Maternal and paternal factors associated with congenital syphilis in Shenzhen, China: a prospective cohort study.

Maternal and paternal factors create considerable obstacles to the elimination of congenital syphilis (CS). A clear understanding of maternal and paternal factors is important in order to define interventions in every community. This study aimed to investigate the maternal and paternal factors associated with CS. A prospective cohort study was conducted from April 25, 2007 to October 31, 2012 at the Shenzhen Center for Chronic Disease Control and Prevention (SCCDC) in China. We screened 279,334 pregnant women and identified 838 women with syphilis. Finally, a total of 360 women with syphilis were included for analysis. At the end of follow-up, 34 infants [9.4 %, 95 % confidence interval (CI): 6.8-12.9 %] were diagnosed with CS. Following adjustment for confounders, maternal history of syphilis [adjusted risk ratio (aRR) = 0.21], prenatal care (aRR = 0.12), and complete treatment (aRR = 0.22) reduced the risk of infants being infected. Every two-fold increase of titer of non-treponemal antibodies (aRR = 1.88), early stage of syphilis (aRR = 9.59), a shorter length of time between the end of the first treatment to childbirth (aRR = 5.39), and every week of delay in treatment (aRR = 2.25) for maternal syphilis as well as paternal history of cocaine use (aRR = 6.28) and positive (aRR = 3.30) or unknown (aRR = 2.79) status of syphilis increased the risk of infants being infected. CS also increased the risk (aRR = 8.02) of neonatal death. Maternal and paternal factors constituted two separate profiles associated with CS. To become more effective, future strategies for the prevention of CS should be targeted to each profile.

Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China.

The purpose of this investigation was to assess the effectiveness of an intervention program on mother-to-child transmission (MTCT) of syphilis and investigate determinants of congenital syphilis (CS) and adverse pregnancy outcomes (APOs). The Shenzhen local government initiated an intervention program of MTCT of syphilis in 2001. Based on this program, maternal and paternal factors associated with CS and APOs among syphilitic women were investigated from 2007 to 2012 by a prospective cohort study. From 2002 to 2012, 2,441,237 pregnant women were screened and screening coverage reached 97.2 % in 2012. In the background of continuing growth of CS in China, CS in Shenzhen significantly decreased from 109.3 cases in 2002 to 9.9 cases in 2012 per 100,000 live births. Maternal education (adjusted odds ratio [aOR]CS = 0.65; aORAPOs = 0.79) and history of syphilis (aORCS = 0.28; aORAPOs = 0.61), as well as paternal age (aORCS = 0.62; aORAPOs = 0.86) and education (aORCS = 0.66; aORAPOs = 0.86) were negatively associated with CS and APOs, but maternal unmarried status (aORCS = 1.95; aORAPOs = 2.61), inadequate antenatal care (ANC) (aORCS = 3.61; aORAPOs = 1.79), more sexual partners (aORCS = 1.51; aORAPOs = 1.39), every week of delay in treatment (aORCS = 2.82; aORAPOs = 1.27), higher baseline titers of nontreponemal antibodies (aORCS = 5.65; aORAPOs = 1.47), early syphilis (aORCS = 23.24; aORAPOs = 26.95), and non-penicillin treatment (aORCS = 3.00; aORAPOs = 2.16), as well as paternal history of cocaine use (aORCS = 2.70; aORAPOs = 2.44) and positive (aORCS = 4.14; aORAPOs = 1.50) or unknown (aORCS = 2.37; aORAPOs = 2.06) status of syphilis increased the risk of CS and APOs. Condom use (aOR = 0.70) decreased MTCT of syphilis. A ten-year program consisting of screening and treatment, early ANC, health education, partners tracking, detection, and treatment, follow-up visits, and information management is an effective means to block MTCT of syphilis. Maternal and paternal factors constituted two separate profiles associated with MTCT of syphilis.

Burden of syphilis infections in Shenzhen, China: a preliminary estimation.

Information on the prevalence and incidence of sexually transmitted infections is important for developing prevention and control strategies and allocating human and financial resources. However, there are no available estimates of such information for many areas in China. In this study, we used the existing data to make a preliminary estimation of syphilis infections in Shenzhen city, in south-eastern China. Data on prevalence rates of syphilis infections among different populations were obtained from the local HIV/sexually transmitted disease second-generation surveillance programme, and the sizes of different populations were estimated based on the most recently available figures. It was estimated that 83,760 (range 77,490-90,020) people are currently infected with syphilis, giving a prevalence of 0.71-0.82% (0.76% on average) in Shenzhen. Around 18% of these syphilis infections occur among men who have sex with men and another 15.8% and 8.7% occur among female sex workers and their clients, respectively. These estimates suggest that a combination of unprotected paid sex and sex between men may be sustaining the epidemic of syphilis in the study area. The preliminary estimates will assist the government in planning and improving its comprehensive intervention programmes for the future control and prevention of syphilis.