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1.
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
2.
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
4.
Rev Bras Epidemiol ; 23: e200012, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32130400

RESUMEN

INTRODUCTION: Syphilis is a sexually transmitted disease, easy to diagnose and treat, but whose incidence is increasing in Brazil. This study estimated the prevalence of the non-performance of serological tests for syphilis during prenatal care, in addition to evaluating its trend and identifying its associated factors in the municipality of Rio Grande, Rio Grande do Sul, Southern Brazil. METHODS: This is a cross-sectional survey that included all pregnant women living in this municipality who gave birth between January 1 and December 31, 2007, 2010, and 2013. A single standardized questionnaire was administered to the mothers within 48 hours of delivery, while they were still in the maternity ward. We used the χ2 test for proportions and linear trend, and Poisson regression with robust adjustment in the multivariate analysis. The effect measure adopted was prevalence ratio (PR). RESULTS: Among the 7,351 mothers who had at least one prenatal visit, the prevalence of non-performance of serological tests for syphilis in the three years studied was 2.9% (95% confidence interval - 95%CI 2.56 - 3.33), with 3.3% (95%CI 2.56 - 3.97) in 2007, 2.8% (95%CI 2.20 - 3.52) in 2010, and 2.7% (95%CI 2.12 - 3.38) in 2013. Black mothers, those with low household income and schooling, and who had few prenatal visits showed higher PR of non-performance of this test. DISCUSSION: The prevalence of non-performance has virtually not changed in the period, and women with high-risk pregnancy showed a greater probability of not undergoing the test. CONCLUSIONS: This municipality needs to reach mothers with lower socioeconomic status, restructure the local health services, and enhance their operationalization to improve the quality of prenatal care.


Asunto(s)
Atención Prenatal/métodos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Análisis Multivariante , Distribución de Poisson , Embarazo , Embarazo de Alto Riesgo , Prevalencia , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
6.
AIDS Behav ; 24(2): 418-427, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30840160

RESUMEN

Transnational migrant workers are known to be at high risk for HIV/STIs. This study estimated the point prevalence of HIV/syphilis and examined correlates of HIV/syphilis testing uptake among female migrant domestic workers in Macao, China. Data was obtained from 1363 female Filipino domestic workers who were offered free rapid HIV and syphilis testing. A mixed methods analysis was undertaken to examine correlates of testing and themes about reasons for not testing. Among 1164 women tested, there were no cases of HIV/syphilis observed and 199 (14.6%) refused HIV/syphilis testing. Greater social integration (aOR 1.12; 95% CI 1.02-1.24), having more than one sexual partner (aOR 1.65; 95% CI 1.02-2.65), and longer working hours on the testing day (aOR 0.97; 95% CI 0.94-1.00), were associated with testing uptake. Among those who tested, the majority (> 70%) had never tested before, suggesting the need to improve testing outreach. Qualitative themes about reasons for not testing included low perceived need and insufficient time. Individual and structural testing barriers should be reduced to optimize HIV/STI testing in migrant populations.


Asunto(s)
Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Migrantes/estadística & datos numéricos , Adolescente , Adulto , China/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Filipinas/etnología , Prevalencia , Factores de Riesgo , Pruebas Serológicas , Conducta Sexual , Parejas Sexuales , Sífilis/epidemiología
7.
Rev. bras. epidemiol ; 23: e200012, 2020. tab
Artículo en Portugués | LILACS | ID: biblio-1092614

RESUMEN

RESUMO: Introdução: A sífilis é uma doença de transmissão sexual de diagnóstico e tratamento fáceis, mas de incidência crescente no Brasil. Este estudo mediu prevalência, avaliou tendência e identificou fatores associados à não realização de exame sorológico para sífilis no pré-natal em Rio Grande, RS. Metodologia: Trata-se de inquérito transversal que incluiu todas as gestantes residentes nesse município que tiveram filho entre 1º de janeiro e 31 de dezembro nos anos de 2007, 2010 e 2013. Aplicou-se à mãe questionário único, padronizado em até 48 horas após o parto, quando ainda na maternidade. Utilizaram-se teste χ2 para proporções e para tendência linear e regressão de Poisson com ajuste robusto na análise multivariável. A medida de efeito usada foi razão de prevalências (RP). Resultados: Entre as 7.351 mães que passaram por pelo menos uma consulta, a prevalência de não realização de sorologia para sífilis nos três anos foi de 2,9% (intervalo de confiança de 95% - IC95% 2,56 - 3,33), sendo de 3,3% (IC95% 2,56 - 3,97) em 2007, 2,8% (IC95% 2,20 - 3,52) em 2010 e 2,7% (IC95% 2,12 - 3,38) em 2013. Mães de cor da pele preta, de baixa renda familiar e escolaridade e que passam por poucas consultas apresentaram maior RP à não realização desse exame. Discussão: A prevalência de não realização praticamente não se modificou no período, com maior probabilidade de não realização entre aquelas de maior risco gestacional. Conclusões: Alcançar mães de pior nível socioeconômico, reestruturar os serviços locais de saúde, aperfeiçoar sua operacionalização a fim de melhorar a qualidade da assistência pré-natal parecem mandatórios nesse município.


ABSTRACT: Introduction: Syphilis is a sexually transmitted disease, easy to diagnose and treat, but whose incidence is increasing in Brazil. This study estimated the prevalence of the non-performance of serological tests for syphilis during prenatal care, in addition to evaluating its trend and identifying its associated factors in the municipality of Rio Grande, Rio Grande do Sul, Southern Brazil. Methods: This is a cross-sectional survey that included all pregnant women living in this municipality who gave birth between January 1 and December 31, 2007, 2010, and 2013. A single standardized questionnaire was administered to the mothers within 48 hours of delivery, while they were still in the maternity ward. We used the χ2 test for proportions and linear trend, and Poisson regression with robust adjustment in the multivariate analysis. The effect measure adopted was prevalence ratio (PR). Results: Among the 7,351 mothers who had at least one prenatal visit, the prevalence of non-performance of serological tests for syphilis in the three years studied was 2.9% (95% confidence interval - 95%CI 2.56 - 3.33), with 3.3% (95%CI 2.56 - 3.97) in 2007, 2.8% (95%CI 2.20 - 3.52) in 2010, and 2.7% (95%CI 2.12 - 3.38) in 2013. Black mothers, those with low household income and schooling, and who had few prenatal visits showed higher PR of non-performance of this test. Discussion: The prevalence of non-performance has virtually not changed in the period, and women with high-risk pregnancy showed a greater probability of not undergoing the test. Conclusions: This municipality needs to reach mothers with lower socioeconomic status, restructure the local health services, and enhance their operationalization to improve the quality of prenatal care.


Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , Adulto , Adulto Joven , Atención Prenatal/métodos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Factores Socioeconómicos , Brasil/epidemiología , Distribución de Poisson , Prevalencia , Estudios Transversales , Análisis Multivariante , Encuestas y Cuestionarios , Embarazo de Alto Riesgo
9.
BMC Pregnancy Childbirth ; 19(1): 392, 2019 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-31664945

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania. METHODS: Between February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test. RESULTS: The median age of enrolled women was 25 (IQR: 22-31) years. Seventy eight (15.6, 95% CI: 12-18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2-85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43-9.62) while parity (aOR: 1.23, 95%CI: 1.04-1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81-26.45) predicted HIV infection. CONCLUSION: A significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Salud Rural/estadística & datos numéricos , Enfermedades de Transmisión Sexual , Sífilis , Virosis , Adulto , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/clasificación , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Enfermedades de Transmisión Sexual/clasificación , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/diagnóstico , Sífilis/epidemiología , Serodiagnóstico de la Sífilis/métodos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Tanzanía/epidemiología , Treponema pallidum/aislamiento & purificación , Virosis/clasificación , Virosis/diagnóstico , Virosis/epidemiología
10.
J Clin Microbiol ; 57(11)2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31462551

RESUMEN

Discordant syphilis test results, with a reactive nontreponemal test and nonreactive treponemal test are usually considered biological false-positive test results (BFPs), which can be attributed to other conditions. Syphilis surveillance laws mandate laboratory reporting of reactive syphilis tests, which include many BFPs. We describe the frequency of BFPs, titer distributions, and titer increases from reported test results in Florida and New York City (NYC). Reactive nontreponemal tests for individuals with at least one nonreactive treponemal test and no reactive treponemal test were extracted from sexually transmitted disease (STD) surveillance systems in Florida and NYC from 2013 to 2017. Characteristics of individuals with BFPs were analyzed after selecting the observation with the highest titer from each individual. We next considered all results from individuals to characterize persons who had a 4-fold titer increase between successive nontreponemal tests. Among 526,540 reactive nontreponemal tests, there were 57,580 BFPs (11%) from 39,920 individuals. Over 90% (n = 52,330) of BFPs were low titer (≤1:4), but 654 (1%) were high-titer BFPs (≥1:32). Very high-titer (≥1:128) BFPs were more common among individuals over 60 years of age (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.22 to 5.91). A 4-fold increase in titer was observed among 1,863 (14%) individuals with more than one reported BFP. Most BFPs detected by surveillance were low titer, but some were high titer and some had a 4-fold increase in titer. Review of patient histories might identify underlying conditions contributing to these high and rising titers.


Asunto(s)
Técnicas de Laboratorio Clínico/normas , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Serodiagnóstico de la Sífilis/normas , Sífilis/diagnóstico , Adolescente , Adulto , Monitoreo Epidemiológico , Reacciones Falso Positivas , Femenino , Florida/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Oportunidad Relativa , Salud Pública/estadística & datos numéricos , Sífilis/epidemiología , Sífilis/microbiología , Treponema pallidum , Adulto Joven
11.
PLoS One ; 13(9): e0204001, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30212544

RESUMEN

BACKGROUND: Although reverse sequence algorithms (RSA) for syphilis screening are performing well, they still have to rely on treponemal confirmatory tests at least for sera reactive by enzyme immunoassay/chemiluminescence immunoassay (EIA/CIA) and unreactive by rapid plasma reagin (RPR). Quebec's laboratory network previously showed that 3.3% of EIA/CIA reactive and weakly-reactive RPR samples (RPR titer of 1 to 4) would have been misclassified as syphilis cases if a treponemal confirmatory test had not been performed. OBJECTIVES: To correlate the magnitude of signal-to-cutoff (S/CO) ratios of the 4 most used commercial first-line EIA/CIA kits in Quebec with syphilis confirmation results and establish a S/CO value above which treponemal confirmation would not be required. METHODS: Serum samples from previously undiagnosed individuals (n = 7 404) obtained between January 2014 and February 2017 that were reactive by EIA/CIA and either negative by RPR or reactive with a low titer (1 to 4) were included in the study. All samples were tested with Treponema pallidum particle agglutination (TP-PA) and, if negative or inconclusive, with a line immunoassay (LIA). Syphilis infection confirmation was defined by a reactive TP-PA or LIA. Logistic regression analysis was used to determine S/CO values (95% CI lower bound = 0.98) above which confirmation would not be required. The four kits studied were Architect TP, BioPlex IgG, Syphilis EIA II, and Trep-Sure. RESULTS: Of 2609 reactive EIA/CIA specimens tested for the determination of S/CO values, 1730 (66%) were confirmed as true syphilis cases. Confirmation rate was significantly higher in samples with low-titer positive RPR (92%) than with negative RPR samples (54%); p<0.01. A linear probability model (95% CI lower bound = 0.98) predicted the S/CO value above which a confirmation would no longer be needed for the Architect TP (16.4), Bioplex IgG (7.4) and Trep-Sure (24.6). No linearity was observed between the S/CO value of Syphilis EIA II and the confirmation rate. The validity of the predicted S/CO values was investigated using 4 795 specimens. The use of an S/CO value of 16.4 with the Architect TP kit and of 24.6 for the Trep-Sure kit would obviate the need for confirmation of 18.5% and 13.2% of sera from the all RPR subgroup, respectively. For the BioPlex IgG kit, 81.1% of sera would not require confirmation when using the S/CO value of 7.4 in the low titer RPR subgroup. CONCLUSION: Signal-to-cut-off values could be used to identify sera that do not require extra treponemal confirmation for 3 of the 4 most used first-line EIA/CIA kits in Quebec. Using these values in our current reverse screening algorithm (RSA) would avoid the need for confirmatory tests in 14 to 20% of sera, a proportion that could reach 75% among low-titer RPR.


Asunto(s)
Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Algoritmos , Errores Diagnósticos , Humanos , Técnicas para Inmunoenzimas/métodos , Técnicas para Inmunoenzimas/estadística & datos numéricos , Tamizaje Masivo/métodos , Tamizaje Masivo/estadística & datos numéricos , Quebec , Relación Señal-Ruido , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Prueba de Inmovilización del Treponema/estadística & datos numéricos
12.
Bull World Health Organ ; 95(9): 657-662, 2017 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-28867847

RESUMEN

PROBLEM: Early detection of syphilis-infected people followed by effective treatment is essential for syphilis prevention and control. APPROACH: Starting in 2010 the local health authority in Yunnan province, China, developed a network of 670 service sites for syphilis testing, diagnosis and treatment or for testing-only with referral for further diagnosis and treatment. Point-of-care tests for syphilis and syphilis interventions were integrated into the existing human immunodeficiency virus (HIV) prevention and control programme. To improve the syphilis services, a pay-for-performance scheme was introduced in which providers were paid for testing and treating patients. LOCAL SETTING: Yunnan province is the region hardest hit by HIV infection and disproportionately burdened with syphilis cases in China. RELEVANT CHANGES: The proportion of attendees at voluntary counselling and testing clinics who were tested for syphilis increased from 46.2% (32 877/71 162) in 2010 to 98.2% (68 012/69 259) in 2015. Syphilis-infected cases treated with the recommended therapy increased from 26.6% (264/993) in 2010 to 82.5% (453/549) in 2015 at designated testing, diagnosis and treatment sites. LESSONS LEARNT: The strategy greatly increased the uptake of syphilis testing and treatment among people at risk. Introduction of point-of-care tests for syphilis increased coverage of the testing services. Introduction of a pay-for-performance scheme seemed to motivate health-care providers to undertake syphilis intervention services.


Asunto(s)
Promoción de la Salud/métodos , Reembolso de Incentivo , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/economía , Antibacterianos/uso terapéutico , China , Femenino , Infecciones por VIH , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Sistemas de Atención de Punto , Embarazo , Vigilancia de Guardia , Sífilis/tratamiento farmacológico , Sífilis/epidemiología
14.
Clin Infect Dis ; 65(3): 389-395, 2017 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-28419198

RESUMEN

Background: Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. Methods: Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. Results: 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend < .0001) and HIV-positive MSM (42% to 77%; Ptrend < .0001). The mean number of tests per man per year increased from 1.3 to 1.6 in HIV-negative MSM (Ptrend < .0001) and from 1.6 to 2.3 in HIV-positive MSM (Ptrend < .0001). 2799 and 1032 syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend < .0001), while the proportion that were secondary decreased from 24% to 19% (Ptrend = .030). Among HIV-positive MSM, early latent infections increased from 23% to 45% (Ptrend < .0001), while secondary infections decreased from 45% to 26% (Ptrend = .0003). Among HIV-positive MSM, decreasing secondary syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). Conclusions: Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression.


Asunto(s)
Homosexualidad Masculina/estadística & datos numéricos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Australia/epidemiología , Estudios Transversales , Humanos , Masculino
15.
Sex Transm Dis ; 44(4): 219-221, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28282647

RESUMEN

United States surveillance data demonstrate that congenital syphilis cases are increasing. We performed an analysis of commercially insured pregnant females using MarketSan to determine syphilis screening rates at different prenatal stages; 85% of pregnant women in this population had a syphilis test performed at least once during the prenatal period.


Asunto(s)
Tamizaje Masivo/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/diagnóstico , Diagnóstico Prenatal/estadística & datos numéricos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Seguro de Salud/estadística & datos numéricos , Tamizaje Masivo/métodos , Embarazo , Serodiagnóstico de la Sífilis/métodos , Estados Unidos , Adulto Joven
16.
Arch Pathol Lab Med ; 141(1): 93-97, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27763779

RESUMEN

CONTEXT: -Syphilis serology screening in laboratory practice is evolving. Traditionally, the syphilis screening algorithm begins with a nontreponemal immunoassay, which is manually performed by a laboratory technologist. In contrast, the reverse algorithm begins with a treponemal immunoassay, which can be automated. The Centers for Disease Control and Prevention has recognized both approaches, but little is known about the current state of laboratory practice, which could impact test utilization and interpretation. OBJECTIVE: -To assess the current state of laboratory practice for syphilis serologic screening. DESIGN: -In August 2015, a voluntary questionnaire was sent to the 2360 laboratories that subscribe to the College of American Pathologists syphilis serology proficiency survey. RESULTS: -Of the laboratories surveyed, 98% (2316 of 2360) returned the questionnaire, and about 83% (1911 of 2316) responded to at least some questions. Twenty-eight percent (378 of 1364) reported revision of their syphilis screening algorithm within the past 2 years, and 9% (170 of 1905) of laboratories anticipated changing their screening algorithm in the coming year. Sixty-three percent (1205 of 1911) reported using the traditional algorithm, 16% (304 of 1911) reported using the reverse algorithm, and 2.5% (47 of 1911) reported using both algorithms, whereas 9% (169 of 1911) reported not performing a reflex confirmation test. Of those performing the reverse algorithm, 74% (282 of 380) implemented a new testing platform when introducing the new algorithm. CONCLUSION: -The majority of laboratories still perform the traditional algorithm, but a significant minority have implemented the reverse-screening algorithm. Although the nontreponemal immunologic response typically wanes after cure and becomes undetectable, treponemal immunoassays typically remain positive for life, and it is important for laboratorians and clinicians to consider these assay differences when implementing, using, and interpreting serologic syphilis screening algorithms.


Asunto(s)
Algoritmos , Laboratorios/estadística & datos numéricos , Ensayos de Aptitud de Laboratorios/estadística & datos numéricos , Encuestas y Cuestionarios , Serodiagnóstico de la Sífilis/estadística & datos numéricos , American Medical Association , Humanos , Laboratorios/normas , Ensayos de Aptitud de Laboratorios/normas , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Tamizaje Masivo/estadística & datos numéricos , Patólogos , Patología Clínica/organización & administración , Patología Clínica/normas , Patología Clínica/estadística & datos numéricos , Prevalencia , Sensibilidad y Especificidad , Sífilis/diagnóstico , Sífilis/epidemiología , Serodiagnóstico de la Sífilis/métodos , Serodiagnóstico de la Sífilis/normas , Estados Unidos/epidemiología
17.
Sex Transm Dis ; 42(12): 702-4, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26562700

RESUMEN

We reviewed 68 cases of possible neurosyphilis among 573 syphilis cases in King County, WA, from 3rd January 2012 to 30th September 2013; 7.9% (95% confidence interval, 5.8%-10.5%) had vision or hearing changes, and 3.5% (95% confidence interval, 2.2%-5.4%) had both symptoms and objective confirmation of complicated syphilis with either abnormal cerebrospinal fluid or an abnormal ophthalmologic examination.


Asunto(s)
Líquido Cefalorraquídeo/microbiología , Ojo/microbiología , Neurosífilis/epidemiología , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis Latente/epidemiología , Treponema pallidum/aislamiento & purificación , Anticuerpos Antibacterianos/líquido cefalorraquídeo , Trazado de Contacto , Técnicas de Diagnóstico Oftalmológico , Femenino , Humanos , Masculino , Neurosífilis/líquido cefalorraquídeo , Neurosífilis/inmunología , Prevalencia , Estudios Retrospectivos , Vigilancia de Guardia , Sífilis Latente/líquido cefalorraquídeo , Sífilis Latente/inmunología , Treponema pallidum/inmunología , Washingtón/epidemiología
18.
AIDS Behav ; 19(11): 2036-43, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26078117

RESUMEN

Men who have sex with men (MSM) in Baltimore are at disproportionately high risk for HIV and syphilis infection. Testing and diagnosis are important first steps in receiving treatment and reducing transmission. We analyzed cross-sectional data collected in 2004-2005, 2008, and 2011 among MSM not reporting a previous positive HIV test (n = 1268) in Baltimore, Maryland as part of the National HIV Behavioral Surveillance System to determine the proportion of men tested for HIV and/or syphilis within the previous 12 months and examine the extent to which opportunities for testing were being missed in health care settings. Within the previous 12 months, 54 % of men had received an HIV test; 31 % had received a syphilis test; and only 23 % of men had received testing for both. Among 979 men who did not receive both tests, 72 % had seen a health care provider in the past year, suggesting missed testing opportunities.


Asunto(s)
Serodiagnóstico del SIDA/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/prevención & control , Adulto , Baltimore/epidemiología , Condones/estadística & datos numéricos , Estudios Transversales , Infecciones por VIH/epidemiología , Humanos , Masculino , Vigilancia de la Población , Análisis de Regresión , Asunción de Riesgos , Sífilis/epidemiología , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-26086162

RESUMEN

INTRODUCTION: Serological tests' limitations in syphilis diagnosis as well as numerous test interpretations mean that patients with discordant serology results can present diagnostic and treatment challenges for clinicians. We analyzed three common diagnostic algorithms for detecting suspected syphilis in high-prevalence populations in Slovenia. METHODS: The prospective study included a total of 437 clinical serum samples from adults throughout Slovenia tested with Rapid Plasma Reagin (RPR), Treponema pallidum hemagglutination (TPHA), and an automated chemiluminescence immunoassay (CIA) according to the manufacturer's instructions. In addition to percent agreement, kappa coefficients were calculated as a secondary measure of agreement between the three algorithms. RESULTS: Overall, of 183 subjects that had seroreactive results, 180 were seroreactive in both the reverse sequence and the European Centre for Disease Prevention and Control (ECDC) algorithm. The traditional algorithm had a missed serodiagnosis rate of 30.0%, the overall percent agreement between the traditional and the reverse algorithm (or the ECDC algorithm) was 87.6%, and the kappa value was 0.733. However, the reverse and ECDC algorithm failed to detect three subjects with positive serodiagnosis determined by additional confirmative treponemal assays. CONCLUSIONS: Our results supported the ECDC algorithm in the serodiagnosis of syphilis in high-prevalence populations and the use of nontreponemal serology to monitor the response to treatment.


Asunto(s)
Algoritmos , Tamizaje Masivo/estadística & datos numéricos , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Adulto , Diagnóstico Diferencial , Reacciones Falso Positivas , Femenino , Humanos , Técnicas para Inmunoenzimas/métodos , Laboratorios/estadística & datos numéricos , Masculino , Estudios Prospectivos , Eslovenia/epidemiología , Sífilis/epidemiología , Serodiagnóstico de la Sífilis/estadística & datos numéricos
20.
Int J Gynaecol Obstet ; 130 Suppl 1: S10-4, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25963909

RESUMEN

BACKGROUND: "Probable active syphilis," is defined as seroreactivity in both non-treponemal and treponemal tests. A correction factor of 65%, namely the proportion of pregnant women reactive in one syphilis test type that were likely reactive in the second, was applied to reported syphilis seropositivity data reported to WHO for global estimates of syphilis during pregnancy. OBJECTIVES: To identify more accurate correction factors based on test type reported. SEARCH STRATEGY: Medline search using: "Syphilis [Mesh] and Pregnancy [Mesh]," "Syphilis [Mesh] and Prenatal Diagnosis [Mesh]," and "Syphilis [Mesh] and Antenatal [Keyword]. SELECTION CRITERIA: Eligible studies must have reported results for pregnant or puerperal women for both non-treponemal and treponemal serology. DATA COLLECTION AND ANALYSIS: We manually calculated the crude percent estimates of subjects with both reactive treponemal and reactive non-treponemal tests among subjects with reactive treponemal and among subjects with reactive non-treponemal tests. We summarized the percent estimates using random effects models. MAIN RESULTS: Countries reporting both reactive non-treponemal and reactive treponemal testing required no correction factor. Countries reporting non-treponemal testing or treponemal testing alone required a correction factor of 52.2% and 53.6%, respectively. Countries not reporting test type required a correction factor of 68.6%. CONCLUSIONS: Future estimates should adjust reported maternal syphilis seropositivity by test type to ensure accuracy.


Asunto(s)
Complicaciones Infecciosas del Embarazo/epidemiología , Diagnóstico Prenatal/estadística & datos numéricos , Serodiagnóstico de la Sífilis/estadística & datos numéricos , Sífilis/epidemiología , Exactitud de los Datos , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Diagnóstico Prenatal/métodos , Sífilis/diagnóstico , Serodiagnóstico de la Sífilis/métodos
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