Dieudonné Sebuhoro,Eric Remera,Steve Kanters,Sabin Nsanzimana

doi:10.1155/2016/4980417

Abstract

Background. The prevalence of syphilis among HIV-infected people is a public health concern, but there is limited literature to describe the true burden of syphilis in resource-limited settings. We conducted this survey in 2013 to estimate the prevalence of syphilis. Methods. A cross-sectional survey. Participants were tested for syphilis and HIV. Factors associated with syphilis infection were identified. Results. The prevalence of syphilis was 0.9% (95% CI: 0.7–1.1). This prevalence was higher in the 25–49-year-old age (1.1% [95% CI: 0.8–1.3]) than in the 15–24-year-old age (0.6% (95% CI: 0.4–0.9)). Women with lower education had a higher prevalence of syphilis (1.2% (95% CI: 0.9–1.5)) compared to others (0.4% (95% CI: 0.2–0.8)). This prevalence among HIV-infected people was six times higher: 4.8% (95% CI: 2.9–7.9) compared to HIV-negative people (0.8% (95% CI: 0.6–1.0)). The prevalence of syphilis among HIV-infected females was 5.9% (95% CI: 3.4–10.0). HIV-infected or concurrent sexual partners was associated with increased syphilis prevalence with aOR = 4.2 (95% CI: 2.5–7.2) and aOR = 4.2 (95% CI: 2.8–6.5), respectively. Conclusions. The prevalence of syphilis was significantly higher among HIV-infected patients. HIV infection and concurrent sexual partners are associated with an increased prevalence of syphilis. Preventing HIV might help in preventing syphilis.

Highlights

Syphilis is an ulcerative sexually transmitted infection (STI) that remains a major global public health problem
HIV-infected or concurrent sexual partners was associated with increased syphilis prevalence with adjusted odds ratio (aOR) = 4.2 and aOR = 4.2, respectively
The lowest prevalence of syphilis was found in Northern Province (0.2%; 95% CI: 0.1–0.6); the highest was found in the city of Kigali (1.3%; 95% CI: 0.7–2.2), and the difference was statistically significant

Summary

Introduction

Syphilis is an ulcerative sexually transmitted infection (STI) that remains a major global public health problem. It is estimated that there are more than 12 million new syphilis infections every year in the world [2, 3], of which 90% of cases are found in resource-limited countries [4]. Primary and secondary syphilis rates have increased every year in United States due to HIV pandemic [8, 9] This association was found in neighboring Kenya. The prevalence of syphilis among HIV-infected people is a public health concern, but there is limited literature to describe the true burden of syphilis in resource-limited settings We conducted this survey in 2013 to estimate the prevalence of syphilis. HIV-infected or concurrent sexual partners was associated with increased syphilis prevalence with aOR = 4.2 (95% CI: 2.5–7.2) and aOR = 4.2 (95% CI: 2.8–6.5), respectively. HIV infection and concurrent sexual partners are associated with an increased prevalence of syphilis.

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Conclusion