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1.
Neurol India ; 70(4): 1635-1638, 2022.
Article in English | MEDLINE | ID: mdl-36076672

ABSTRACT

Background/Objective: Neurosyphilis can be associated with a variety of clinical manifestations. There are only a few cases of neurosyphilis associated with parkinsonism-plus syndromes (PPSs) that have been reported in the literature. We describe a case of an elderly woman who presented with abnormal gait and progressive visual disturbance, probably secondary to neurosyphilis. Methods: Literature search was performed in Embase, Google Scholar, Medline, Scielo, and ScienceDirect using a set of terms that included parkinsonism, tremor, and syphilis. Case Report: A 64-year-old female was admitted because of vision problems, gait disturbances, and cognitive impairment. The neurological examination revealed bradykinesia, rigidity, and rest tremor. The pupils were bilaterally small and reacted in size to a near object but did not constrict when exposed to bright light. The conjugate eye movements showed a defective downward gaze. On neuropsychological examination, the mini-mental state exam showed a moderate cognitive impairment. Reduced phonemic fluency was observed. A positive serum venereal disease research laboratory (VDRL) test was noted. A cerebrospinal fluid analysis showed positive VDRL. Brain and cervical spine magnetic resonance imaging was normal. An electro-encephalogram showed diffused slow waves. Penicillin G was started. Six months after, the patient had a full recovery of her conjugate eye movements and cognitive functions. Upon further questioning, the patient reported no response with a levodopa attempt. Conclusions: To the authors' knowledge, two individuals developed progressive supra-nuclear palsy (PSP), and one presented corticobasal degeneration (CBD), probably associated with neurosyphilis. This is the second case to document the occurrence of a progressive supra-nuclear palsy because of syphilis.


Subject(s)
Movement Disorders , Neurosyphilis , Parkinsonian Disorders , Syphilis , Aged , Female , Humans , Middle Aged , Movement Disorders/complications , Neurosyphilis/complications , Neurosyphilis/diagnosis , Paralysis , Parkinsonian Disorders/complications , Syndrome , Syphilis/complications
2.
Curr Opin Infect Dis ; 35(5): 452-460, 2022 10 01.
Article in English | MEDLINE | ID: mdl-36066379

ABSTRACT

PURPOSE OF REVIEW: In light of alarming increases in the incidence of congenital syphilis in many middle and higher income countries across the globe, this review summarizes recent changes in the epidemiology of syphilis, highlights recommended changes to testing in pregnancy and provides an update for the management of syphilis infection in pregnancy (SIP) and of the infant born to a mother with SIP. RECENT FINDINGS: The re-emergence of congenital syphilis is a result of increasing infectious syphilis in women of childbearing age, which is in turn a result of increasing syphilis in the general population particularly in Indigenous and marginalized populations. Potential reasons for the increase include changing sexual practices and increased travel and migration, as well as factors that limit healthcare access, particularly access to antenatal care and limited awareness and education amongst mothers and maternity services. A single antenatal test for syphilis is insufficient; more frequent testing in pregnancy is necessary even for women deemed to be low risk. The management of SIP and of the newborn is complex and guidelines should be readily available with clear recommendations. SUMMARY: Congenital syphilis is preventable. The current crisis calls for a global and national multipronged, co-ordinated approach involving public health and hospital systems which includes education of individuals and healthcare workers, availability of updated guidelines for prevention and treatment, prioritization of antenatal testing, assurance of accessible and prompt treatment and appropriate assessment and follow-up of infants.


Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Syphilis , Female , Humans , Infant , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Prenatal Care , Prenatal Diagnosis , Syphilis/diagnosis , Syphilis/epidemiology , Syphilis/prevention & control , Syphilis, Congenital/diagnosis , Syphilis, Congenital/epidemiology , Syphilis, Congenital/prevention & control
3.
PLoS One ; 17(9): e0273658, 2022.
Article in English | MEDLINE | ID: mdl-36084099

ABSTRACT

INTRODUCTION: Since 2011, remote Australian Aboriginal and Torres Strait Islander communities have experienced an outbreak of infectious syphilis, with young people aged 15-29 years over-represented in notifications. The Young Deadly Syphilis Free multi-media campaign was implemented in 12 remote regions in four Australian jurisdictions over nine months from 2017-2018. Campaign components included television and radio advertisements, social media posts, and health promotion resources available via a dedicated website. The aim of this research was to evaluate the impacts (proximal, mediator, distal) of the Young Deadly Syphilis Free campaign for young Aboriginal people and health and community workers residing in remote campaign regions. METHODS: A cross-sectional (post-only) evaluation design was used. Data were collected through online surveys; metrics for social media (Facebook, Instagram) were also collected to determine campaign engagement via social media. A 22-item young people survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); along with intended behaviour and knowledge and attitudes (mediator variables). A 24-item health and community worker survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); and changes in professional practice (distal variable). Descriptive statistics summarised demographic characteristics and univariate analysis examined associations between key variables. RESULTS: Just over half (n = 25, 58%) of young people and three quarters (n = 36; 75%) of health and community workers were aware of the campaign. Recognition of key campaign messages was high for both participant groups (>64%), and television, Facebook, and website were the most common campaign exposure routes. Positive impacts on intended behaviour (young people) and professional practice (health and community workers) were also reported. Facebook was effective in engaging some young people in campaign content and was preferred by young people for accessing information. CONCLUSION: The findings point to the value of utilising a multi-media campaign in raising awareness about syphilis among young Aboriginal people and health and community workers in remote Australian regions. A longer-term campaign that accommodates the diverse needs of Aboriginal young people from geographically remote communities would optimise campaign impacts and support behavioural change.


Subject(s)
Native Hawaiian or Other Pacific Islander , Syphilis , Adolescent , Australia/epidemiology , Cross-Sectional Studies , Health Promotion , Humans , Syphilis/epidemiology , Syphilis/prevention & control , Television
4.
PLoS One ; 17(9): e0273713, 2022.
Article in English | MEDLINE | ID: mdl-36094912

ABSTRACT

BACKGROUND: Intense transmission of syphilis has emerged in some Canadian Arctic communities despite screening and prevention efforts. The remoteness of most communities and limited diagnostic infrastructure yield long delays (≥14 days) between screening and treatment of cases. These hamper syphilis control efforts and may contribute to sustained transmission. Syphilis rapid diagnostic tests (RDTs) have been developed to make screening more accessible and to inform clinical decision-making within the same clinical encounter. These RDTs have been successfully deployed in several countries, but not yet in Canada. METHODS AND DESIGN: We describe the methodology of the "Stopping Syphilis Transmission in Arctic Communities Through Rapid Diagnostic Testing" (STAR) study, wherein the clinical and epidemiological impact of deploying a dual syphilis RDT in the context of ongoing transmission in Nunavut and Nunavik will be evaluated. In this prospective multisite field evaluation, sexually active individuals aged ≥14 years at risk for syphilis will be offered screening by an RDT at the point-of-care by non-laboratory trained registered nurses. Whole blood and serum specimens will be concurrently collected, when feasible, for rapid testing with an RDT containing both treponemal and non-treponemal components (Chembio DPP® Syphilis Screen & Confirm) and compared to laboratory-based reference testing according to a reverse sequence algorithm. The diagnostic accuracy of the RDT, using both whole blood and centrifuged serum specimens, will be validated under real-world conditions in remote Northern settings, outside of specialized laboratories. Additionally, screening-to-treatment time, case detection rates, and the number of infectious contacts averted by using the RDT relative to reference testing will be estimated. The impact of both diagnostic approaches on syphilis transmission dynamics will also be modeled. DISCUSSION: This study will provide much needed evidence for strengthening rapid responses to emerging syphilis outbreaks in remote Arctic regions, by supplementing traditional diagnostic strategies with an RDT to rapidly triage patients likely in need of treatment. These results will also inform the development and tailoring of future diagnostic strategies and public health responses to emerging outbreaks in the North.


Subject(s)
Syphilis , Arctic Regions , Canada/epidemiology , Humans , Prospective Studies , Syphilis/diagnosis , Syphilis/epidemiology , Syphilis Serodiagnosis/methods
5.
Rev Bras Enferm ; 75(6): e20210965, 2022.
Article in English, Portuguese | MEDLINE | ID: mdl-36102473

ABSTRACT

OBJECTIVES: to analyze the evidence available in literature on factors associated with inadequate treatment of syphilis in pregnant women. METHODS: an integrative review, carried out in the LILACS, CINAHL, Web of Science, Scopus, PubMed and EMBASE databases, with controlled descriptors therapeutic and prenatal syphilis. RESULTS: nine publications composed the interpretative analysis, in which low education, income and maternal age, temporary lack of medication and HIV infection were associated with inadequate treatment of syphilis during pregnancy, in addition to delay or absence of prenatal care and receiving the 1st dose of penicillin, lack of tests or treatment less than 30 days before childbirth, and partners' low compliance with treatment. FINAL CONSIDERATIONS: among the main factors associated with inadequate treatment, clinical and sociodemographic aspects stand out, as well as failures in drug dispensing, prescription and monitoring of treatment of pregnant women and their partners by the health system.


Subject(s)
HIV Infections , Pregnancy Complications, Infectious , Syphilis , Female , Humans , Parturition , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Prenatal Care , Syphilis/drug therapy
6.
Front Public Health ; 10: 873754, 2022.
Article in English | MEDLINE | ID: mdl-36117594

ABSTRACT

Background: Syphilis has spread throughout China, especially in Zhejiang Province which endangers the health and lives of people. However, the spatial and temporal epidemiological studies of syphilis in Zhejiang are not thorough enough. The temporal and spatial variation and the relevant factors of syphilis incidence should be analyzed for more effective prevention and control in Zhejiang, China. Methods: Data on confirmed cases of syphilis in Zhejiang Province from 2005 to 2018 was used and the spatio-temporal distributions were described. The spatial autocorrelation analysis and SaTScan analysis were performed to identify spatio-temporal clusters. A Bayesian spatial Conditional Autoregression (CAR) model was constructed to explore the relationships between syphilis incidence and common social and natural indicators. Results: 474,980 confirmed cases of syphilis were reported between 2005 and 2018 with a large peak in 2010. Farmers and unemployed people accounted for the largest proportion of confirmed cases. And the significant spatial clusters of syphilis were concentrated in the north of Zhejiang Province, especially in more economically developed regions. Seven spatio-temporal clusters were identified and the main three high-risk areas were located in Hangzhou (RR = 1.62, P < 0.05), Zhoushan and Ningbo (RR = 1.99, P < 0.05), and Lishui (RR = 1.68, P < 0.05). The findings showed that the morbidity of syphilis was positively correlated with the Gross Domestic Product (GDP) per capita, the number of health technicians per 10,000 people, the proportion of the elderly and air temperature were negatively correlated with the proportion of the urban population, the proportion of men and precipitation. Conclusions: The spatio-temporal analysis revealed that the prevalence of syphilis was still serious in Zhejiang Province. Syphilis high-risk areas were mainly located in the more developed coastal regions where more targeted intervention measures were required to be implemented. The study highlighted the need to strengthen Sexually Transmitted Diseases (STD) screening and health education for high-risk groups and improve the coverage of syphilis testing to reduce hidden syphilis cases.


Subject(s)
Syphilis , Aged , Bayes Theorem , China/epidemiology , Humans , Incidence , Male , Spatio-Temporal Analysis , Syphilis/epidemiology
7.
Medicine (Baltimore) ; 101(37): e30586, 2022 Sep 16.
Article in English | MEDLINE | ID: mdl-36123886

ABSTRACT

RATIONALE: Syphilis is a bacterial, systemic infectious disease caused by Treponema pallidum spirochetes, which spread rapidly through the body affecting various organs. The term neurosyphilis (NS) refers to a CNS infection that can occur at any stage of the disease. The lack of a gold standard for the diagnosis of NS greatly hinders diagnosis, which must be based mainly on clinical assessment. PATIENT CONCERNS: A 58-year-old man reported dizziness and headache for a week and right-sided hearing impairment, with suspected transient cerebral ischemic attack. A month later he experience transient speech disturbance and suspected cerebral ischemic stroke. DIAGNOSIS: MRI showed fresh ischemic lesions with a diameter up to 10 mm in the deep brain structures on the left side and foci of subacute ischemia also in the deep structures and the brain stem. Cerebrospinal fluid examination showed positive Pandy's reaction, doubtful Noone-Apelt reaction, increased protein level and decreased glucose level. The reactive result of the USR test performed (VDRL) finally allowed the diagnosis of symptomatic CNS syphilis. INTERVENTIONS: Empiric treatment for bacterial meningitis was administered. The patient was transferred to the Department of Infectious Diseases for further treatment. OUTCOMES: The diagnosis has been confirmed at the Department of Infectious Diseases after repeating CSF analysis including VDRL and FTA-ABS. LESSON: Symptoms of NS are nonspecific, hence the diagnostic process is not straightforward. Despite the availability of modern diagnostic techniques, establishing a final diagnosis was challenging, but the patient ultimately received appropriate treatment. It is important to remember that syphilis is not only a disease known from history lessons but is still present in modern times and its incidence is increasing.


Subject(s)
Neurosyphilis , Stroke , Syphilis , Glucose , Humans , Male , Middle Aged , Neurosyphilis/cerebrospinal fluid , Syphilis/diagnosis , Syphilis Serodiagnosis/methods , Treponema pallidum
9.
Front Public Health ; 10: 966813, 2022.
Article in English | MEDLINE | ID: mdl-36091532

ABSTRACT

Background: Accurate incidence prediction of sexually transmitted diseases (STDs) is critical for early prevention and better government strategic planning. In this paper, four different forecasting models were presented to predict the incidence of AIDS, gonorrhea, and syphilis. Methods: The annual percentage changes in the incidence of AIDS, gonorrhea, and syphilis were estimated by using joinpoint regression. The performance of four methods, namely, the autoregressive integrated moving average (ARIMA) model, Elman neural network (ERNN) model, ARIMA-ERNN hybrid model and long short-term memory (LSTM) model, were assessed and compared. For 1-year prediction, the collected data from 2011 to 2020 were used for modeling to predict the incidence in 2021. For 5-year prediction, the collected data from 2011 to 2016 were used for modeling to predict the incidence from 2017 to 2021. The performance was evaluated based on four indices: mean square error (MSE), mean absolute error (MAE), and mean absolute percentage error (MAPE). Results: The morbidities of AIDS and syphilis are on the rise, and the morbidity of gonorrhea has declined in recent years. The optimal ARIMA models were determined: ARIMA(2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(3,1,2)(1,1,2)12 for AIDS, gonorrhea, and syphilis 1-year prediction, respectively; ARIMA (2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(2,1,1)(0,1,0)12 for AIDS, gonorrhea and syphilis 5-year prediction, respectively. For 1-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 23.26, 20.24, 18.34, and 18.63, respectively; For gonorrhea, the MAPEs are 19.44, 18.03, 17.77, and 5.09, respectively; For syphilis, the MAPEs are 9.80, 9.55, 8.67, and 5.79, respectively. For 5-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 12.86, 23.54, 14.74, and 25.43, respectively; For gonorrhea, the MAPEs are 17.07, 17.95, 16.46, and 15.13, respectively; For syphilis, the MAPEs are 21.88, 24.00, 20.18 and 11.20, respectively. In general, the performance ranking of the four models from high to low is LSTM, ARIMA-ERNN, ERNN, and ARIMA. Conclusion: The time series predictive models show their powerful performance in forecasting STDs incidence and can be applied by relevant authorities in the prevention and control of STDs.


Subject(s)
Acquired Immunodeficiency Syndrome , Gonorrhea , Sexually Transmitted Diseases , Syphilis , Acquired Immunodeficiency Syndrome/epidemiology , China/epidemiology , Gonorrhea/epidemiology , Humans , Models, Statistical , Sexually Transmitted Diseases/epidemiology , Syphilis/epidemiology
10.
Article in English | MEDLINE | ID: mdl-36078229

ABSTRACT

(1) Background: Maternal syphilis (MS) and congenital syphilis (CS) are serious public health problems worldwide due to their high morbidity and mortality rates. (2) Objective: Evaluating the applicability of Clinical Protocols and Treatment Guidelines on case incidence trends in Brazil and Portugal. (3) Methods: The review was done through bibliographic research in two public databases and government websites from both countries, published between 2007 and 2022. All guidelines that contained CS and MS were selected. (4) Results and discussion: After evaluation, we found that Brazil and Portugal have adequate protocols for screening and treating congenital and maternal syphilis. (5) Conclusion: The results suggest that CS and MS incidence are notably higher in Brazil than in Portugal due to economic, cultural, and social disparities and the differences in territory size. Therefore, these demographic and socioeconomic factors could strongly influence efforts to fight against syphilis and thus control the infection.


Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Syphilis , Brazil/epidemiology , Clinical Protocols , Female , Humans , Portugal/epidemiology , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Syphilis/epidemiology , Syphilis/prevention & control , Syphilis, Congenital/diagnosis , Syphilis, Congenital/epidemiology , Syphilis, Congenital/prevention & control
11.
Article in English | MEDLINE | ID: mdl-36078254

ABSTRACT

Syphilis remains a growing and resurging infectious disease in China. However, exploring the influence of environmental factors on the spatiotemporal distribution of syphilis remains under explore. This study aims to analyze the spatiotemporal distribution characteristics of syphilis in Ningxia, Northwest China, and its potential environmental influencing factors. Based on the standardized incidence ratio of syphilis for 22 administrative areas in Ningxia from 2004 to 2017, spatiotemporal autocorrelation and scan analyses were employed to analyze the spatial and temporal distribution characteristics of syphilis incidence, while a fixed-effect spatial panel regression model identified the potential factors affecting syphilis incidence. Syphilis incidence increased from 3.78/100,000 in 2004 to 54.69/100,000 in 2017 with significant spatial clustering in 2007 and 2009-2013. The "high-high" and "low-low" clusters were mainly distributed in northern and southern Ningxia, respectively. The spatial error panel model demonstrated that the syphilis incidence may be positively correlated with the per capita GDP and tertiary industry GDP and negatively correlated with the number of health facilities and healthcare personnel. Sex ratio and meteorological factors were not significantly associated with syphilis incidence. These results show that the syphilis incidence in Ningxia is still increasing and has significant spatial distribution differences and clustering. Socio-economic and health-resource factors could affect the incidence; therefore, strengthening syphilis surveillance of migrants in the economically developed region and allocating health resources to economically underdeveloped areas may effectively help prevent and control syphilis outbreaks in high-risk cluster areas of Ningxia.


Subject(s)
Syphilis , China/epidemiology , Cluster Analysis , Humans , Incidence , Meteorological Concepts , Spatial Analysis , Spatio-Temporal Analysis , Syphilis/epidemiology
12.
Clin Lab ; 68(7)2022 Jul 01.
Article in English | MEDLINE | ID: mdl-35975522

ABSTRACT

BACKGROUND: Acquired immunodeficiency syndrome (AIDS) remains a major global public health problem. This study aimed to obtain current epidemiological data on the Human immunodeficiency virus (HIV) infections in Mogadishu, Somalia. METHODS: This study included 92,270 anti-HIV test results reported for 82,954 different individuals between 2015 and 2019. HIV tests were performed using the Architect HIV Ag/Ab Combo assay and retested with the Elecsys HIV combi PT assay. RESULTS: HIV seropositivity was found to be 0.32% (269/82,954) in all individuals over a period of four years. Anti-HIV seropositivity in the 0 - 14, 15 - 19, 15 - 24, 15 - 49, and > 15 age groups were as follows: 0.17% (11/6,441), 0.17% (12/7,131), 0.15% (35/24,132), 0.37% (212/56,895), and 0.34% (258/76,513), respectively. In HIV-infected patients, anti-HBs, HBsAg, anti-HCV, and anti-TP (syphilis) seropositivity was found to be 30.3% (56/185), 9.54% (23/241), 1.24% (3/242), and 3.45% (2/58), respectively. CONCLUSIONS: The findings from this study provide comprehensive data on the HIV epidemiology in Somalia. We believe that the results presented in this study will contribute to the risk analysis and planning of preventive policies of national and global health organizations.


Subject(s)
HIV Infections , Syphilis , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Seroprevalence , Humans , Retrospective Studies , Seroepidemiologic Studies , Somalia/epidemiology
13.
Med Trop Sante Int ; 2(2)2022 06 30.
Article in French | MEDLINE | ID: mdl-35919257

ABSTRACT

Introduction: Syphilis is a sexually transmitted disease. All organs might be affected, but ocular syphilis occurs only in 0.6 percent of patients. A resurgence of syphilis cases has been observed for several years in many countries, especially in HIV-infected subjects. These patients often present with concomitant primary and secondary lesions or extensive presentations of syphilis. Case reports: We report 2 patients with syphilitic uveitis diagnosed and treated at the department of infectious diseases at the University hospital of Marrakech. Ocular involvement was inaugural in both HIV patients. Each had a specific treatment, but none had a complete recovery of visual function; the first patient was treated by ceftriaxone and the second one was treated by penicillin. Conclusion: Syphilis must be discussed in all patients diagnosed with uveitis or papillitis. The diagnosis should be suspected in cases of eye inflammation even in the absence of favourable clinical presentation or anamnesis. Search for HIV co-infection should be systematic. Although not evidence-based, prompt therapy may lead to functional recovery. Ceftriaxone could be a suitable alternative to penicillin in the treatment of early syphilis in HIV-infected patients. This treatment has a concomitant effectiveness even for asymptomatic forms of neurosyphilis. Ocular syphilis is a form of neurosyphilis and requires neurosyphilis therapy regardless of when it develops after primary infection.Conventional syphilis staging is of little use in understanding ocular syphilis. Co-infection between HIV and ocular syphilis is common, but does not affect response to a neurosyphilis regimen of penicillin in the short term.


Subject(s)
Coinfection , Endophthalmitis , Eye Infections, Bacterial , HIV Infections , Neurosyphilis , Syphilis , Uveitis , Ceftriaxone/therapeutic use , Coinfection/drug therapy , Endophthalmitis/complications , Eye Infections, Bacterial/diagnosis , HIV Infections/complications , Humans , Morocco , Neurosyphilis/complications , Penicillins/therapeutic use , Syphilis/complications , Uveitis/diagnosis
14.
BMJ Open ; 12(8): e065348, 2022 08 25.
Article in English | MEDLINE | ID: mdl-36008067

ABSTRACT

OBJECTIVES: As, cases of congenital syphilis (CS) and infectious syphilis among women more than doubled in Florida and across the nation during 2013-2019, we sought to understand what may be contributing to these increases in Florida. DESIGN: A two time-period observational study. SETTING: Pregnant women with reported syphilis infections and their pregnancy outcomes (2013-2014 and 2018-2019) in Florida. PARTICIPANTS: 1213 pregnant women with reported syphilis infections living in Florida and 341 infants meeting the CS case definition. OUTCOME MEASURES: We assessed what proportion of the increase in CS was from increases in maternal syphilis infections. We examined maternal demographics, infection characteristics and timing of diagnoses that could explain the increase in CS. Finally, we reviewed if changes in presentation or severity of CS cases occurred. RESULTS: During 2013-2014, 83 (21%) of 404 pregnant women with syphilis delivered babies with CS. During 2018-2019, 258 (32%) of 809 pregnant women with syphilis delivered babies with CS. Comparing CS prevention rates, it was determined that 65% of the increase in CS was due to the increases in maternal syphilis infections. The proportion of maternal cases staged as primary or secondary increased over time (7%-13%) (p<0.01) and reports of drug use became slightly more common (6%-10%) (p=0.02). During 2018-2019, women delivering CS infants were more likely to be reinfected during the same pregnancy (27 (10%) vs 5 (6%) p=0.23) and more had negative third trimester screening tests (43 (17%) vs 7 (8% p=0.07)). The percentage of infants with CS who had ≥1 sign or symptom increased from 35% to 40%, and the combined total of stillbirths and infant deaths increased from 5 to 26. CONCLUSIONS: Recently, more pregnant women are being infected with syphilis and a higher per cent are not being treated to prevent CS. The reasons for this finding are unclear.


Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Syphilis , Female , Florida/epidemiology , Humans , Infant , Observational Studies as Topic , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , Syphilis/diagnosis , Syphilis, Congenital/diagnosis , Syphilis, Congenital/epidemiology , Syphilis, Congenital/prevention & control
16.
J Emerg Med ; 63(2): 296-299, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36038437

ABSTRACT

BACKGROUND: Syphilis is a sexually transmitted infection that has been increasing in prevalence since the early 2000s. Ocular involvement occurs in a minority of patients and must be in the differential diagnosis for patients who present with red eye and uveitis. CASE REPORT: A 29-year-old woman presented to the emergency department with a painful, mydriatic red eye. Review of systems revealed a rash as well as a recent genital lesion and, on further questioning, she admitted to a history of intravenous drug use and high-risk sexual activity. Ophthalmology was consulted and the patient was diagnosed with bilateral uveitis. Serologic testing was positive for syphilis, and she was admitted and treated with intravenous penicillin, with resolution of her uveitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Red eye is a common ocular symptom in patients presenting to the emergency department. The differential diagnosis of the red eye is broad and can range from benign etiologies, such as conjunctivitis, to life- and sight-threatening conditions, such as endogenous endophthalmitis. Systemic diseases such as syphilis may present with primarily ocular symptoms, and ocular syphilis must be identified and managed appropriately to prevent devastating sequelae.


Subject(s)
Eye Infections, Bacterial , Syphilis , Uveitis , Adult , Eye Infections, Bacterial/complications , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Female , Humans , Mydriatics/therapeutic use , Penicillins/therapeutic use , Syphilis/complications , Syphilis/diagnosis , Syphilis/drug therapy , Uveitis/diagnosis , Uveitis/drug therapy , Uveitis/etiology , Vision Disorders
17.
Brasília, D.F.; OPAS; 2022-08-30. (OPAS-MS/BRA/CDE/22-0029).
Non-conventional in Portuguese | PAHO-IRIS | ID: phr2-56330

ABSTRACT

Embora o número de casos da sífilis no Brasil seja preocupante, o mais importante é a demonstração da necessidade de um reforço integrado de ações de vigilância, prevenção e controle da infecção para mudar o cenário nacional de liderança de sífilis e sífilis congênita na Região das Américas. Considerando a necessidade de dar continuidade às estratégias para controle da sífilis, previstas na Agenda de Ações Estratégicas, o evento buscou destacar os importantes resultados durante o biênio 2020-21 (anos auge da pandemia de COVID-19) e apresentar as recomendações que possam subsidiar os gestores do SUS para o alcance de melhores resultados até 2030. O evento foi realizado na OPAS e contou com a presença de representantes da SVS e SAPS do Ministério da Saúde (MS), CONASS, CONASEMS, OPAS /OMS, UNICEF, UNAIDS, UNESCO, 60 representantes de 12 estados e outras entidades. Nesse conjunto de realidades e aspirações, foi elaborado o “Relatório Técnico da Semana Nacional de Enfrentamento à Sífilis e Sífilis Congênita - 2021: que cenário nós queremos discutir nos próximos anos?" A atividade teve o objetivo de dar visibilidade aos resultados de projetos financiados pela OPAS, os quais abrangeram estratégias para o enfrentamento da sífilis e sífilis congênita. Optou-se por percorrer um caminho metodológico, considerando: um breve histórico-político que embasa a relevância do tema; diálogo e escuta qualificada com parceiros e atores estratégicos; os documentos técnicos e resoluções do MS e da OPAS, citados nas referências ao longo do relatório; e o registro das evidências.


Subject(s)
Syphilis , Syphilis, Congenital , Sexually Transmitted Diseases , Communicable Diseases , COVID-19 , Americas , Brazil
18.
Washington, D.C.; OPS; 2022-08-04.
in Spanish | PAHO-IRIS | ID: phr-56219

ABSTRACT

Esta tercera edición del documento sobre validación mundial de la eliminación de la transmisión maternoinfantil (ETMI) proporciona procesos estandarizados y criterios elaborados por consenso para validar la ETMI del VIH, la sífilis y el VHB, y para reconocer a los países con carga alta por estas enfermedades que han logrado avances significativos en el camino hacia la eliminación. Se hace especial hincapié en la rendición de cuentas dirigida por los países, el análisis riguroso, la evaluación intensiva de los programas y la colaboración a múltiples niveles, incluida la participación de las comunidades de mujeres con VIH o con VHB. Asimismo, se fomenta un enfoque armonizado para la triple eliminación, pero, dependiendo de su disposición operativa, los países pueden optar por centrarse en obtener la validación de ETMI única, doble o triple. Por último, en esta edición se actualizan los instrumentos y las listas de verificación en los ámbitos de la evaluación de los datos y los sistemas de vigilancia; los servicios de laboratorio; el programa, y los derechos humanos, la igualdad de género y la participación de la comunidad, que están disponibles en línea.


Subject(s)
HIV , Hepatitis B virus , Syphilis , HIV , Hepatitis B virus , Infectious Disease Transmission, Vertical , Infectious Disease Transmission, Vertical
20.
J Med Internet Res ; 24(8): e37850, 2022 08 25.
Article in English | MEDLINE | ID: mdl-36006685

ABSTRACT

BACKGROUND: HIV and sexually transmitted infections (STIs) are major global public health concerns. Over 1 million curable STIs occur every day among people aged 15 years to 49 years worldwide. Insufficient testing or screening substantially impedes the elimination of HIV and STI transmission. OBJECTIVE: The aim of our study was to develop an HIV and STI risk prediction tool using machine learning algorithms. METHODS: We used clinic consultations that tested for HIV and STIs at the Melbourne Sexual Health Centre between March 2, 2015, and December 31, 2018, as the development data set (training and testing data set). We also used 2 external validation data sets, including data from 2019 as external "validation data 1" and data from January 2020 and January 2021 as external "validation data 2." We developed 34 machine learning models to assess the risk of acquiring HIV, syphilis, gonorrhea, and chlamydia. We created an online tool to generate an individual's risk of HIV or an STI. RESULTS: The important predictors for HIV and STI risk were gender, age, men who reported having sex with men, number of casual sexual partners, and condom use. Our machine learning-based risk prediction tool, named MySTIRisk, performed at an acceptable or excellent level on testing data sets (area under the curve [AUC] for HIV=0.78; AUC for syphilis=0.84; AUC for gonorrhea=0.78; AUC for chlamydia=0.70) and had stable performance on both external validation data from 2019 (AUC for HIV=0.79; AUC for syphilis=0.85; AUC for gonorrhea=0.81; AUC for chlamydia=0.69) and data from 2020-2021 (AUC for HIV=0.71; AUC for syphilis=0.84; AUC for gonorrhea=0.79; AUC for chlamydia=0.69). CONCLUSIONS: Our web-based risk prediction tool could accurately predict the risk of HIV and STIs for clinic attendees using simple self-reported questions. MySTIRisk could serve as an HIV and STI screening tool on clinic websites or digital health platforms to encourage individuals at risk of HIV or an STI to be tested or start HIV pre-exposure prophylaxis. The public can use this tool to assess their risk and then decide if they would attend a clinic for testing. Clinicians or public health workers can use this tool to identify high-risk individuals for further interventions.


Subject(s)
Chlamydia Infections , Gonorrhea , HIV Infections , Sexually Transmitted Diseases , Syphilis , Algorithms , Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Internet , Machine Learning , Male , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control , Syphilis/diagnosis
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