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1.
Arq Neuropsiquiatr ; 79(2): 103-106, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33759975

RESUMEN

BACKGROUND: Syphilis is an endemic disease, particularly in low- and middle-income countries, with vascular involvement in large vessels (aortitis), but no clear relationship with stroke patients, except for those who presented with meningovascular neurosyphilis. OBJECTIVE: To investigate the relationship between a positive history of syphilis determined by serological testing and ischemic stroke etiology, particularly small vessel disease (SVD). METHODS: In total, 269 first-ever ischemic stroke patients admitted to the stroke unit were tested for syphilis. Patients with neurosyphilis were excluded. All patients were classified according to the ASCOD phenotyping as SVD - when SVD was the potential causal mechanism (S1) - or non-SVD - when SVD was uncertain (S2), unlike (S3), or not detected (S0). RESULTS: Syphilis was positive in 32 (12%) patients. When comparing patients with positive and negative serology, the only significant difference was SVD as the causal mechanism (S1) in patients with positive results: 9 (28%) vs. 22 (9%), p<0.01. CONCLUSION: The current study showed that the frequency of positive syphilis serological test was higher in patients with first-ever ischemic stroke and SVD as the potential causal mechanism. This finding could be related to the endothelial dysfunction occurring in syphilis.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular , Sífilis , Isquemia Encefálica/complicaciones , Humanos , Sífilis/complicaciones , Sífilis/epidemiología , Serodiagnóstico de la Sífilis
2.
Artículo en Inglés | MEDLINE | ID: mdl-33533807

RESUMEN

Syphilis, an infectious disease considered a global public health concern, can cause stillbirths and neonatal deaths. This highlights the importance of continuous surveillance studies among women of reproductive age. A cross-sectional study was carried out to analyze the prevalence and risk factors associated with Treponema pallidum infection in women assisted by primary health care units in Dourados, a city located in Mato Grosso do Sul State, Brazil, which borders Paraguay. A questionnaire was applied to a population-based sample, blood samples were collected for syphilis testing and multivariable analyses were performed to screen associations with T. pallidum infection. The prevalence of T. pallidum infection was 6.04%. Bivariate analysis showed that women referring multiple sexual partners (c2: 6.97 [p=0.014]), income less 2 minimal wages (c2: 15.93 [p=0.003]), who did not have high school (c2: 12.64 [p=0.005]), and reporting history of STIs (c2: 7.30 [p=0.018]) are more likely to have syphilis. In the multivariate analysis, a highest prevalence ratio was observed in women with income less than 2 minimal wages (PR: 0.96 [95% CI: 0.85 - 0.97]), and who did not have high school (PR: 0.94 [95% CI: 0.90 - 0.98]). In addition, 80% of the women reported irregular use of condoms and 63.89% declared having sexual intercourses with multiple partners, which creates more opportunities for the transmission of the infection. These results highlight the need for healthcare systems to implement initiatives to monitor syphilis screening and the commitment of patients and their sexual partners to the treatment in order to achieve a decrease of new cases.


Asunto(s)
Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Adulto , Anciano , Brasil/epidemiología , Ciudades , Condones , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Salud Pública , Estudios Seroepidemiológicos , Sífilis/diagnóstico , Sexo Inseguro
3.
Sex Transm Dis ; 48(5): 381-384, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33534404

RESUMEN

ABSTRACT: During the initial height of COVID-19 in New York State excluding New York City in March 2020, reports of sexually transmitted infections declined. Prediction models developed to estimate the incidence of early syphilis and gonorrhea during the COVID-19 pandemic were used to study impact on STI diagnoses/reporting and inform sexual health program planning.


Asunto(s)
Modelos Teóricos , Enfermedades de Transmisión Sexual/epidemiología , Gonorrea/epidemiología , Humanos , Incidencia , New York/epidemiología , Pandemias , Sífilis/epidemiología
4.
BMC Pregnancy Childbirth ; 21(1): 98, 2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33516183

RESUMEN

BACKGROUND: This study estimated the prevalence of curable sexually transmitted and reproductive tract infections (STIs/RTIs) among pregnant women attending antenatal care (ANC) in rural Zambia, evaluated the effectiveness of syndromic management of STIs/RTIs versus reference-standard laboratory diagnoses, and identified determinants of curable STIs/RTIs during pregnancy. METHODS: A total of 1086 pregnant women were enrolled at ANC booking, socio-demographic information and biological samples were collected, and the provision of syndromic management based care was documented. The Piot-Fransen model was used to evaluate the effectiveness of syndromic management versus etiological testing, and univariate and multivariate logistic regression analyses were used to identify determinants of STIs/RTIs. RESULTS: Participants had a mean age of 25.6 years and a mean gestational age of 22.0 weeks. Of 1084 women, 700 had at least one STI/RTI (64.6%; 95% confidence interval [CI], 61.7, 67.4). Only 10.2% of infected women received any treatment for a curable STI/RTI (excluding syphilis). Treatment was given to 0 of 56 women with chlamydia (prevalence 5.2%; 95% CI, 4.0, 6.6), 14.7% of participants with gonorrhoea (prevalence 3.1%; 95% CI, 2.2, 4.4), 7.8% of trichomoniasis positives (prevalence 24.8%; 95% CI, 22.3, 27.5) and 7.5% of women with bacterial vaginosis (prevalence 48.7%; 95% CI, 45.2, 51.2). An estimated 7.1% (95% CI, 5.6, 8.7) of participants had syphilis and received treatment. Women < 20 years old were more likely (adjusted odds ratio [aOR] = 5.01; 95% CI: 1.23, 19.44) to have gonorrhoea compared to women ≥30. The odds of trichomoniasis infection were highest among primigravidae (aOR = 2.40; 95% CI: 1.69, 3.40), decreasing with each subsequent pregnancy. Women 20 to 29 years old were more likely to be diagnosed with bacterial vaginosis compared to women ≥30 (aOR = 1.58; 95% CI: 1.19, 2.10). Women aged 20 to 29 and ≥ 30 years had higher odds of infection with syphilis, aOR = 3.96; 95% CI: 1.40, 11.20 and aOR = 3.29; 95% CI: 1.11, 9.74 respectively, compared to women under 20. CONCLUSIONS: Curable STIs/RTIs were common and the majority of cases were undetected and untreated. Alternative approaches are urgently needed in the ANC setting in rural Zambia.


Asunto(s)
Coinfección/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Infecciones del Sistema Genital/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Coinfección/diagnóstico , Coinfección/parasitología , Estudios Transversales , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Humanos , Modelos Logísticos , Análisis Multivariante , Embarazo , Atención Prenatal , Prevalencia , Infecciones del Sistema Genital/diagnóstico , Infecciones del Sistema Genital/parasitología , Población Rural , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/parasitología , Factores Socioeconómicos , Sífilis/epidemiología , Tricomoniasis/epidemiología , Vaginosis Bacteriana/epidemiología , Vaginosis Bacteriana/parasitología , Adulto Joven , Zambia/epidemiología
5.
Public Health ; 190: 62-66, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33360028

RESUMEN

OBJECTIVES: This study aimed to investigate the epidemiological characteristics of syphilis between 2013 and 2018 in the Haidian District of Beijing in China. In addition, this study suggests potential strategies to control the spread of syphilis infection. STUDY DESIGN: Observational study. METHODS: Data were collected from the Infectious Disease Reporting System at medical institutions within the Haidian District of Beijing between 2013 and 2018. Epidemiological methods, combined with Chi-squared test, were used to analyse the distribution of syphilis in terms of time, region, population and development stage. RESULTS: In total, 3048 patients with syphilis were reported in the Haidian District between 2013 and 2018, with an average annual prevalence of 14.26 per 100,000 population. The prevalence of syphilis was higher in rural than urban regions, and the sex ratio of male-to-female was 1.52:1. Patients aged 20-29 years accounted for 22.60% (689/3048) of the total cases. In terms of occupational distributions, the highest proportion (30.61%; 933/3048) was seen in individuals who were homemakers or unemployed. Latent syphilis was present in 66.83% (2037/3048) of patients and accounted for an increased proportion of syphilis cases each year. CONCLUSIONS: Syphilis was epidemic in the Haidian District of Beijing between 2013 and 2018. High prevalence was seen in young and middle-aged males living in urban areas. The prevalence of syphilis has been increasing since 2016; thus, public health policies and intervention strategies need to be strengthened to curb the spread of infection.


Asunto(s)
Población Rural/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Distribución por Sexo , Serodiagnóstico de la Sífilis , Adulto Joven
6.
Av. odontoestomatol ; 36(3): 161-173, sept.-dic. 2020. graf
Artículo en Español | IBECS | ID: ibc-197415

RESUMEN

INTRODUCCIÓN: la sífilis es una infección bacteriana, que se puede transmitir por contacto sexual o de forma congénita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. MATERIAL Y MÉTODO: se realizó una búsqueda en la base de datos PubMed, utilizándose como palabras clave: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "oral manifestations", "oral lesions". Como criterios de inclusión se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sífilis y trabajos en inglés y español. No hubo restricción por fecha. RESULTADOS: se seleccionaron un total de 18 artículos, la N total de pacientes fue de 201. El 10,05% padecía sífilis primaria, el 52,76% sífilis secundaria y el 36, 68% sífilis terciaria. Las lesiones orales predominantes de la sífilis primaria fueron úlceras, inflamación, chancro sifilítico; en la sífilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamación, lesiones papulares, lesiones maculares, lesiones erosivas; en la sífilis terciaria aparecen gomas sifilíticos, lesiones leucoplásicas y atrofia lingual. DISCUSIÓN: la sífilis es una infección bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnóstico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomática


INTRODUCTION: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. MATERIAL AND METHOD: a search was made in the PubMed database, using as keywords: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "Oral manifestations", "oral lesions". The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. RESULTS: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. DISCUSSION: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form


Asunto(s)
Humanos , Sífilis/patología , Sífilis/epidemiología , Enfermedades de la Boca/patología , Sífilis/diagnóstico , Boca/lesiones , Diagnóstico Diferencial , Penicilinas/administración & dosificación , Penicilina G Benzatina/administración & dosificación , Doxiciclina/administración & dosificación , Amoxicilina/administración & dosificación , Probenecid/administración & dosificación
7.
Rev Saude Publica ; 54: 105, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146297

RESUMEN

OBJECTIVE: To evaluate the prevalence of HIV, syphilis and hepatitis B infection among women deprived of liberty in the state of Roraima, Brazil, and its correlation with perceptions, knowledge and behavioral factors. METHOD: This is a cross-sectional study, with simple systematic sampling, conducted at the Public Female Prison in Boa Vista, State of Roraima, in 2017. A total of 168 inmates (93.8% of the population) were evaluated by in-person interviews and rapid tests. RESULTS: The prevalence of sexually transmitted infections (STI) was 20.2%, being 4.7% HIV, 15.5% syphilis, and 0.0% hepatitis B. Multivariate analysis confirmed as risk factors for acquiring an STI: being over 30 years of age [adjusted odds ratio (OR): 2.57; 95%CI 1.03-6.40); low schooling (adjusted OR: 2.77; 95%CI 1.08-5.05); little knowledge about condom use (adjusted OR: 2.37; 95%CI 1.01-7.31); and believing that there is no risk of contracting syphilis (adjusted OR: 2.36; 95%CI 1.08-6.50). CONCLUSION: The population deprived of liberty is a group of highly vulnerable to STI. The high prevalence of these infections can be explained by knowledge deficits on the subject, distorted perceptions and conditions peculiar to imprisonment, which result in risky behavior. We emphasize the need to implement educational programs for preventing, diagnosing and treating STI for this population.


Asunto(s)
Infecciones por VIH/epidemiología , Prisioneros/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos
8.
Rev Saude Publica ; 54: 109, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146299

RESUMEN

OBJECTIVE: To analyze the shortage of benzathine penicillin G (BPG), characterizing its temporal evolution and spatial distribution in the city of Rio de Janeiro from 2013 to 2017. METHODS: This ecological study used gestational and congenital syphilis notifications, BPG distribution records, and sociodemographic data from the population of Rio de Janeiro. To quantify the shortage, a BPG supply indicator was estimated per quarter for each neighborhood between 2013 and 2017. Thematic maps were created to identify areas and periods with greater BPG shortage, described according to sociodemographic factors, health services network, and epidemiological features in the incidence of syphilis. RESULTS: BPG shortage in Rio de Janeiro from 2013 to 2017 was not homogeneous in space nor in time. The temporal evolution and spatial distribution of BPG scarcity shows that the shortage affected the inhabitants of the municipality in different ways. Shortage was lower in 2013 and 2016 and more severe in 2014, 2015, and 2017, particularly in neighborhoods within the programmatic areas PA3 and PA5, poorer and with higher prevalence rates of gestational and congenital syphilis. CONCLUSIONS: Analyzing BPG shortage and its temporal evolution and spatial distribution in Rio de Janeiro allowed us to realize that the inhabitants are affected in different ways. Understanding this process contributes to the planning of actions to face shortage crises, minimizing possible impacts on the management of syphilis and reducing inequality in access to treatment.


Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Penicilina G Benzatina/provisión & distribución , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Brasil/epidemiología , Femenino , Humanos , Masculino , Penicilina G Benzatina/uso terapéutico , Embarazo , Análisis Espacio-Temporal , Sífilis/tratamiento farmacológico , Sífilis Congénita/tratamiento farmacológico
9.
PLoS One ; 15(10): e0239951, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33002081

RESUMEN

Sri Lanka has a low-level HIV epidemic. This study aims to provide evidence on HIV, syphilis and hepatitis B (HBV) prevalence, sexual risk behaviours and utilisation of HIV prevention interventions among female sex workers (FSW) in the cities Colombo, Galle, and Kandy. Using respondent-driven sampling (RDS), we recruited a total of 458 FSW in Colombo, 360 in Galle and 362 in Kandy from November 2017 to March 2018. Participants provided biological specimens for testing for infections and completed a behavioural questionnaire. We found no HIV nor HBV infections in Galle and Kandy, and low HIV (0.4%) and HBV surface antigen (0.6%) prevalence in Colombo. FSW in Colombo had higher positivity on Treponema pallidum-particle agglutination test (8.4%) compared to Galle (2.0%) and Kandy (2.5%). About two thirds of FSW heard of HIV in each of the cities. Around 90% of FSW used condom at last sex with a client in both Colombo and Galle, but considerably less in Kandy (57.1%). However, lower proportion of FSW used condoms every time during sex with clients in the past 30 day: 22.9% of FSW in Colombo, 26.6% in Kandy and 68.4% in Galle. Across cities, 17.5%-39.5% of FSW reported being tested for HIV in the past 12 months or knowing HIV positive status. The commonest reasons for never testing for HIV was not knowing where to test (54.2% in Colombo, 41.8% in Galle, 48.1% in Kandy) followed by inconvenient testing location (23.7% in Colombo and 31.1% in Kandy). HIV has not yet been firmly established among FSW in three cities in Sri Lanka, but the vulnerability towards HIV and STIs is substantial. HIV interventions should be intensified by expanding community-based HIV testing approaches, increasingawareness of HIV risks and addressing socio-structural vulnerabilities of FSW to HIV.


Asunto(s)
Seropositividad para VIH/epidemiología , Hepatitis B/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Serodiagnóstico del SIDA/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Sri Lanka , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sexo Inseguro/estadística & datos numéricos
10.
Rev Bras Epidemiol ; 23: e200103, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33053094

RESUMEN

OBJECTIVE: To analyze how syphilis detection rates evolved from 2011 to 2017 according to sex, age and place of residence in the state of São Paulo. METHODS: A historical series was organized with data from the Notification Disease Information System. The acquired syphilis detection rates (ASDR) per 100,000 inhabitants and the acquired syphilis detection rates including pregnant women with syphilis (PASDR) per 100,000 inhabitants were described. For a trend analysis of the rates in the studied period, the Poisson Jointpoint (inflection point) model was performed, and the annual percentage change (APC) per segment and the average annual percentage change (AAPC) were estimated, with respective 95% confidence intervals (95%CI). RESULTS: A total of 205,424 cases of acquired syphilis and syphilis in pregnant women in the period were reported. The ASDR per 100,000 inhabitants ranged from 26.0 to 84.6 between 2011 and 2017 and the PASDR per 100,000 inhabitants ranged from 33.7 to 108.9; the trend was increasing in both, and an inflection point was identified dividing the ASDR and PASDR curve into two periods: 2011 to 2013 and 2013 to 2017: the AAPC found for ASDR was 21.0% (95%CI 15.5 ‒ 26.4) and the PASDR was 21.2% (95%CI 16.4 ‒ 26.1), in the age groups up to 24 years old, there was a significant growth in both sexes. A heterogeneity in the evolution of rates by region of the state was observed between 2011 and 2017. CONCLUSIONS: The increasing trend in acquired syphilis detection rates can be attributed to better adherence to notification and disproportionate involvement of young people.


Asunto(s)
Notificación de Enfermedades/estadística & datos numéricos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Adolescente , Adulto , Brasil/epidemiología , Femenino , Humanos , Masculino , Embarazo , Adulto Joven
11.
BMC Public Health ; 20(1): 1526, 2020 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-33081743

RESUMEN

BACKGROUND: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. METHODS: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. RESULTS: Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)). CONCLUSIONS: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.


Asunto(s)
Trazado de Contacto/métodos , Amigos , Gonorrea/epidemiología , Red Social , Sífilis/epidemiología , Adolescente , Adulto , Baltimore/epidemiología , Revelación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual , Adulto Joven
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1313-1318, 2020 Aug 10.
Artículo en Chino | MEDLINE | ID: mdl-32867442

RESUMEN

Objective: To investigate the epidemiological characteristics of syphilis in Zhejiang province and to provide scientific basis for the development of syphilis prevention and control strategies. Methods: A descriptive epidemiological analysis was conducted on the incidence data of syphilis in Zhejiang from 2010 to 2019. Results: During the period, the incidence rate of syphilis decreased from 94.90/100 000 in 2010 to 53.53/100 000 in 2019 with an average decreasing rate of 6.16%. The annual decreases of the incidences of congenital syphilis, primary syphilis and secondary syphilis were all obvious, which were 43.47%, 21.38% and 14.19% respectively. The proportion of latent syphilis cases increased with year. Except for Lishui, the incidences of syphilis in the remaining 10 prefectures showed declining trends. The incidence rates in both men and women showed declining trends with the average rates of 4.80% and 6.45% respectively. The incidence peaks occurred in old men aged ≥60 years and in sexually active women aged 20-34 years, and the syphilis cases in age group ≥60 years increased significantly. The cases were mainly farmers, accounting for 43.00%. Conclusion: The incidence of syphilis in Zhejiang showed a decreasing trend, but the situation remains serious, indicating that the intensity and quality of the comprehensive prevention and control needs to be further strengthened.


Asunto(s)
Sífilis/epidemiología , Adulto , China/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Adulto Joven
13.
Rev Fac Cien Med Univ Nac Cordoba ; 77(3): 136-142, 2020 08 21.
Artículo en Español | MEDLINE | ID: mdl-32991112

RESUMEN

Introducción La sífilis constituye un problema de salud mundial. Objetivo: establecer la prevalencia de sífilis y la distribución según estadio en pacientes asistidos en el Servicio de Dermatología de Junio 2010 a Junio 2018, y comparar las características epidemiológicas que pudieran influir en el aumento de la prevalencia. Métodos Estudio de cohorte retrospectivo de pacientes ≥ 15 años, con diagnóstico de sífilis adquirida. Para el análisis de los datos se consideraron dos periodos: P1: 2010-2015 y P2: 2015-2018, de acuerdo al aumento de prevalencia observado en la vigilancia mensual, y la comparación entre variables considerando sífilis temprana y tardía. Resultados  Se incluyeron 1582 pacientes, 51% (805) en P1 y 49% (777) en P2. La prevalencia de sífilis global en nuestro servicio fue de 7,1 %, con un alto porcentaje de pacientes embarazadas y puérperas (54% del total de las mujeres). La prevalencia en P1 fue de 5,8%, y 9,3 % en P2 (p < 0,01). En P2 la sífilis temprana ascendió a un 53% (p< 0,01), disminuyeron los tratamientos completos y aumentaron los casos sin seguimiento. La sífilis temprana se asoció con menor edad, ausencia de pareja estable, y más consultas espontáneas y tratamientos completos. Conclusión Observamos un aumento sostenido de la prevalencia de sífilis adquirida, con un incremento de la sífilis temprana, que implica mayor riesgo de transmisión. También se evidenció menor adherencia al tratamiento y controles necesarios. La alta tasa de sífilis gestacional pone en alerta el déficit importante en los controles prenatales en nuestro sistema de salud. Introduction: Syphilis constitutes a global health problem. Objective: to establish the prevalence of syphilis and the distribution according to stage in patients assisted in the Dermatology Service from June 2010 to June 2018, and compare the epidemiological characteristics that could influence the increase in prevalence. Methods: Retrospective cohort study of patients ≥ 15 years, with diagnosis of acquired syphilis. For the analysis of the data, two periods were considered: P1: 2010-2015 and P2: 2015-2018, according to the increase in prevalence observed in the monthly surveillance, and the comparison between variables considering early and late syphilis. Results: 1582 patients were included, 51% (805) in P1 and 49% (777) in P2. The prevalence of global syphilis in our service was 7.1%, with a high percentage of pregnant and postpartum patients (54% of all women). The prevalence in P1 was 5.8%, and 9.3% in P2 (p <0.01). In P2, early syphilis amounted to 53% (p <0.01), complete treatments decreased and cases without follow-up increased. Early syphilis was associated with younger age, absence of a stable partner, and more spontaneous consultations and complete treatments. Conclusion: We observed a sustained increase in the prevalence of acquired syphilis, with an increase in early syphilis, which implies a greater risk of transmission. There was also less adherence to treatment and necessary controls. The high rate of gestational syphilis puts the significant deficit in prenatal controls in our health system on alert.


Asunto(s)
Sífilis , Femenino , Humanos , Embarazo , Prevalencia , Estudios Retrospectivos , Sífilis/epidemiología
14.
Artículo en Inglés | MEDLINE | ID: mdl-32963885

RESUMEN

In Samoa, the seroprevalence rates of sexually transmitted infections other than HIV have been endemically high over the past decade, despite years of prevention programming. Odds ratio and χ2 tests were conducted to compare the rates of positivity of chlamydia, gonorrhoea, hepatitis B and C, and syphilis across age groups from 2012 and 2017 surveillance data in Samoa. Young people aged 15-19 years were significantly more likely to have a chlamydia infection compared to all other age groups in both 2012 and 2017. Hepatitis B infections were more common in males and those aged 30 and above in both 2012 and 2017. Hepatitis C had no significant differences in age, but it was more common in males in 2012 and more common in females in 2017. Older age groups (aged 45 and above) were more likely to have a positive syphilis test in both 2014 and 2017 when compared to those aged 15-24 years. The results of this analysis confirm previously observed trends in Samoa for younger age groups' prevalence of chlamydia and gonorrhoea, and for older age groups' prevalence of hepatitis B and C. But the analysis also unexpectedly found that older age groups (aged 45 and above) are more likely to test positive for syphilis (for years 2014 and 2017). Further studies are needed to assess behavioural risk factors associated with older populations to explain the increase in risk and to design interventions suited to this demographic.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Gonorrea/epidemiología , Hepatitis/epidemiología , Sífilis/epidemiología , Adolescente , Adulto , Distribución por Edad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Samoa/epidemiología , Distribución por Sexo , Adulto Joven
15.
Western Pac Surveill Response J ; 11(1): 29-40, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32963889

RESUMEN

Objective: To estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15-49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs). Methods: The Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995-2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas. Results: Prevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sensitivity analyses. Discussion: This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO's Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Gonorrea/epidemiología , Sífilis/epidemiología , Adolescente , Adulto , Femenino , Fiji/epidemiología , Humanos , Micronesia/epidemiología , Persona de Mediana Edad , Modelos Estadísticos , Papúa Nueva Guinea/epidemiología , Prevalencia , Samoa/epidemiología , Adulto Joven
16.
PLoS One ; 15(9): e0239543, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32986767

RESUMEN

HIV prevalence is estimated to be 2.7% in South Sudan; however, little is known about the young country's epidemic. We conducted a respondent-driven sampling biobehavioral survey in Juba of female sex workers (FSW) aged ≥15 years who sold or exchanged sex in the last 6 months to learn more about this population. We enrolled 838 FSW from November 2015 to March 2016 and estimated HIV prevalence to be 37.8%. Prevalence of active syphilis was 7.3%. FSW were from South Sudan and most neighboring countries. Comprehensive knowledge of HIV was 11.1% and 64.2% of FSW had never spoken with an outreach worker. In multivariable analysis, HIV was associated with being from Uganda (aOR: 3.3, 95% CI: 1.7-6.1) or Kenya (aOR: 4.3, 95% CI: 1.5-13.0) versus from South Sudan. Our survey suggests that FSW may play a critical role in South Sudan's HIV epidemic and highlights the importance of tailoring services to the unique needs of FSW of all nationalities in Juba.


Asunto(s)
Infecciones por VIH/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Femenino , Humanos , Kenia/epidemiología , Prevalencia , Sudán del Sur/epidemiología , Encuestas y Cuestionarios , Uganda/epidemiología , Adulto Joven
17.
Waste Manag ; 118: 122-130, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32892089

RESUMEN

There are millions of waste pickers worldwide that are predominantly located in low- and middle-income countries. They survive on sorting and selling reusable orrecyclable materials discarded by society.While sorting, they are exposed to occupational risks and hazards, including cuts from sharp objects and medical wastes, that could be contaminated by infectious diseases. Because of these exposures, a study was conducted to determine the prevalence of syphilis and other sexually transmitted infections (STI's) among waste pickers. A cross-sectional study using a semi-structured questionnaire and blood samples for serological tests were collected. A total of 1,025 waste pickers were interviewed. Most participants were women (67.54%), without a partner (70.11%), were an average of 40 years old, and had between 3 and 4 children. There were 755 samples collected for syphilis, 791 for HIV, 866 for hepatitis B, and 859 for hepatitis C. Of these samples, 28 (3.70%) waste pickers had reagent serology for syphilis, 6 (0.75%) for HIV; 6 (0.69%) for acute hepatitis B and 1 (0.11%) for hepatitis C. Overall, this study identified the serological status of waste pickers; this information can be used to encourage waste pickers to seek health treatment for STIs and receive education to understand the risks associated with being exposed to medical waste or syringes.


Asunto(s)
Eliminación de Residuos , Enfermedades de Transmisión Sexual , Sífilis , Adulto , Brasil/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Reciclaje , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/epidemiología
18.
BMC Infect Dis ; 20(1): 684, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32948128

RESUMEN

BACKGROUND: Untreated male partners are a critical source of maternal re-infection. Contact tracing is a good way to identify infection among partners and reduce risk of mother-to-child transmission related to maternal re-infection. This study aimed to analyze the current situation and related factors of contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners. METHOD: Data of syphilis-seropositive pregnant women and their male partners attending clinic for syphilis-screening were obtained from the Shenzhen Program for Prevention of Congenital Syphilis. Contact tracing rate of syphilis-seropositive pregnant women and syphilis prevalence among male partners were counted, and related factors were also analyzed using a random-effects logistic regression model. RESULT: Of the 1299 syphilis-seropositive pregnant women, 74.1% (963/1299) had their male partners receiving syphilis-screening and 19.1% (184/963) of male partners were syphilis-infected. For pregnant women, being divorced (adjusted odds ratio [AOR] =0.39; 95%CI: 0.17-0.87), seeking for emergency services at their first antenatal clinics visits (AOR = 0.58; 95%CI: 0.44-0.77), reporting willingness to notify partner(AOR = 7.65; 95%CI: 4.69-12.49), multi-partners (AOR = 1.38; 95%CI:1.03-1.86) and having a history of drug abuse (AOR = 0.37; 95%CI: 0.14-1.00)were independently associated with successful contact tracing. For male partners, of minority ethnicity (AOR = 4.15; 95%CI: 1.66-10.34), age at first sex>20(AOR = 0.57; 95%CI: 0.37-0.87), reporting multi-partners (AOR = 1.60; 95%CI: 1.04-2.46), having a history of drug abuse (AOR = 4.07; 95%CI: 1.31-12.64) were independently associated with syphilis-infection. In addition, pregnant women with TRUST titer ≥1:8 (AOR = 2.81; 95%CI: 1.87-4.21), having a history of adverse pregnancy outcomes (AOR = 1.70; 95%CI: 1.14-2.53), reporting multi-partners (AOR = 0.43; 95%CI: 0.29-0.64) and reporting the current partner as the source of syphilis (AOR = 5.05; 95%CI: 2.82-9.03) were independently associated with partners' syphilis-infection. CONCLUSION: Contact tracing is feasible and effective in identifying syphilis-infected partners among syphilis-seropositive pregnant women. Contact tracing is associated with many factors such as women's marital status, services at their first antenatal clinics visit and willingness of partner notification. Partners' ethnicity, age at first sex, multi-partners and history of drug abuse as well as women's levels of TRUST titer were associated with partners' syphilis-infection.


Asunto(s)
Trazado de Contacto , Complicaciones Infecciosas del Embarazo/epidemiología , Sífilis/transmisión , Adolescente , Adulto , Instituciones de Atención Ambulatoria , China/epidemiología , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Modelos Logísticos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Oportunidad Relativa , Embarazo , Resultado del Embarazo , Mujeres Embarazadas , Prevalencia , Parejas Sexuales , Sífilis/epidemiología , Sífilis Congénita/prevención & control , Sífilis Congénita/transmisión , Adulto Joven
19.
Public Health Rep ; 135(1_suppl): 57S-64S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735188

RESUMEN

OBJECTIVES: California is experiencing a syphilis and congenital syphilis epidemic, and many persons diagnosed with syphilis report a history of recent incarceration or sexual contact with a person who has recently been incarcerated. Fresno County's local health department and jail collaborated to implement a routine syphilis screening policy for male adults aged 18-30 and female adults aged 18-35 booked into the facility. We evaluated syphilis screening, case finding, and treatment rates after implementation of the new policy. METHODS: We linked jail census and laboratory data to syphilis surveillance data to assess screening coverage, positivity, and treatment rates for age-eligible persons who were booked into Fresno County Jail from April 1, 2016, through December 31, 2017. RESULTS: Of 24 045 age-eligible persons who were booked into the jail during the study period, 5897 (24.5%) were female and 18 148 (75.5%) were male. Of 7144 (29.7%) persons who were screened for syphilis, 611 (8.6%) had a reactive rapid plasma reagin blood test result (16.4% [253 of 1546] of female adults; 6.4% [358 of 5598] of male adults) and 238 (3.3%) were newly diagnosed with syphilis, as confirmed by matching to the surveillance system (6.9% [106 of 1546] of female adults; 2.4% [132 of 5598] of male adults). Of persons identified with syphilis, 51.7% (n = 123 of 238) received adequate recommended treatment (59.4% [63 of 106] of female adults; 45.5% [60 of 132] of male adults). CONCLUSIONS: The age-based syphilis screening policy adopted in this jail yielded high positivity, including newly identified syphilis infections among female adults of childbearing age. The targeted screening policy was formalized in the county-negotiated contract with the jail's private correctional health care company in 2018-a strategy that can be replicated.


Asunto(s)
Tamizaje Masivo/organización & administración , Prisiones/organización & administración , Sífilis/diagnóstico , Sífilis/epidemiología , Adolescente , Adulto , California/epidemiología , Femenino , Humanos , Incidencia , Masculino , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Adulto Joven
20.
BMC Infect Dis ; 20(1): 617, 2020 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-32819294

RESUMEN

BACKGROUND: Millions of lives around the world are being saved annually through blood transfusion. However, blood transfusion is among the essential vehicles for transmitting infections. The overall prevalence of Transfusion Transmissible Infections among blood donors differs around the world, reflecting the variation in the prevalence of these infections. This study aims to assess the prevalence and trends of Transfusion Transmissible Infections among blood donors in Qatar. METHODS: This is a cross-sectional study utilizing donation records of 5 years from January 2013 to December 2017. We included in the study results for all screening and confirmatory tests for Hepatitis B Virus, Hepatitis C Virus, Human T-lymphotropic Virus-I/II, Syphilis and Malaria. RESULTS: Among the 190,509 donations received at the donation centre during the study period, about 91% of donations were received from males and 9% from females. The overall positivity rate for all tests was 1.87, 2.23, 1.78, 2.31, 2.67% for the years 2013 through 2017, with an increasing yearly trend by 6% each year. The overall positivity rates for Hepatitis C Virus, Human T-lymphotropic Virus-I/II, Hepatitis B Virus, Syphilis and Malaria (2013-2017) were 0.60, 0.18, 0.30, 0.43 and 0.20%, respectively. CONCLUSION: The overall positivity rate of all tests combined for the Transfusion Transmissible Infections demonstrated a gradually increasing trend from 2013 to 2017. However, the trend for each infection (Hepatitis C Virus, Hepatitis B Virus, Syphilis and Malaria) was fluctuating except for Human T-lymphotropic Virus-I/II, which was increasing. Supporting the development of effective prevention and control strategies requires further comprehensive investigations for better estimation of the burden of these infections.


Asunto(s)
Donantes de Sangre/estadística & datos numéricos , Reacción a la Transfusión/epidemiología , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por HTLV-II/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Humanos , Malaria/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Qatar/epidemiología , Sífilis/epidemiología , Adulto Joven
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