Increase In Incidence Of Syphilis Research Articles

Global, regional, and national burden of syphilis, 1990-2021 and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021.

To comprehensively assess the global burden of syphilis and related risk factors over 1990-2021, forecast future disease trends, and understand the impact of syphilis on global health. Global Burden of Disease Study 2021 (GBD 2021) data were used for age-, sex-, and region-stratified analysis of the numbers and age-standardized rates (per 100,000 population) of syphilis incidence, prevalence, deaths, and disability-adjusted life years (DALYs). Next, a differential analysis of syphilis risk factors was performed. Finally, trends for years after 2021 were predicted using Bayesian age-period-cohort (BAPC) prediction models. In 2021, the total number of syphilis prevalence globally was 70,541,482.80 (95% uncertainty interval: 54,910,897.66-88,207,651.97), with the highest numbers noted in Central Sub-Saharan Africa [4,622.60 (95% uncertainty interval: 3,591.97-5,753.45)]. Over 1990-2021, the global age-standardized prevalence and incidence rates increased, whereas the age-standardized death and DALY rates decreased. Among all groups, infants aged <5 years demonstrated the highest age-standardized DALY rates. Moreover, the lower the sociodemographic index (SDI), the higher was the age-standardized rate. The primary factor contributing to syphilis disease burden was identified to be unsafe sex. BAPC analysis revealed an overall increase in age-standardized prevalence rate in the <5-year age group over 1990-2035, and the highest age-standardized prevalence rate occurred in the 25-34-year age group. Between 1990 and 2021, syphilis occurrence and prevalence increased consistently. Projections indicated a continual increase in syphilis incidence in children aged <5 years, and age-standardized prevalence rates were the highest in adults aged 25-34 years. Our results regarding the epidemiological trends of syphilis and its variations across regions, age groups, and sexes may aid policymakers in addressing the global impact of the disease effectively.

Seasonality of syphilis in males through the 2011 to 2019 mandatory surveillance period: A cross-sectional study in South Korea.

Although the effects of seasonality on syphilis have been discussed previously, no previous study has evaluated the seasonality of syphilis incidence by sex and age group. We examined the seasonality of syphilis incidence by sex and age group in Korea from 2011 to 2019. The incidence of syphilis was calculated on the basis of Korea Diseases Control and Prevention Agency data, and an autoregressive integrated moving average (ARIMA) model and seasonal and trend decomposition using Loess were used to analyze the seasonality of the incidence in relation to epidemiological factors. The annual age-standardized incidence rates of primary, secondary, and congenital syphilis were 21.1, 8.8, and 64.0 cases/million persons, respectively, from 2011 to 2019. The highest incidence rates for primary and secondary syphilis were observed among those aged 20 to 29, 13 to 19, and 30 to 49 years, but not among the lower age groups. In analyses based on the ARIMA model, all univariate time series showed the highest goodness-of-fit results with ARIMA for primary syphilis (1,1,2), secondary syphilis (1,1,1), and congenital syphilis (0,1,2) (2,0,0) models. This study suggests that the incidence of secondary syphilis shows a summer seasonality for males and the highest incidence rate in the 20 to 29-year age group for both males and females in Korea. Public health action is needed to prevent an increase in syphilis incidence associated with sex, age group, and seasonal patterns.

Clinical cаse of latent cerebral meningovascular syphilis

Syphilis is one of the oldest known sexually transmitted diseases. Despite numerous scientific studies, syphilis infection affects humanity. The relevance of the syphilis problem is primarily determined by social factors. For hundreds of years, the incidence of sexually transmitted diseases, including syphilis, has been increasing in times of social disruption, such as wars, environmental disasters, etc. We should expect their growth at present, the time of the Ukrainian-russian war. Cases of early forms of syphilis are already being registered.The elimination of specialised medical institutions and uncontrolled treatment of syphilis patients will lead to an increase in the incidence of latent forms with damage to the nervous system, internal organs, musculoskeletal system, etc. As a result, it will cause the loss of working capacity, disability, and mortality. Undoubtedly, patients will be treated mainly on an outpatient basis with penicillin of prolonged action.The publication is devoted to the description of a clinical case of latent cerebral meningovascular syphilis in a patient who had been treated for early latent syphilis for 12 consecutive years. The probable cause of neurosyphilis, in our opinion, is the patient’s use of a durant drug to penicillin (benzathini benzylpenicillinum). We cannot ignore the resistance of Treponema pallidum to antibiotics and the specifics of the interaction between the syphilis pathogen and the patient’s immune system.With this message, we draw the attention of family doctors, neurologists, dermatovenerologists and other specialists to the possible increase in syphilis incidence due to the war of russia against Ukraine. Parenteral administration of penicillin antibiotics in hospital setting, followed by long-term serological monitoring, remains the method of choice in the treatment of syphilis. Treatment of syphilis with durant drugs of penicillin should be carried out as an exception. Long-term results of treatment with these medications indicate relatively frequent cases of complications, such as neurosyphilis, visceral and early latent syphilis, etc.

Primary syphilitic proctitis associated with human immunodeficiency virus infection in a male patient who had sex with men: a case report

Background: Men who have sex with men (MSM) have frequent rectal infections. Although a large increase in incidence of syphilis has been reported in recent years, rectal chancre is a rare manifestation that can easily be neglected. Methods: We describe a male patient who had sex with men and presented with protracted chronic proctitis and scaly rashes. A diagnosis of HIV infection and early syphilis with syphilitic proctitis (rectal chancre) was confirmed by the findings of ulcerative proctitis under colonoscopy, the presence of Treponema pallidum in rectal ulcer biopsy specimens by immunohistochemistry, and positive serologic test results for human immunodeficiency virus type 1 (HIV-1) and syphilis. Results: Intramuscular benzathine penicillin G (2.4 million Units) given once a week for three consecutive weeks resulted in complete resolution of rectal and skin lesions. The patient also began regular anti-viral therapy against HIV infection. Conclusion: Immunohistochemical detection of Treponema pallidum in the primary infection tissue is a useful complement to serologic tests for the diagnosis of syphilis by clinical laboratories. Healthy and protective sexual behavior is advocated to avoid possible infections in MSM.

DIAGNOSIS AND TREATMENT OF SYPHILIS IN PATIENTS COINFECTED WITH HUMAN IMMUNODEFICIENCY

A review article is addressed the issue of the diagnosis and treatment of syphilis that is developing against the background of HIV infection. A small number of HIV-infected patients may have false-negative or false-positive serological tests for syphilis. Patients with co-infection are at higher risk of the nervous system involvement as well as ocular and otological syphilis. The cases of treatment failure and neurorelapses are also more frequent in HIV-positive patients with syphilis. The effectiveness of neurosyphilis treatment in co-infected patients is difficult to assess, as the normalization of the CSF in HIV-positives is going slower comparing to HIV-negatives. The inevitable increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. In this regard, a comprehensive study of the co-infection problem and improvement of approaches to managing patients based on the principles of evidence-based medicine is required.

Neurosyphilis in HIV-infected patients

A review article is addressed the issue of the diagnosis and treatment of neurosyphilis that is developing against the background of HIV-infection. HIV-infected patients are at higher risk of neurologic, ocular and auricular manifestation of syphilis as well as treatment failures and relapses. Diagnosis of neurosyphilis in HIV-positive patients is complicated because both infections cause similar changes in the cerebrospinal fluid (CSF). The effectiveness of neurosyphilis treatment in patients with HIV co-infection is difficult to estimate, since the normalization of their CSF goes slower comparing to HIV-negatives. The increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. This necessitates a comprehensive study of the problem and requires the development of new approaches to neurosyphilis diagnosis and treatment in co-infected patients.

The effect of penicillin therapy on cognitive outcomes in neurosyphilis: a systematic review of the literature

ObjectiveNeurosyphilis commonly presents with cognitive impairment, and penicillin remains the treatment of choice. However, despite a rapid increase in syphilis incidence, the effect of penicillin on long-term cognitive outcomes has not previously been evaluated. We therefore aimed to assess the effect of penicillin on cognitive function in neurosyphilis. MethodsWe performed a systematic review of all studies of neurosyphilis, where cognitive function was assessed objectively both before and after penicillin therapy for at least one patient. Where Mini-Mental State Examination (MMSE) scores were taken, we performed a paired-samples t test to assess the change in cognitive function and aimed to correlate this with change in serological titers. ResultsNine studies met inclusion criteria. The one cohort study reported a nonsignificant overall improvement in MMSE, while amalgamation of case reports produced a significant improvement (P=.02) in MMSE after treatment. However, follow-up duration was inadequate, and data were insufficient to correlate changes in cognitive function with serological markers. ConclusionsDespite evidence of short-term improvement, there are insufficient data to support the long-term benefit of penicillin therapy on cognitive function in neurosyphilis.

Stroke after Initiating IV Penicillin for Neurosyphilis: A Possible Jarisch-Herxheimer Reaction.

Introduction. Syphilis incidence has increased in the US in the last decade. Jarisch-Herxheimer reaction (JHR) is a well-documented adverse effect of penicillin treatment in syphilis. Stroke has not been reported as part of its phenomenology. Case Report. A 57-year-old man presented with worsening memory. His minimental status examination score was 14/30. Serum RPR test was positive and VDRL test in the CSF was reactive. Within six hours of first dose of IV crystalline penicillin G, he was found to have hemineglect and difficulty moving the left leg. MRI of the brain showed multiple acute ischemic strokes. Immediate MRA ruled out vascular occlusion. Penicillin treatment was stopped. Four hours later, he was found to be febrile and had two episodes of generalized tonic-clonic seizures. Conclusions. We report a case of confirmed neurosyphilis with no known modifiable stroke risk factors, who developed acute ischemic stroke and other constitutional symptoms consistent with JHR after IV penicillin. This is the first reported case in literature where an acute ischemic stroke can be attributed to Jarisch-Herxheimer reaction. Given an increase in incidence of syphilis in recent years, our case underlies the importance of keeping in mind potential catastrophic drug adverse reactions in neurosyphilis patients.

Syphilis Serologic Prevalence Monitoring Among STD Clinic Clients: Correlation With Reported Syphilis Incidence, San Diego, CA, 1985–2004

To describe the serologic test for syphilis (STS) prevalence among STD clinic clients, determine the correlation between STS prevalence trends and reported community-diagnosed primary and secondary (P&S) case incidence, and evaluate the usefulness of STS prevalence monitoring as a component of syphilis surveillance. During the period 1985-2004, 21,4336 STS were done among STD clinic clients and a variety of STS prevalence measures were evaluated. From 1985-1991, 10.2% of STS were positive, which declined to 5.6% during 1992-2004. Overall, STS positivity (>or=1:8) and male positivity (>or=1:8) trends were correlated with reported community-diagnosed P&S case incidence and case incidence in men (r = 0.58 and r = 0.81, respectively). Male STS positivity (>or=1:8) began increasing in 2001, 1 year before the increase in syphilis incidence in men, which began in the latter half of 2002 and occurred mostly among men who have sex with men. In a syphilis outbreak in men who have sex with men, STS prevalence (>or=1:8) among male STD clinic clients was a useful measure of syphilis case incidence trends and may provide an early warning for a subsequent increase in community-diagnosed case incidence.