Proportion Of Syphilis Cases Research Articles

Sexually Transmitted Infections surveillance among the patient population in Belgian general practice

Abstract Background In Europe, prevalence of Sexually Transmitted Infections (STI) is continuously increasing. The Belgian public health institute ensures STI surveillance in general practices through the Sentinel General Practitioners (SGP) network. Between 2015 and 2020, the SGP reported cases for 5 STIs: chlamydia, gonorrhoea, syphilis herpes and genital warts. The objective is the surveillance of STI in primary care. Methods General practitioners (GPs) report STI cases through the SGP network on a voluntary basis, using an online questionnaire. This questionnaire is developed in cooperation with STI experts, as well as a steering committee group composed of GPs and representatives of regional health agencies. Results In total 1009 cases were registered from 2015 until 2020 within the SGP network. 59.8% of patients consulting for STIs were men, of which 63.5% had exclusively heterosexual contacts and 24.8% are Men who have sex with Men (MSM). 91.8% of women had exclusively heterosexual contacts. Chlamydia was the most common STI (57.4%). Women are more likely to be diagnosed with chlamydia (OR 1.6; 95% CI 1.1-2.2) and herpes (OR 1.7; 95% CI 1.0-2.9) than men. Men represented most of the gonorrhoea (79.77%) and syphilis (86.7%) cases. Having bi- or homosexual contacts increases the likelihood of getting gonorrhoea (OR 3.3; 95% CI 2.1-5.1) and syphilis (OR 13.7; 95% CI 7.4-25.3). Incidence of Chlamydia is estimated at 68.81/100000, and incidence of gonorrhoea at 21.11/100000 over 6 years. Conclusions We observe a slight increase in chlamydia and gonorrhoea incidence in the Belgian population over the study period. MSM are at higher risk of STI and represent an overwhelming proportion of syphilis cases. Being a woman is associated with higher risk of acquiring chlamydia and herpes infection. We recommend continuing prevention and awareness campaigns targeting high risk groups. Key messages MSM and women remain high-risk populations regarding STIs among the patient population of general practitioners. Continuous STI surveillance is necessary to monitor STI related healthcare needs and adapt prevention programs.

Human Immunodeficiency Virus Seropositivity and Early Syphilis Stage Associated With Ocular Syphilis Diagnosis: A Case-control Study in British Columbia, Canada, 2010-2018.

The incidence of syphilis has been increasing worldwide in the last 20 years, disproportionately impacting those living with human immunodeficiency virus (HIV). Alongside this increase, several jurisdictions have reported increasing incidences of syphilis-related complications, including ocular syphilis. We sought to characterize ocular syphilis cases in British Columbia (BC), Canada. This case-control study compared ocular syphilis cases, matched (1:4) to syphilis controls, that were diagnosed in BC between January 2010 and December 2018. Multivariable logistic regression was used to identify potential correlates of ocular syphilis, where variables were included in the final model if significant (P ≤ .05). During the study period, there were 6716 syphilis diagnoses, including 66 (0.98%) ocular syphilis cases. The median age of cases was 49.5 years (interquartile range 39-59). Most (87.8%) patients were male, where 54.6% identified as men who have sex with men. The most common ophthalmologic diagnosis was panuveitis (42.4%). Of ocular syphilis patients, 48.5% were living with HIV at the time of their syphilis diagnosis, compared to 26.4% of controls (P = .001). The proportion of syphilis cases with ocular syphilis increased from 0.48% in 2010 to 0.83% in 2018. The final multivariable model demonstrated correlates between ocular syphilis and early syphilis stage, including primary/secondary (odds ratio [OR] 4.96, 95% confidence interval [CI] 1.86-13.24) and early latent (OR 4.29, 95% CI 1.62-11.34) stages, and HIV serostatus (OR 2.16, 95% CI 1.14-4.09). Ocular syphilis increased over the study period, both in absolute numbers and as a proportion of all syphilis cases, a finding consistent with other jurisdictions. These findings highlight the importance of vigilance for ocular syphilis, to avoid diagnostic and treatment delays.

Characteristics of primary and late latent syphilis cases which were initially non-reactive with the rapid plasma reagin as the screening test

The aim of the study was to determine the characteristics of primary and late latent syphilis cases that were non-reactive on initial screening by rapid plasma reagin (RPR) but reactive by treponemal tests. RPR test results of all primary and late latent syphilis cases in the province of Alberta, Canada during 1980-2001 were compiled. The proportion of syphilis cases that were non-reactive by RPR testing was compared with reactive cases. Multiple logistic regression was used to identify factors associated with non-reactive RPR results. Among primary syphilis cases, 224 (26%) were non-reactive on initial RPR and were compared with 639 reactive primary cases. Independent factors associated with a non-reactive result were male gender (odds ratio, [OR] = 1.99 [1.22-3.26]), Caucasian ethnicity (OR = 1.77 [1.20-2.61]) and diagnosis during the 1980-1986 syphilis outbreak period in Alberta (OR = 3.13 [1.45-6.74]). Of the late latent cases, 512 (39%) were non-reactive by RPR and 791 were reactive. A non-reactive test for late latent cases was associated with male gender (OR = 2.91 [2.15-3.94]), Canadian Aboriginal (OR = 2.91 [1.59-5.32]), Caucasian (OR = 1.87 [1.35-2.58]), black ethnicity (OR = 1.76 [1.28-2.42]) and diagnosis during the 1980-1986 Alberta syphilis outbreak (OR = 1.67 [1.29-2.16]). RPR testing alone is insufficient to diagnose primary and late latent infections under certain conditions and patient characteristics. Case detection was lower for late latent syphilis when compared with primary syphilis based on the properties of the RPR. Further studies are needed to inform the optimal use of the RPR test in laboratory testing algorithms for the diagnosis of syphilis and to determine the cost effectiveness of better screening tests for syphilis.