Prevention Of Syphilis Research Articles

Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study

BackgroundGlobally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV).MethodsA cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P < 0.05.ResultsOf the 3082 PLHIV individuals in our study, 2294 (74.4%) were female and 2867 (93.0%) were receiving ART. With a median age of 36 years, 211 (6.8%, 95% CI 6.0–7.7) were positive for syphilis. The prevalence of syphilis was highest in people aged 60 years and over (21.1%, 95%CI 14.7–29.2), followed by people aged 50–60 years (15.5%, 95%CI 11.9–19.9) and in the widowed population (11.9%, 95%CI 8.9–15.8). There were no differences in syphilis seropositivity between gender, ART status, ART regimen, duration of ART, HIV viral load and hospital level of care. Older age (50–60 years: adjusted OR 3.49, 95%CI 2.09–5.85 P < 0.001; 60–100 years: adjusted OR 4.28, 95%CI 2.21–8.17, P < 0.001) was an independent predictor of seropositive syphilis.ConclusionsWe observed a high prevalence of syphilis among PLHIV. Older people and widowed population have higher syphilis seropositivity. Older age was an independent predictor of syphilis positivity. Therefore, we call for the integration of syphilis screening, treatment and prevention in HIV services.

The Congenital Syphilis Prevention Cascade: Reimagining a Missed Prevention Opportunities Framework for Effective Intervention.

Congenital syphilis (CS) rates have risen in the United States since 2013. Prevention of CS requires testing and treatment of pregnant and pregnancy-capable persons at high risk for syphilis. We developed a CS Prevention Cascade to assess how effectively testing and treatment interventions reached pregnant persons with a CS outcome.

Congenital syphilis: performance of primary care services in São Paulo, 2017.

To evaluate congenital syphilis prevention actions in primary health care services in the state of São Paulo. Cross-sectional evaluative research that used indicators extracted from the Survey of Evaluation and Monitoring of Primary Care Services ( Avaliação e Monitoramento de Serviços da Atenção Básica - QualiAB) in the state of São Paulo in 2017. An evaluative matrix composed of 31 indicators of prevention of congenital syphilis, categorized into four domains of analysis: diagnosis and treatment of acquired syphilis (10); basic infrastructure and resources (7); prevention of congenital syphilis during prenatal care (7); and educational actions and prevention of sexually transmitted infections (7). The frequency of services with positive responses for each indicator and the percentage of service performance were calculated based on the proportion of indicators reported per service and the overall average observed. Subsequently, services were classified into four quality groups, and associations between groups and each indicator, type of organizational arrangement and location were estimated. 2,565 services participated, located in 503 municipalities, with an overall average performance of 74.9%. The domain "diagnosis and treatment of acquired syphilis" had the highest performance (89.8%), followed by "infrastructure and basic resources" (79.5%), "prevention of congenital syphilis in prenatal care" (73.3%) and "educational actions and prevention of sexually transmitted infections" (56.8%). There was a significant difference between quality groups and all indicators and types of organizational arrangements. The evaluated services have limitations in the development of actions to prevent congenital syphilis, mainly related to health education and actions included in prenatal care, such as screening and adequate treatment of pregnant women and their partners. Changes are needed in the work process, with the expansion of educational and surveillance actions, as well as the qualification of the teams to effectively comply with the protocols.

Epidemiological analysis of syphilis surveillance among entry-exit population at Shanghai Port, China from 2014 to 2022

ObjectiveTo investigate the epidemiological characteristics of syphilis cases detected among entry-exit personnel at Shanghai ports from 2014 to 2022 and the changing trend of the syphilis epidemic in the region so as to provide data support for the scientific and effective prevention and control of syphilis at ports.MethodsFrom January 2014 to December 2022, the subjects of syphilis screening at Shanghai port were selected. Physical examination and serological testing were used to confirm syphilis. All the data used were downloaded from the HIS system of Shanghai International Travel Healthcare Center. Descriptive epidemiology was used to analyze the characteristics of the detected cases, and the linear trend Chi-square test was used to analyze the trend between groups.ResultsFrom 2014 to 2022, a total of 918 cases of syphilis were detected among entry-exit personnel at Shanghai port, with a total detection rate of 154.68/100 000. The detection rate was the highest in 2015 and the lowest in 2022, showing a downward trend year by year since 2015. 54.36% of syphilis patients from East Asia were detected. Syphilis cases were reported in all age groups; most cases were under 39 years old, accounting for 36.06%. The syphilis detection rate in males was significantly higher than in females (79.63% vs. 20.4%). The main way of transmission was sexual transmission, accounting for 60.89%, among which male-to-male transmission was the primary way (22.36%).ConclusionThe detection rate of syphilis among entry-exit personnel at Shanghai port has been decreasing continuously in recent years. Targeted health intervention should be carried out according to the monitoring results.

Prevalence of Syphilis among Pregnant Women attending antenatal care clinic, Udaipur, Southern Rajasthan

Background Maternal syphilis is an important cause of adverse pregnancy outcome . Syphilis, caused by infection with Treponema pallidum, is a mucocutaneous sexually transmitted infection (STI) with high infectivity in the early stages. Untreated maternal syphilis is strongly associated with adverse birth outcomes including increased incidence of stillbirths, low birth weight and premature live births compared with uninfected women. The WHO recommends serological test for syphilis in pregnancy and treatment with injectable penicillin, including the partner, as a routine part of antenatal care. Ideally this screening should be done in the first trimester or at first antenatal visit and again early in the third trimester. Method A retrospective, quantitative study of hospital and laboratory records of all pregnant women booked at the RNT Medical college for antenatal care in a one-year period (1ST JULY 2021 to 30TH JUNE 2022) was carried out. Data were collected from department register maintained by authority. VDRL testing was done to screen the patient. Data were analysed. Result : During the study period, 10194 antenatal clinic patients had VDRL screening out of which 27 were positive. The overall prevalence rate in this study was 0.26% Conclusion Universal screening of all pregnant women at first antenatal visit with a non-treponemal test should be used for screening for syphilis in pregnancy. Also considering prevalence of gestational syphilis in Udaipur region , policy translation is required at state and national level to scale up prevention, screening, and management of syphilis.

Congenital Syphilis-An Illustrative Review.

Congenital syphilis is caused by the spirochete, Treponema pallidum, which can be transmitted from an infected mother to her fetus during pregnancy or by contact with a maternal lesion at the time of delivery. The incidence of congenital syphilis is rapidly increasing all over world with 700,000 to 1.5 million cases reported annually between 2016 and 2023. Despite the widespread availability of Penicillin, 2677 cases were reported in 2021 in the US. Clinical manifestations at birth can vary widely ranging from asymptomatic infection to stillbirth or neonatal death. Low birth weight, rash, hepatosplenomegaly, osteolytic bone lesions, pseudoparalysis, central nervous system infection, and long-term disabilities have been reported in newborns with congenital syphilis. Prevention of congenital syphilis is multifaceted and involves routine antenatal screening, timely treatment of perinatal syphilis with penicillin, partner tracing and treatment, and health education programs emphasizing safe sex practices and strategies to curb illicit drug use. Neonatal management includes risk stratification based on maternal syphilis history, evaluation (nontreponemal testing, complete blood counts, cerebrospinal fluid, and long-bone analysis), treatment with penicillin, and followup treponemal testing. Public health measures that enhance early detection during pregnancy and treatment with penicillin, especially in high-risk mothers, are urgently needed to prevent future cases of congenital syphilis.

Congenital Syphilis in the Medicaid Program: Assessing Challenges and Opportunities Through the Experiences of Seven Southern States.

Rates of congenital syphilis cases are increasing, particularly among lower socioeconomic populations within the southern United States. Medicaid covers a significant portion of these births, which provides an opportunity to improve birth outcomes. This project sought to collect information from key stakeholders to assess facilitators of and barriers to Medicaid funding of prenatal syphilis screening and to provide insight into improving screening and lowering incidence through the Medicaid program. Seven southern states (Alabama, Georgia, Kentucky, Louisiana, North Carolina, South Carolina, and Tennessee) were identified for this assessment. Researchers conducted a legal and policy analysis for each state to gather information on factors affecting congenital syphilis prevention, identify knowledge gaps, and inform the development of interview guides. Seventeen structured interviews with 29 participants were conducted to gather information on facilitators and barriers to receiving timely prenatal syphilis screening through the Medicaid program. Interview transcripts were analyzed and compared to identify key themes. Barriers to timely prenatal syphilis screening include varied laws among the states on the timing of screening, Medicaid reimbursement policies that may not adequately incentivize testing, Medicaid enrollment issues that affect both enrollment and continuity of care, and lack of clear understanding among providers on recommended testing. This work provides insight into systemic issues that may be affecting rates of prenatal syphilis screening and incidence among Medicaid enrollees and others in the U.S. South. To address rising congenital syphilis cases, policymakers should consider requiring third trimester syphilis screening, adopting policies to enhance access to prenatal care, adapting Medicaid payment and incentive models, and promoting collaboration between Medicaid and public health agencies.

"The History of the Study of the Etiology, Pathogenesis, Diagnosis, Treatment, and Prevention of Syphilis, in the Reflection of Philately, Numismatics and Bonistics"

"The History of the Study of the Etiology, Pathogenesis, Diagnosis, Treatment, and Prevention of Syphilis, in the Reflection of Philately, Numismatics and Bonistics"

Pregnant women's knowledge about congenital syphilis in a Primary Health Care unit in Belém, Pará

Objective: to understand the knowledge of pregnant women about congenital syphilis from the perspective of the health education process in a primary health care unit of the Unified Health System. Methods: descriptive study with a qualitative approach, carried out in a Basic Health Unit in Belém, Pará, which interviewed 14 pregnant women. Data were interpreted according to the content analysis technique: pre-analysis; exploration of the material; treatment of results and interpretation. Results: from the participants' statements, three categories emerged: pregnant women's knowledge about congenital syphilis, health education about congenital syphilis in prenatal care and care and prevention of congenital syphilis. Conclusion: public policies are needed to sensitize women and partners and train professionals who provide prenatal care.

Seroprevalence and Risk Factors of Sexually Transmitted Blood-Borne Infections among Pregnant Women Attending Antenatal Care in Jirapa, Upper West Region of Ghana.

Sexually transmitted blood-borne infections (STBBIs) contribute to negative outcomes of pregnancy. Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections in pregnancy contribute significantly to maternal and child morbidities and mortalities. This study assessed the prevalence, knowledge, and risk factors of STBBIs (HBV, HCV, HIV, and syphilis) among pregnant women attending antenatal clinics in Jirapa. A cross-sectional study design involving 246 pregnant women was employed for the study. A structured questionnaire was used to solicit information about the knowledge, prevalence, and risk factors of STBBIs. The overall prevalence of STBBIs was 11.4%; HBV prevalence was 9.8% and 0.8% each for HCV, HIV, and syphilis. About 66% of mothers were aware of mother-to-child transmission of infections during pregnancy. Knowledge of transmission of HIV (93.9%), hepatitis (67.1%), and syphilis (53.7%) in pregnancy was relatively high. Knowledge of risk factors for HIV, hepatitis, and syphilis was 97.6%, 74.4%, and 76.0%, respectively. More than 98% of respondents knew about the prevention of HIV, hepatitis, and syphilis. Significant risk factors associated with and predictive of STBBIs were female genital mutilation (FGM) and gravidity. The occurrence of STBBIs among pregnant women was strongly associated with FGM and gravidity. Public health education should be directed at stopping the practice of FGM and improving reproductive health in the study area.

147 A Digital Approach to Syphilis Infection Prevention

OBJECTIVES/GOALS: The goal of this study is to explore the effectiveness of a digital health education curriculum aimed at increasing syphilis beliefs and screening behavior among young African American females residing in Jefferson County, AL. METHODS/STUDY POPULATION: Study Population: African American, cis-gender women, aged 18-29, who reside in Jefferson County, AL Sample Size: N = 50 Measurements: 1) Champion Health Belief Model scale adapted for measuring syphilis perceptions and syphilis screening behavior Analysis Plan: IBM SPSS Statistics 29 will be used to analyze intervention data. Pre-and post-intervention data will be analyzed to calculate a screening request rate for each period. We will use Cohen’s D effect sizes to measure screening requests rate differences post intervention completion. The small sample size and exploratory nature of this project make the descriptive statistics valuable. RESULTS/ANTICIPATED RESULTS: We anticipate that the digital syphilis prevention intervention will positively influence participants’ beliefs regarding syphilis and their syphilis screening behaviors. DISCUSSION/SIGNIFICANCE: Innovative preventive approaches to reducing syphilis disease spread is a national priority as rates have risen annually throughout the last decade. African American women experience the greatest disease burdens associated with syphilis. This study leverages tailored strategies to effectively address this ailment in the target population.

A ATUAÇÃO DO ENFERMEIRO NA PREVENÇÃO DA SÍFILIS CONGÊNITA E OS ESPAÇOS DE DISCUSSÃO

ABSTRACT Objective: to know the possibilities for nurses' discussion and performance spaces in the quadrilateral of training in the health area: teaching, care, management and social control in the prevention of congenital syphilis. Method: a qualitative and exploratory-descriptive research study, theoretically supported by public health policies. The data were collected in July 2020 through nine online focus groups with a total of 42 nurses from 18 municipalities in the mountainous region of the state of Santa Catarina, Brazil. For data systematization, thematic content analysis was used with the support of the Atlas.ti software, version 8.0. Results: nurses' performance occurred especially during direct assistance to patients, when performing rapid tests, monitoring prenatal care and following-up cases of the disease. Discussions about congenital syphilis took place in care spaces. As for the quadrilateral, the nurses related health care to direct assistance and to management of the work organization process in relation to the prevention of congenital syphilis, in addition to pointing out weaknesses in education and social control. They suggested training managers about the quadrilateral. Conclusion: the nurses acted in the prevention of congenital syphilis through direct assistance, making it necessary to expand actions to combat syphilis, especially by increasing the discussion spaces and the elaboration of strategies that involve professionals, managers, researchers and the community in an articulated way about the reality of syphilis in the state, as well as about prevention and treatment means.

Sífilis na gestação e fatores que dificultam o tratamento na Atenção Primária: revisão integrativa

Objective: To investigate the factors that hinder the treatment of syphilis during pregnancy, in Primary Health Care. Methods: This is an integrative review with an exploratory scope, in which 11 articles were selected whose reference met the research requirements in the time frame from 2015 to 2022. The scientific bases that were used are the Lilacs, Scielo and in Google Scholar search engine. Results: When analyzing the selected articles, it was found that it is important for the knowledge of the academic community because it elucidates the failures in prenatal care related to the prevention of syphilis during pregnancy and contributes to reflection and creation of strategies that minimize the problem. Final considerations: It is evident that it is relevant to address issues related to the influence of the correct treatment of pregnant women with syphilis on the NB's prognosis, the occurrence of reinfections related to the lack of treatment of the partners and what are the ways used to keep health professionals informed. on the management of syphilis during pregnancy, in the same way that they are prepared to clarify and clear up doubts from patients and partners.

Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update.

Congenital syphilis (CS) has dramatically increased in the United States (US) in the past decade despite the widespread availability of penicillin.Once considered an infection on the verge of elimination, CS has re-emerged as a familiar neonatal pathogen in US hospitals. This rise in cases has prompted the evaluation of potential causes and updates in prevention and management guidelines.Following a structured narrative approach, we reviewed CS data reports, peer-reviewed research articles, and updated management guidelines from state health departmentsover the past two decades. Our main search criteria centered on the treatment and prevention of CS, with a focus on prenatal health disparities. We identified geographical regions reporting disproportionate rates of CS, examined state laws regarding maternal syphilis testing, and evaluated potential reasons for the recent rise in cases. This article examines the current epidemiology, screening, and management recommendations for perinatal and CS in the US.It also reviews pathogenesis and clinical features in perinatal and pediatric populations. Finally, it highlights the likely contributing factors to increased CS rates and identifies areas for future research. Dramatically rising CS cases in certain regions and racial groups reflect gaps in the prevention, timely diagnosis, treatment, and management of perinatal syphilis and CS. Healthcare providers attending to mothers and children should recognize the re-emergence of this pathogen and be familiar with new screening and management guidelines.Increased federal funding for targeted interventions and research that address vulnerable populations is critical to curbing the re-emergence of this infection.

Similarity Analysis in Understanding Online News in Response to Public Health Crisis.

The "Syphilis No!" campaign the Brazilian Ministry of Health (MoH) launched between November 2018 and March 2019, brought forward the concept "Test, Treat and Cure" to remind the population of the importance of syphilis prevention. In this context, this study aims to analyze the similarity of syphilis online news to comprehend how public health communication interventions influence media coverage of the syphilis issue. This paper presented a computational approach to assess the effectiveness of communication actions on a public health problem. Data were collected between January 2015 and December 2019 and processed using the Hermes ecosystem, which utilizes text mining and machine learning algorithms to cluster similar content. Hermes identified 1049 google-indexed web pages containing the term 'syphilis' in Brazil. Of these, 619 were categorized as news stories. In total, 157 were grouped into clusters of at least two similar news items and a single cluster with 462 news classified as "single" for not featuring similar news items. From these, 19 clusters were identified in the pre-campaign period, 23 during the campaign, and 115 in the post-campaign. The findings presented in this study show that the volume of syphilis-related news reports has increased in recent years and gained popularity after the SNP started, having been boosted during the campaign and escalating even after its completion.

Impact of COVID-19 epidemic on syphilis case reporting in China

Objective: To analyze the impact of COVID-19 epidemic on syphilis case reporting in China, and provide evidence to evaluate the epidemic situation of syphilis and strengthen the prevention and control of syphilis during COVID-19 epidemic. Methods: The data were collected from the National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention, National STD Management Information System, and the "nCov2019" R package of github website. The changes of reported cases of syphilis before and during COVID-19 epidemic in China were analyzed. Joinpoint regression model was established by using the reported case number of syphilis from 2010 to 2018, the data in 2019 was used for validation, and the number of syphilis cases in 2020 and 2021 was predicted. The impact of COVID-19 epidemic on the number of syphilis cases was evaluated with calculating the percentage error (PE) between actual number and predicted number of syphilis cases reported.The correlation between reported cases of syphilis and COVID-19 was analyzed by Spearman's correlation analysis. The softwares of Joinpoint 4.9.1.0 and SPSS 18.0 were used for statistical analysis. Results: In 2020 and 2021, the reported cases of syphilis in China decreased significantly by 13.32% and 10.41%, respectively, compared with 2019 (before COVID-19 epidemic), and the reported cases of syphilis in 2021 increased by 3.36% compared with 2020. The reported cases of syphilis in 2020 and 2021 decreased by 17.95% and 20.41%, respectively, compared with predicted numbers. From January to March 2020, the reported monthly case number of syphilis was completely negatively correlated with the confirmed case number of COVID-19 (rs=-1.00, P<0.001). In the provinces with different scales of COVID-19 epidemic, there was also a negative correlation between the monthly reported case number of syphilis and confirmed case number of COVID-19 (all P<0.05). Conclusions: In China, the change of reported cases of syphilis was closely associated with COVID-19 epidemic in 2020 and 2021. Due to the influence of COVID-19 epidemic, the number of reported cases of syphilis decreased significantly, but it should not be thought that syphilis incidence will become a decline trend in the future. It is necessary to carefully and scientifically assess the changes in syphilis epidemic.

Failures in Prevention of Congenital Syphilis

Failures in Prevention of Congenital Syphilis

Analysis of the Impact of Communication Campaigns under the Project "Syphilis No": A National Tool for Inducing and Promoting Health.

Syphilis is increasingly prevalent around the world as a result of complex factors. In Brazil, the government declared a syphilis epidemic in 2016 and then set a strategic agenda to respond to this serious public health problem. In a joint effort, Brazil's Federal Court of Accounts (TCU) recommended that novel and diversified health communication strategies should be developed, which the "Syphilis No" project (SNP) later conducted through nationwide mass communication campaigns. We performed exploratory data analysis to identify and understand the results of three health communication campaigns by considering syphilis data trends in Brazil. The SNP, by using traditional and innovative means of communication, focused on multiple target audiences to encourage behavior changes through awareness and syphilis knowledge acquisition via the internet. In addition, the SNP disseminated information on syphilis testing, prevention, and treatment through social media and multiple media outlets. We observed that the period of the health campaigns corresponded to the period when the syphilis testing uptake increased and the number of reported cases dropped. Thus, our findings indicate that public health responses could substantially benefit from the use of health communication campaigns as a tool for health promotion, education, and transformation.

Preconception syphilis seroprevalence and association with duration of marriage and age among married individuals in Guangdong Province, China: A population-based cross-sectional study.

Duration of marriage (DoM) and age are important characteristics of married individuals, who are the critical population for eliminating mother-to-child transmission (MTCT) of syphilis. A deep understanding of the preconception syphilis seroprevalence (PSS) and its distribution among this population may be able to help to eliminate MTCT. However, few population-based epidemiological studies have been focused on this group, and the association of DoM and age with PSS remains unclear. This study used data from 4,826,214 married individuals aged 21-49 years who participated in the National Free Preconception Health Examination Project in Guangdong Province, China, between 2014 and 2019. Syphilis was screened using the rapid plasma reagin (RPR) test. The seroprevalence time series, seroprevalence map, and hot spot analysis (HSA) were employed to visualize the spatiotemporal distribution. The restricted cubic spline (RCS) based on multivariate logistic regression was used to model the association of DoM and age with PSS. The interactions on the additive scale of DoM and age were also assessed. The PSS was 266.61 per 100,000 persons (95% CI: 262.03-271.24) and the burden was higher in economically underdeveloped area within the province. A strong J-shaped non-linearity association was observed between age and PSS. Specifically, the risk of seropositivity was relatively flat until 27 years of age among men and increased rapidly afterwards, with an adjusted odds ratio (aOR) of 1.13 (95% CI: 1.12-1.13) per unit. Among women, the risk of seropositivity was relatively flat until 25 years of age and increased rapidly afterwards with an aOR of 1.08 (95% CI: 1.08-1.09) per unit. DoM was negatively associated with PSS among married individuals. Moreover, the combined effects of age and DoM appeared to be synergistic. Our findings suggest that attention should be paid to preventing syphilis in underdeveloped areas and that syphilis screening in newly married individuals who are in their late 20s or older should be recommended. Additionally, early syphilis prevention strategies should be implemented among young people as early as possible.

Investigation of the immune escape mechanism of Treponema pallidum.

Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subspecies pallidum (T. pallidum), which is a public health problem that seriously affects human health worldwide. T. pallidum is characterized by early transmission and immune escape and is therefore termed an "invisible pathogen". This review systematically summarizes the host's innate and adaptive immune responses to T. pallidum infection as well as the escape mechanisms of T. pallidum. To lay the foundation for assessing the pathogenic mechanism and the systematic prevention and treatment of syphilis. The immune escape mechanism of T. pallidum plays an important role in its survival. Exploring the occurrence and development of these mechanisms has laid the foundation for the development of syphilis vaccine.