Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.361
Filtrar
1.
Rev Saude Publica ; 54: 120, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33295590

RESUMEN

OBJECTIVE: To analyze knowledge, attitudes and practices of university adolescents about syphilis. METHODS: Cross-sectional, analytical, census-type study, developed with the universe of adolescents aged 18 and 19 years (n = 598), enrolled in three institutions of higher education in a municipality of Piauí (n = 598), which total 20 courses in the areas of Health Sciences, Applied Social Sciences, Exact and Earth, Engineering and Linguistics, Letters and Art. Data collection occurred from March to May 2019, based on a questionnaire adapted from the Pesquisa de Conhecimentos, Atitudes e Práticas da População Brasileira of 2013 (PCAP - Survey of Knowledge, Attitudes and Practices in the Brazilian Population), consisting of questions related to sociodemographic variables (gender, family arrangement, father's schooling, mother's schooling, skin color or race, employment, household income), knowledge, attitude and practice regarding the disease, the last three being classified by scores. The variables that presented p ≤ 0.20 in the bivariate analysis, by Pearson's chi-square test, were included in three multivariate logistic models, and the outcomes in each model were knowledge, attitude and practice, respectively; remaining at the end those at the level of p < 0.05. RESULTS: Boys have a 39.6% lower chance of having adequate/regular knowledge (ORa = 0.604; 95%CI 0.415-0.878), whereas the highest chances are associated with "living alone, with relatives and friends" (ORa = 4.567; 95%CI 1.417-14.719) and having a very positive/positive attitude (ORa = 6.937; 95%CI 4.562-10.550). Lower chances of an adequate practice are associated with boys (ORa = 0.480; 95%CI 0.301-0.766) and lower father's schooling (ORa = 0.440; 95%CI 0.241-0.806). CONCLUSION: Most participants' knowledge and attitude regarding syphilis were not sufficient to the adoption of an adequate sexual practice for the prevention of the disease, showing the need to investigate other variables that may be implicated in this cognitive incoherence.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Estudiantes/psicología , Sífilis/prevención & control , Adolescente , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Estudiantes/estadística & datos numéricos , Universidades , Adulto Joven
2.
BMC Public Health ; 20(1): 1604, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33097015

RESUMEN

BACKGROUND: There are limited data globally on HIV in men who engage in casual and transactional sex with female tourists. METHODS: In 2018 we carried out a respondent-driven sampling (RDS) survey among beach boys in Galle, Sri Lanka, to determine prevalence of HIV and other infections, HIV risk behaviours and utilisation of HIV prevention services. Eligibility criteria included men who cruise in and around beach areas and who had anal and/or vaginal sex with female or male tourists in the 12 months before the survey. RESULTS: We recruited 373 beach boys. Approximately 49.6% of the participants were married, while 45.7% were single and 4.7% divorced, separated or widowed. A lower percentage of beach boys reported regular partners in the past 12 months (52.3%) compared to casual partners (95.4%). Condom use at last sex with a casual partner was higher (76.7%) compared to condom use with regular partners (58.3%). Condom use at last sex with a tourist was reported by 75.3%. Ever receiving money, goods or services in exchange for sex was reported by 39.7%. For 85.5% of beach boys who sold sex, the last paying partner was a tourist (85.5%) and a woman (82.0%). In the past 12 months before the survey, 32.3% of beach boys paid money for sex, and 99.5% did so from women. Ever been tested for HIV was reported by 35.3, and 69.1% of those were tested in the 6 months before the survey. In the adjusted multivariate analysis, significant correlates of never testing for HIV were lack of comprehensive knowledge about HIV and unprotected last sexual intercourse with tourists. The prevalent infections were: HIV, 0.3% (95% CI 0.0-0.4%); syphilis, 0.5% (0.0-1.2%); herpes virus type-2, 5.0% (2.5-7.5%). CONCLUSIONS: There are low level HIV and syphilis prevalence among beach boys in Galle but a high level of sexual risk taking. Beach boys may be acting as a bridge for HIV transmission between higher-risk groups (paying female tourists, men who have sex with men) and lower-risk heterosexual female population in Sri Lanka. More research is needed in South-East Asia on men who trade sexual services to female and male tourists.


Asunto(s)
Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Conductas de Riesgo para la Salud , Conducta Sexual , Parejas Sexuales , Turismo , Adolescente , Adulto , Anciano , Herpes Simple/epidemiología , Herpes Simple/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sri Lanka/epidemiología , Sífilis/epidemiología , Sífilis/prevención & control , Adulto Joven
3.
PLoS Pathog ; 16(9): e1008871, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32936831

RESUMEN

Deconvolution of syphilis pathogenesis and selection of candidate syphilis vaccinogens requires detailed knowledge of the molecular architecture of the Treponema pallidum outer membrane (OM). The T. pallidum OM contains a low density of integral OM proteins, while the spirochete's many lipoprotein immunogens are periplasmic. TP0751, a lipoprotein with a lipocalin fold, is reportedly a surface-exposed protease/adhesin and protective antigen. The rapid expansion of calycin/lipocalin structures in the RCSB PDB database prompted a comprehensive reassessment of TP0751. Small angle X-ray scattering analysis of full-length protein revealed a bipartite topology consisting of an N-terminal, intrinsically disordered region (IDR) and the previously characterized C-terminal lipocalin domain. A DALI server query using the lipocalin domain yielded 97 hits, 52 belonging to the calycin superfamily, including 15 bacterial lipocalins, but no Gram-negative surface proteins. Surprisingly, Tpp17 (TP0435) was identified as a structural ortholog of TP0751. In silico docking predicted that TP0751 can bind diverse ligands along the rim of its eight-stranded ß-barrel; high affinity binding of one predicted ligand, heme, to the lipocalin domain was demonstrated. qRT-PCR and immunoblotting revealed very low expression of TP0751 compared to other T. pallidum lipoproteins. Immunoblot analysis of immune rabbit serum failed to detect TP0751 antibodies, while only one of five patients with secondary syphilis mounted a discernible TP0751-specific antibody response. In opsonophagocytosis assays, neither TP0751 nor Tpp17 antibodies promoted uptake of T. pallidum by rabbit peritoneal macrophages. Rabbits immunized with intact, full-length TP0751 showed no protection against local or disseminated infection following intradermal challenge with T. pallidum. Our data argue that, like other lipoprotein lipocalins in dual-membrane bacteria, TP0751 is periplasmic and binds small molecules, and we propose that its IDR facilitates ligand binding by and offloading from the lipocalin domain. The inability of TP0751 to elicit opsonic or protective antibodies is consistent with a subsurface location.


Asunto(s)
Proteínas Bacterianas/inmunología , Vacunas Bacterianas/inmunología , Inmunización , Lipoproteínas/inmunología , Sífilis/inmunología , Treponema pallidum/inmunología , Animales , Proteínas Bacterianas/genética , Vacunas Bacterianas/genética , Humanos , Lipoproteínas/genética , Dominios Proteicos , Pliegue de Proteína , Conejos , Sífilis/genética , Sífilis/patología , Sífilis/prevención & control , Treponema pallidum/genética , Treponema pallidum/patogenicidad
4.
Arch Pathol Lab Med ; 144(11): 1344-1351, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-32810868

RESUMEN

CONTEXT.­: Sexually transmitted infections (STIs) are among the most common communicable diseases globally and are associated with significant morbidity and mortality worldwide. Point-of-care tests have the potential to revolutionize the prevention and control of STIs by enabling rapid diagnosis and early treatment of infections, thus interrupting transmission and preventing the sequelae of untreated infections. Currently, there are several point-of-care (POC) tests available for the diagnosis of Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infections, although these tests differ with regard to their performance, turnaround time, and cost. OBJECTIVE.­: To provide an updated review of the POC tests available and under development for the diagnosis of T pallidum, C trachomatis, N gonorrhoeae, and T vaginalis infections, to discuss the context for which these tests might be used, and to highlight future directions for test development. DATA SOURCES.­: We reviewed the literature pertaining to the recent development and performance evaluations of POC tests for the diagnosis of syphilis, chlamydia, gonorrhea, and trichomonas. CONCLUSIONS.­: Recently, there has been rapid development of new POC tests for STIs. Although there are inexpensive, rapid, and accurate POC tests available for syphilis, there are few such tests available for the diagnosis of chlamydia, gonorrhea, or trichomonas, and currently none with the ability to detect antimicrobial resistance in N gonorrhoeae. Research evaluating implementation strategies for the currently available tests and the development of additional POC tests that are rapid, accurate, and affordable are urgently needed to address the rising number of STIs worldwide.


Asunto(s)
Tamizaje Masivo/métodos , Pruebas en el Punto de Atención/normas , Enfermedades de Transmisión Sexual/diagnóstico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/prevención & control , Diagnóstico Precoz , Gonorrea/diagnóstico , Gonorrea/prevención & control , Humanos , Tamizaje Masivo/economía , Pruebas en el Punto de Atención/economía , Pruebas en el Punto de Atención/estadística & datos numéricos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Enfermedades de Transmisión Sexual/prevención & control , Sífilis/diagnóstico , Sífilis/prevención & control
5.
BMC Infect Dis ; 20(1): 405, 2020 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-32522244

RESUMEN

BACKGROUND: Syphilis is a sexually and vertically transmitted infection caused by the bacteria Treponema pallidum for which there are few proven alternatives to penicillin for treatment. For pregnant women infected with syphilis, penicillin is the only WHO-recommended treatment that will treat the mother and cross the placenta to treat the unborn infant and prevent congenital syphilis. Recent shortages, national level stockouts as well as other barriers to penicillin use call for the urgent identification of alternative therapies to treat pregnant women infected with syphilis. METHODS: This prospective, randomized, non-comparative trial will enroll non-pregnant women aged 18 years and older with active syphilis, defined as a positive rapid treponemal and a positive non-treponemal RPR test with titer ≥1:16. Women will be a, domized in a 2:1 ratio to receive the oral third generation cephalosporin cefixime at a dose of 400 mg two times per day for 10 days (n = 140) or benzathine penicillin G 2.4 million units intramuscularly based on the stage of syphilis infection (n = 70). RPR titers will be collected at enrolment, and at three, six, and nine months following treatment. Participants experiencing a 4-fold (2 titer) decline by 6 months will be considered as having an adequate or curative treatment response. DISCUSSION: Demonstration of efficacy of cefixime in the treatment of active syphilis in this Phase 2 trial among non-pregnant women will inform a proposed randomized controlled trial to evaluate cefixime as an alternative treatment for pregnant women with active syphilis to evaluate prevention of congenital syphilis. TRIAL REGISTRATION: Trial identifier: www.Clinicaltrials.gov, NCT03752112. Registration Date: November 22, 2018.


Asunto(s)
Antibacterianos/uso terapéutico , Cefixima/uso terapéutico , Sífilis/tratamiento farmacológico , Brasil/epidemiología , Protocolos de Ensayos Clínicos como Asunto , Ensayos Clínicos Fase II como Asunto , Femenino , Humanos , Penicilina G Benzatina/uso terapéutico , Distribución Aleatoria , Sífilis/microbiología , Sífilis/prevención & control , Resultado del Tratamiento , Treponema pallidum/efectos de los fármacos , Treponema pallidum/aislamiento & purificación
6.
BMC Infect Dis ; 20(1): 444, 2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-32576149

RESUMEN

BACKGROUND: The syphilis epidemic continues to cause substantial morbidity and mortality worldwide, particularly in low- and middle-income countries, despite several recent disease control initiatives. Though our understanding of the pathogenesis of this disease and the biology of the syphilis agent, Treponema pallidum subsp. pallidum has improved over the last two decades, further research is necessary to improve clinical diagnosis and disease management protocols. Additionally, such research efforts could contribute to the identification of possible targets for the development of an effective vaccine to stem syphilis spread. METHODS: This study will recruit two cohorts of participants with active syphilis infection, one with de novo infection, one with repeat infection. Whole blood specimens will be collected from each study participant at baseline, 4, 12, 24, 36, and 48 weeks, to track specific markers of their immunological response, as well as to compare humoral reactivity to Treponema pallidum antigens between the two groups. Additionally, we will use serum specimens to look for unique cytokine patterns in participants with early syphilis. Oral and blood samples, as well as samples from any syphilitic lesions present, will also be collected to sequence any Treponema pallidum DNA found. DISCUSSION: By furthering our understanding of syphilis pathogenesis and human host immune response to Treponema pallidum, we will provide important data that will help in development of new point-of-care tests that could better identify active infection, leading to improved syphilis diagnosis and management. Findings could also contribute to vaccine development efforts.


Asunto(s)
Vacunas Bacterianas/uso terapéutico , Sífilis/epidemiología , Sífilis/prevención & control , Treponema pallidum/inmunología , Vacunación , Antígenos Bacterianos/inmunología , Secuencia de Bases , Estudios de Cohortes , Citocinas/análisis , ADN Bacteriano/genética , Estudios de Seguimiento , Humanos , Tipificación Molecular , Perú/epidemiología , Sífilis/sangre , Sífilis/inmunología , Treponema pallidum/genética
7.
Einstein (Sao Paulo) ; 18: eAO4978, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32428062

RESUMEN

Objective To determine the prevalence of syphilis and the associated risk factors in a female prison unit. Methods This was a cross-sectional study including 113 women whom data were collected in two stages: first, blood test to check for syphilis seropositivity; and then collection of information through a form to assess risk situations for sexually transmitted infections. Results Overall, syphilis prevalence was found to be 22.1% among the female prison population (n=25) and 28.6% among pregnant women. A statistically significant relationship was found between syphilis infection and previous history of sexually transmitted infections (p=0.04). However, most participants diagnosed with the disease were unaware of a history of sexually transmitted infection in the last 12 months (n=20/80.0%). The use of condom with fixed partners was considered to be a protective factor (odds ratio of 0.76; 95% of confidence interval 0.68-0.85). Conclusion The prevalence of syphilis among the female prison population was high, particularly among pregnant women. Preventive and therapeutic measures as well as appropriate prenatal care can minimize the impact of syphilis in prison systems and, consequently, improve such health outcomes nationwide.


Asunto(s)
Sífilis/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sífilis/prevención & control , Adulto Joven
8.
Int J STD AIDS ; 31(7): 613-618, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32366180

RESUMEN

The sexual health services in the Birmingham and Solihull area of the United Kingdom, called Umbrella, has been offering home-based testing for sexually transmitted infections to patients since August 2015. The aim of this service evaluation was to evaluate the uptake, return rate and new diagnosis rates of home-based testing in comparison with clinic-based testing for human immunodeficiency virus (HIV), syphilis (STS) and hepatitis B. Home-based testing, although popular, had low uptake amongst high-risk groups such as men who have sex with men (MSM), compared to the clinic-based group (1% versus 11%, p < 0.001). This resulted in low positivity rates for HIV (0.02%) and STS (0.17%) and no new cases of hepatitis B in the home-based group. Therefore, our results show that home-based testing is not a cost-effective method of testing for HIV and likely this is also the case for hepatitis B and STS. Our recommendation would be to encourage uptake of home-based testing in high-risk groups such as MSM and Black Africans to improve the diagnosis rates of HIV, STS and hepatitis B. Alternatively, the continuation of home-based blood testing in the Birmingham and Solihull area will need to be reviewed by Umbrella as a cost-saving strategy for the service in the future.


Asunto(s)
Instituciones de Atención Ambulatoria/estadística & datos numéricos , Prestación de Atención de Salud/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Tamizaje Masivo/métodos , Autocuidado/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Sífilis/diagnóstico , Sífilis/prevención & control , Adolescente , Adulto , Autoevaluación Diagnóstica , Femenino , Infecciones por VIH/psicología , Hepatitis B/psicología , Virus de la Hepatitis B , Humanos , Masculino , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/psicología , Sífilis/psicología , Serodiagnóstico de la Sífilis , Treponema pallidum , Reino Unido , Adulto Joven
9.
PLoS Negl Trop Dis ; 14(5): e0008078, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32463835
10.
J Glob Health ; 10(1): 010504, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32280458

RESUMEN

Background: Countdown to 2030 (CD2030) tracks progress in the 81 countries that account for more than 90% of under-five child deaths and 95% of maternal deaths in the world. In 2017, CD2030 identified syphilis screening and treatment during antenatal care (ANC) as priority indicators for monitoring. Methods: Country-reported data in the UNAIDS Global AIDS Monitoring System (GAM) system were used to evaluate four key syphilis indicators from CD2030 countries: (1) maternal syphilis screening and (2) treatment coverage during ANC, (3) syphilis seroprevalence among ANC attendees, and (4) national congenital syphilis (CS) case rates. A cascade analysis for CD2030 countries with coverage data for the number of women attending at least 4 antenatal care visits (ANC4), syphilis testing, seroprevalence and treatment was performed to estimate the number of CS cases that were attributable to missed opportunities for syphilis screening and treatment during antenatal care. Results: Of 81 countries, 52 (64%) reported one or more values for CS indicators into the GAM system during 2016-2017; only 53 (65%) had maternal syphilis testing coverage, 41 (51%) had screening positivity, and 40 (49%) had treatment coverage. CS case rates were reported by 13 (16%) countries. During 2016-2017, four countries reported syphilis screening and treatment coverage of ≥95% consistent with World Health Organization (WHO) targets. Sufficient data were available for 40 (49%) of countries to construct a cascade for data years 2016 and 2017. Syphilis screening and treatment service gaps within ANC4 resulted in an estimated total of 103 648 adverse birth outcomes with 41 858 of these occurring as stillbirths among women attending ANC4 (n = 31 914 408). Women not in ANC4 (n = 25 619 784) contributed an additional 67 348 estimated adverse birth outcomes with 27 198 of these occurring as stillbirths for a total of 69 056 preventable stillbirths attributable to syphilis in these 40 countries. Conclusion: These data and findings can serve as an initial baseline evaluation of antenatal syphilis surveillance and service coverage and can be used to guide improvement of delivery and monitoring of syphilis screening and treatment in ANC for these priority countries.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Sífilis/diagnóstico , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Tamizaje Masivo , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal , Sífilis/epidemiología , Sífilis/prevención & control , Sífilis Congénita/diagnóstico , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control , Organización Mundial de la Salud
11.
BMC Public Health ; 20(1): 480, 2020 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-32276624

RESUMEN

BACKGROUND: Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to determine the husband's willingness-to-pay (WTP) for his HIV and syphilis screening tests and potential factors affecting STI screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. METHODS: A pilot open-ended interview was conducted among 50 participants to estimate the mean and standard deviation of WTP prices for HIV and syphilis screening tests. A questionnaire was developed to obtain demographics, STI knowledge and screening history, as well as two contingent valuation methods (bidding and payment scale), using the mean WTP prices identified from the pilot study as a starting WTP with »SD step-up/down. The survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. Descriptive statistics and logistic regression were used for data analysis. RESULTS: During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP prices for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the WTP prices from the bidding method. CONCLUSIONS: The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.


Asunto(s)
Financiación Personal , Infecciones por VIH/prevención & control , Tamizaje Masivo/economía , Esposos/psicología , Sífilis/prevención & control , Adulto , Instituciones de Atención Ambulatoria , Femenino , Humanos , Masculino , Proyectos Piloto , Embarazo , Atención Prenatal , Esposos/estadística & datos numéricos , Encuestas y Cuestionarios , Tailandia , Cobertura Universal del Seguro de Salud
12.
Sex Transm Infect ; 96(5): 342-347, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32241905

RESUMEN

OBJECTIVES: In 2016, WHO estimated 376 million new cases of the four main curable STIs: gonorrhoea, chlamydia, trichomoniasis and syphilis. Further, an estimated 290 million women are infected with human papillomavirus. STIs may lead to severe reproductive health sequelae. Low-income and middle-income countries carry the highest global burden of STIs. A large proportion of urogenital and the vast majority of extragenital non-viral STI cases are asymptomatic. Screening key populations and early and accurate diagnosis are important to provide correct treatment and to control the spread of STIs. This article paints a picture of the state of technology of STI point-of-care testing (POCT) and its implications for health system integration. METHODS: The material for the STI POCT landscape was gathered from publicly available information, published and unpublished reports and prospectuses, and interviews with developers and manufacturers. RESULTS: The development of STI POCT is moving rapidly, and there are much more tests in the pipeline than in 2014, when the first STI POCT landscape analysis was published on the website of WHO. Several of the available tests need to be evaluated independently both in the laboratory and, of particular importance, in different points of care. CONCLUSION: This article reiterates the importance of accurate, rapid and affordable POCT to reach universal health coverage. While highlighting the rapid technical advances in this area, we argue that insufficient attention is being paid to health systems capacity and conditions to ensure the swift and rapid integration of current and future STI POCT. Unless the complexity of health systems, including context, institutions, adoption systems and problem perception, are recognised and mapped, simplistic approaches to policy design and programme implementation will result in poor realisation of intended outcomes and impact.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Pruebas en el Punto de Atención/organización & administración , Enfermedades de Transmisión Sexual/diagnóstico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Infecciones por Chlamydia/transmisión , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Humanos , Ciencia de la Implementación , Masculino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/prevención & control , Infecciones por Mycoplasma/transmisión , Mycoplasma genitalium , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/prevención & control , Sífilis/transmisión , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/prevención & control , Vaginitis por Trichomonas/transmisión
13.
Sci Rep ; 10(1): 5472, 2020 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-32214152

RESUMEN

The Spectrum-STI model, structured by sub-groups within a population, was used in a workshop in Yunnan, China, to estimate provincial trends in active syphilis in 15 to 49-year-old adults. Syphilis prevalence data from female sex workers (FSW), men who have sex with men (MSM), and lower-risk women and men in Yunnan were identified through literature searches and local experts. Sources included antenatal care clinic screening, blood donor screening, HIV/STI bio-behavioural surveys, sentinel surveillance, and epidemiology studies. The 2017 provincial syphilis prevalence estimates were 0.26% (95% confidence interval 0.17-0.34%) in women and 0.28% (0.20-0.36%) in men. Estimated prevalence was 6.8-fold higher in FSW (1.69% (0.68-3.97%) than in lower-risk women (0.25% (0.18-0.35%)), and 22.7-fold higher in MSM (5.35% (2.74-12.47%) than in lower-risk men (0.24% (0.17-0.31%). For all populations, the 2017 estimates were below the 2005 estimates, but differences were not significant. In 2017 FSW and MSM together accounted for 9.3% of prevalent cases. These estimates suggest Yunnan's STI programs have kept the overall prevalence of syphilis low, but prevalence remains high in FSW and MSM. Strengthening efforts targeting FSW and MSM, and identification of other risk populations e.g. among heterosexual men, are critical to reduce syphilis.


Asunto(s)
Vigilancia de Guardia , Sífilis/epidemiología , Adolescente , Adulto , China/epidemiología , Femenino , Heterosexualidad , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Riesgo , Factores de Riesgo , Trabajadores Sexuales , Sífilis/diagnóstico , Sífilis/prevención & control , Adulto Joven
16.
Clin Infect Dis ; 70(1): 136-139, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31237616

RESUMEN

Syphilis control programs have been scaled up due to the substantial burden in China. We analyzed syphilis incidence according to demographic, spatiotemporal, and economic factors. The increasing latent syphilis diagnoses and declining congenital syphilis suggest the effectiveness of scale-up screening. However, primary and secondary cases persist, especially in inland provinces.


Asunto(s)
Sífilis Congénita , Sífilis , China/epidemiología , Humanos , Incidencia , Análisis Espacio-Temporal , Sífilis/diagnóstico , Sífilis/epidemiología , Sífilis/prevención & control , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control
18.
Rev. Esc. Enferm. USP ; 54: e03645, 2020. tab, graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1143709

RESUMEN

RESUMO Objetivo Identificar os fatores relacionados ao processo de trabalho no que se refere à adesão das equipes de Atenção Primária ao teste rápido para HIV, sífilis, hepatites B e C durante o acompanhamento do pré-natal e a administração da penicilina benzatina na atenção primária à saúde. Método Estudo descritivo, exploratório, quantitativo, realizado entre os meses de julho e novembro de 2018, com profissionais das equipes da Estratégia de Saúde da Família do Seridó Norte-Rio-Grandense. Resultados Participaram do estudo 18 municípios, 94 Unidades Básicas de Saúde e 100 equipes de Estratégia de Saúde da Família. O enfermeiro era o principal envolvido no serviço de testagem, 93% das equipes entrevistadas ofereciam o teste na rotina do serviço. Dessas equipes, 97,8% realizavam a testagem no pré-natal, 51,6% disponibilizavam o teste para a gestante no início do terceiro trimestre e 57% ofereciam o teste rápido para os(as) parceiros(as) sexuais. A penicilina benzantina estava disponível em 87,1% das equipes, todavia, 49,5% não administravam a medicação na atenção primária. Conclusão O processo de testagem se mostrava fragilizado, pois, mesmo havendo disponibilidade do teste no pré-natal, as demais atividades interligadas ao processo de trabalho não ocorriam adequadamente.


RESUMEN Objetivo Identificar los factores relacionados con el proceso de trabajo relativo a la adhesión de los equipos de atención primaria a las pruebas rápidas de detección del VIH, la sífilis y la hepatitis B y C durante el seguimiento prenatal y la administración de penicilina benzatínica en la atención primaria de salud. Método Estudio descriptivo, exploratorio y cuantitativo, realizado entre julio y noviembre de 2018, con profesionales de la Estrategia de Salud Familiar de la región Seridó en el Río Grande do Norte. Resultados Participaran del estudio 18 municipios, 94 Unidades básicas de salud y 100 equipos de Estrategia de Salud Familiar. El enfermero fue el principal involucrado en el servicio de pruebas, el 93% de los equipos entrevistados ofrecieron la prueba en la rutina del servicio. De estos equipos, 97,8% realizó la prueba prenatal, 51,6% puso la prueba a disposición de la mujer embarazada al principio del tercer trimestre y el 57% ofreció la prueba rápida para parejas sexuales. El 87,1% de los equipos disponía de penicilina benzatina, pero el 49,5% no la administraba en la atención primaria. Conclusión El proceso de prueba se debilitó porque, aunque la prueba estaba disponible en el período prenatal, las demás actividades relacionadas con el proceso de trabajo no se desarrollaron adecuadamente.


ABSTRACT Objective To identify the factors related to the work process regarding the adherence of Primary Healthcare teams to the rapid test for HIV, syphilis, hepatitis B and C during prenatal care and administration of benzathine penicillin in primary healthcare. Method A descriptive, exploratory and quantitative study conducted between the months of July and November 2018, with professionals from the Family Health Strategy teams of the Seridó Norte-Rio-Grandense region in Rio Grande do Norte State, Brazil. Results There were 18 municipalities, 94 Basic Health Units and 100 Family Health Strategy teams which participated in the study. The nurse was the main person involved in the testing service, and 93% of the interviewed teams offered the test in the service routine. Of these teams, 97.8% underwent prenatal testing, 51.6% offered the test to the pregnant woman at the beginning of the third trimester, and 57% offered the rapid test to sexual partners. Benzantine penicillin was available in 87.1% of the teams; however, 49.5% did not administer the medication in primary healthcare. Conclusion The testing process proved to be fragile because even if the test was available in prenatal care, the other activities linked to the work process did not occur properly.


Asunto(s)
Humanos , Atención Prenatal , Sífilis/prevención & control , VIH , Estrategia de Salud Familiar , Pruebas en el Punto de Atención , Hepatitis Viral Humana/prevención & control , Personal de Salud , Enfermería de Atención Primaria
19.
Infect Dis Poverty ; 8(1): 97, 2019 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-31791415

RESUMEN

BACKGROUND: Low-fee female sex workers (FSWs) are at high risk of acquiring and spreading human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) in China. There is an urgent need to develop comprehensive intervention measures targeted towards low-fee FSWs to reduce HIV/STD infections. Thus, this study aimed to reduce HIV/STD infections among low-fee FSW through a matched-pair, community-based randomized intervention trial carried out in 12 cities in three provinces in China. METHODS: Four cities from Guangxi Zhuang Autonomous Region, four from Yunnan Province, and four from Hunan Province were paired and participants received either the intervention package (including condom promotion, HIV and syphilis testing, reimbursement for syphilis treatment costs, and free anti-retroviral therapy or the current standard of care. Venue-based, convenience sampling was used to recruit FSWs. A face-to-face interview and HIV and syphilis blood testing was conducted at baseline and follow-up intervals of 24 months. Generalized linear mixed models (GLMM) were used to evaluate the effect of the intervention package on reducing HIV/STD infection in the FSWs. RESULTS: A total of 1024 eligible FSWs were enrolled in the baseline survey and 843 in the follow-up. GLMM results showed that syphilis infection was reduced by 49% in the intervention group compared to the current standard of care group (P = 0.0378, OR = 0.51, 95% CI: 0.27-0.96). FSWs aged 35 years or older were 2.38 times more likely to get syphilis infection compared to those younger than 35 years old (P <  0.0001, OR = 2.38, 95% CI: 1.55-3.65). The risk of syphilis infection among more educated FSWs was 0.43 times less than those with lower levels of education (P <  0.05, OR = 0.43, 95% CI: 0.63-0.93). CONCLUSIONS: This study demonstrates that comprehensive interventions can lead to significant declines in syphilis infection amongst low-tier FSWs. Integrating both behavioral and biomedical intervention measures should be considered when developing programs for low-fee FSWs. TRIAL REGISTRATION: CHiCTR-TRC-12002655.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Renta/estadística & datos numéricos , Trabajadores Sexuales/estadística & datos numéricos , Sífilis/prevención & control , Adulto , China , Control de Enfermedades Transmisibles/economía , Investigación Participativa Basada en la Comunidad , Femenino , Humanos , Persona de Mediana Edad , Trabajadores Sexuales/clasificación , Adulto Joven
20.
Sci Rep ; 9(1): 19547, 2019 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-31862938

RESUMEN

The aim of this study was to evaluate the effectiveness of preventing mother to child syphilis transmission to improve pregnancy outcomes. We performed a retrospective analysis of municipal databases of mother-to-child syphilis transmission. Pregnant women with syphilis were included. Group specific pregnancy outcomes were analyzed according to treatment. A total of 28 pregnant women were diagnosed with syphilis in 2012; 321 were diagnosed with syphilis in 2018. A prevalence of 0.14% was observed amongst pregnant women in Suzhou city from 2012-2018. Primary treatments included benzathine penicillin, ceftriaxone sodium or erythromycin when patients were allergic to Benzathine penicillin. The treatment coverage was 81.57%, and only 52.86% of pregnant women were adequately treated. Adverse pregnant outcomes were higher amongst untreated women. Expanding early screening coverage and promoting treatment were key to improving pregnancy outcomes amongst women with syphilis.


Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Sífilis/prevención & control , Sífilis/transmisión , Adulto , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Eritromicina/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Penicilina G Benzatina/uso terapéutico , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo , Atención Prenatal , Estudios Retrospectivos , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA