Sujet(s)
Infections à VIH , Hépatite B , Transmission verticale de maladie infectieuse , Syphilis , Femelle , Humains , Grossesse , Hépatite B/transmission , Hépatite B/épidémiologie , Hépatite B/prévention et contrôle , Infections à VIH/transmission , Infections à VIH/épidémiologie , Inde/épidémiologie , Transmission verticale de maladie infectieuse/prévention et contrôle , Complications infectieuses de la grossesse , Syphilis/transmission , Syphilis/épidémiologieRÉSUMÉ
BACKGROUND: Both pre-donation and post-donation deferrals pose challenges to blood safety and availability. This study delved into the deferral rates before donations and their underlying reasons, as, transfusion transmissible infections (TTIs) leading to post-donation deferrals among potential blood donors at the Kwale Satellite Blood Transfusion Centre (KSBTC) in Kenya. METHODS: We performed a retrospective electronic record review of pre- and post-donation deferrals among blood donors at KSBTC, 2018-2022. The pre-donations deferral rate and reasons for deferral were analyzed. Accepted donations were analyzed to determine the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. Descriptive statistics were calculated and both crude odds ratio (COR) and adjusted odds ratio (AOR), and their 95% confidence intervals (CI) were calculated. Variables with p < 0.05 were considered statistically significant. RESULTS: A review was conducted on 12,633 blood donation records. Among these, individuals 2,729/12,633 (21.60%) were deferred from donating with the primary reason being low hemoglobin levels, constituting 51.86% of deferrals. Around 773/9,904 (7.80%) of blood units, were discarded due to at least one TTI. Among these, HBV accounted for 4.73%, HIV for 2.01%, HCV for 1.21%, and Syphilis for 0.59% of cases. The adjusted odds ratio for male donors were, (aOR = 1.3, 95% CI 1.01-1.57), donors with none or primary education level (aOR = 1.4 95% CI 1.11-1.68), first-timer donors (aOR = 1.2, 95% CI 1.01-1.44), and static strategy for blood collection (aOR = 1.4, 95%CI 1.12-1.63) were independently potentially associated with testing positive for at least one TTI. CONCLUSION: The study indicates that TTIs continue to pose a risk to the safety of Kenya's bloodstock, with a notable prevalence of HBV infections. Male donors, individuals with limited education, first-time donors, and utilizing a fixed strategy for blood collection were identified as potential risk factors independently associated with TTIs.
Sujet(s)
Donneurs de sang , Humains , Kenya/épidémiologie , Mâle , Donneurs de sang/statistiques et données numériques , Études rétrospectives , Femelle , Adulte , Adulte d'âge moyen , Jeune adulte , Syphilis/épidémiologie , Adolescent , Sélection de donneurs/statistiques et données numériques , Hépatite B/épidémiologie , Infections à VIH/épidémiologie , Hépatite C/épidémiologie , PrévalenceRÉSUMÉ
BackgroundSyphilis in blood donors (BD) has increased in many countries.AimWe aimed to describe trends in syphilis seroposivity in BD in France, to identify risk factors and assess if a non-treponemic test (NTT) could define BD having recovered from syphilis for more than 1â¯year.MethodsThe analysis covered the period 2007 to 2022 and 45,875,939 donations. Of the 474 BD syphilis-positive in 2022, 429 underwent additional investigations with an NTT. History of syphilis was obtained at the post-donation interview or based on serology results for repeat donors.ResultsUntil 2021, positivity rates remained stable (mean: 1.18/10,000 donations, range: 1.01-1.38). An increased rate was observed in 2022 (1.74/10,000; p = 0.02). Over the whole study period, prevalence was 2.2 times higher in male than in female BD (4.1 times higher in 2022). The proportion of males with an identified risk factor who have sex with men increased from 16.7% in 2007 to 64.9% in 2022. Based on NTT, 79 (18%) of the donors who were seropositive in 2022 were classified as having been infected in the previous year. History of syphilis was available for 30 of them. All had an infection within the previous 3 years. Among seven donors with a syphilis < 12 months before testing, one had an NTT titre ≥ 8, three a titre between 1 and 4, three were negative.ConclusionSyphilis seropositivity increased considerably in BDs in 2022, mostly in males, notably MSM. Available data did not allow appropriate evaluation of the NTT to distinguish recent from past infection.
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Donneurs de sang , Sérodiagnostic de la syphilis , Syphilis , Humains , Donneurs de sang/statistiques et données numériques , Syphilis/épidémiologie , Syphilis/diagnostic , Syphilis/sang , Mâle , France/épidémiologie , Femelle , Adulte , Prévalence , Facteurs de risque , Sérodiagnostic de la syphilis/méthodes , Adulte d'âge moyen , Treponema pallidum/immunologie , Treponema pallidum/isolement et purification , Études séroépidémiologiques , Jeune adulte , Homosexualité masculine/statistiques et données numériquesRÉSUMÉ
Approximately 10-12 million new syphilis infections occur annually worldwide, including in pregnant women. This study identified the factors associated with syphilis in pregnant women admitted to a tertiary maternity ward in the State of Paraná, Brazil. This is an ambispective, paired case-control study (1:2 ratio) conducted from September 2020 to October 2021. Pregnant patients (n = 93) admitted to the maternity ward, who were tested with the Venereal Disease Research Laboratory (VDRL) and rapid reagent test, were compared with 186 controls, matched by age and period of hospital admission. Sociodemographic, behavioral, prenatal, and maternity healthcare information was collected through interviews. The data were analyzed using binary logistic regression. Results showed that race/skin color other than white (OR: 2.12; 95%CI: 1.19-3.80; p < 0.001), having more than one sexual partner (OR: 3.69; 95%CI: 1.70-8.00; p = 0.001), being a former smoker (OR: 2.07; 95%CI: 1.07-4.01; p = 0.030) and a current smoker (OR: 4.31; 95%CI: 1.55-11.98; p = 0.005), as well as having a history of sexually transmitted infections (OR: 10.87; 95%CI: 4.04-29.27; p < 0.0.01) were risk factors for gestational syphilis. In summary, the study indicated that sociodemographic, behavioral, and healthcare-related variables were associated with gestational syphilis. Therefore, practitioners could benefit from incorporating these factors to deliver evidence-based treatment for gestational syphilis.
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Complications infectieuses de la grossesse , Syphilis , Humains , Femelle , Grossesse , Brésil/épidémiologie , Syphilis/épidémiologie , Études cas-témoins , Adulte , Complications infectieuses de la grossesse/épidémiologie , Complications infectieuses de la grossesse/microbiologie , Facteurs de risque , Jeune adulte , Soins de santé tertiaires , AdolescentRÉSUMÉ
BACKGROUND: Co-infections involving human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis pose significant public health problems during pregnancy. It can increase the risk of adverse outcomes for both the woman and the infant more than each infection alone does. However, the magnitude of these co-infections remains insufficiently documented. Hence, this study aimed to determine the seroprevalence of HIV, HBV, and syphilis co-infections and associated risk factors among pregnant women attending antenatal care in Amhara region referral hospitals in northern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted in Amhara regional state referral hospitals from January 1 to February 30, 2024, among 606 pregnant women. Pregnant women were selected using a systematic random sampling technique. An interviewer-administered questionnaire and chart review were used to collect data. Data were analyzed in SPSSV26.0. Descriptive statistics were used to determine the magnitude of co-infections, and binary logistic regression was used to determine associated factors. Variables with a P-value < 0.05 were used to declare statistical significance. RESULT: Overall, 4.1% (95% CI: 2.7, 6.1) of pregnant women were co-infected. The prevalence of specific co-infections was 2% (95% CI: 1, 3.5) for HIV/HBV, 1.3% (95% CI: 0.6, 2.6) for HIV/syphilis, and 0.8% (95% CI: 0.3, 1.9) for HBV/syphilis. No cases of triple co-infection were observed. Women with a history of unsafe sex (AOR = 8.2, 95% CI: 1.5, 16.7) and incarceration (AOR = 9.3, 95% CI: 1.6, 20.8) were associated with HIV/syphilis co-infection. For HIV/HBV co-infection, contact with jaundice patients (AOR = 5.5, 95% CI: 1.3, 22.5) and women with a history of STIs (AOR = 4.6, 95% CI: 1.4, 14.9) was significantly associated. Women with STI history (AOR = 6.3, 95% CI: 1.2, 15.9) were also significantly associated with HBV/syphilis co-infection. CONCLUSION: Despite the government's elimination efforts, a relatively high prevalence of coinfections with the infections studied was found among pregnant women. Therefore, HIV, HBV, and syphilis testing and treatment packages should be strengthened by targeting pregnant women with a history of STIs, contact with patients with jaundice, a history of incarceration, and unsafe sex.
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Co-infection , Infections à VIH , Hépatite B , Complications infectieuses de la grossesse , Prise en charge prénatale , Syphilis , Humains , Femelle , Syphilis/épidémiologie , Syphilis/complications , Grossesse , Éthiopie/épidémiologie , Hépatite B/épidémiologie , Adulte , Infections à VIH/épidémiologie , Infections à VIH/complications , Études transversales , Co-infection/épidémiologie , Études séroépidémiologiques , Complications infectieuses de la grossesse/épidémiologie , Jeune adulte , Adolescent , Facteurs de risque , PrévalenceSujet(s)
Pénicillines , Syphilis , Humains , Syphilis/traitement médicamenteux , Syphilis/diagnostic , Syphilis/épidémiologie , Pénicillines/effets indésirables , Pandémies , Histoire du 19ème siècle , Antibactériens/usage thérapeutique , Antibactériens/effets indésirables , Histoire du 20ème siècleRÉSUMÉ
INTRODUCTION: The objective of this study was to investigate the seroprevalence of syphilis and its possible influencing factors in patients with mental illness. METHODOLOGY: A total of 24,414 patients with mental illness from 2019 to 2021 were included. Serum syphilis antibody test results and available demographic data were collected. Chi-square test and regression analysis were used to analyze the data. RESULTS: The seroprevalence of syphilis was 0.59% (95% CI 0.49-0.69%) in patients with mental illness in the study area. There were significant differences in the seroprevalence of syphilis in age, marital status, occupation, urban region, and mental disease classification. The seroprevalence of syphilis increased with age (p < 0.01). The seroprevalence of syphilis was higher in patients with "Nonorganic sleep disorders" and "Reaction to severe stress, and adjustment disorders". Adjusted logistic regression analysis showed that the seroprevalence of syphilis in patients with mental illness was associated with age, region, and psychiatric classification. Older age group was a risk factor for syphilis seropositivity. Compared with schizophrenia, "bipolar affective disorder" (OR = 1.707, 95% CI: 1.017-2.864, p = 0.043) and "severe stress response and adjustment disorders"(R = 4.912, 95% CI: 1.138-21.204, p = 0.033) were risk factors for syphilis antibody positivity. CONCLUSIONS: The patients with "nonorganic sleep disorders" and "reaction to severe stress, and adjustment disorders" had a high seroprevalence of syphilis. Age and psychosis types became the influencing factors of the positive rate of serum syphilis antibody in patients with mental illness.
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Troubles mentaux , Syphilis , Humains , Études séroépidémiologiques , Mâle , Adulte , Femelle , Adulte d'âge moyen , Syphilis/épidémiologie , Syphilis/complications , Troubles mentaux/épidémiologie , Jeune adulte , Facteurs de risque , Adolescent , Sujet âgé , Chine/épidémiologieRÉSUMÉ
BACKGROUND: In Latin America, Peru has the second highest number of cases of monkeypox (Mpox), of which more than 50 % are Human Immunodeficiency Virus (HIV)-positive. Here, we compared the epidemiological and clinical characteristics of Mpox between people with and without HIV in Peru. METHODS: We conducted a national retrospective study using data on confirmed cases of Mpox reported by the Peruvian National Surveillance System from 15 June 2022 to 31 December 2023. RESULTS: A total of 3561 confirmed cases of Mpox were included. Of these, 2123 (60 %) patients were people living with HIV (PLWH), with increased odds for those aged 30 years or older, homosexual (adjusted odds ratio [aOR] 8.58 [6.95-10.59], p<0.0001), bisexual (aOR=4.44 [3.46-5.69], p<0.0001), sex workers (aOR=2.24 [1.07-4.68], p=0.032), people with a history of syphilis (aOR=2.07 [1.66-2.58], p<0.001), and hospitalized (aOR=3.08 [2.03-4.68], p<0.001). PLWH were more likely to have proctitis (aOR=1.73 [1.26-2.37], p=0.001). The overall mortality was 20 of 3561 (0.56 %). Among PLWH and Mpox, more deaths occurred in hospitalized (p<0.001) and non-ART (p<0.001) individuals. CONCLUSION: Our findings highlight that HIV infection among Mpox cases in Peru is associated with high-risk sexual behaviour and a high likelihood of hospitalization.
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Infections à VIH , Orthopoxvirose simienne , Humains , Pérou/épidémiologie , Mâle , Femelle , Adulte , Infections à VIH/épidémiologie , Infections à VIH/complications , Études rétrospectives , Adulte d'âge moyen , Jeune adulte , Orthopoxvirose simienne/épidémiologie , Adolescent , Facteurs de risque , Co-infection/épidémiologie , Syphilis/épidémiologie , Syphilis/complicationsRÉSUMÉ
INTRODUCTION: Blood donation is vital for healthcare; however, transfusion-transmitted infections (TTIs) pose a serious risk. This study investigated the seroprevalence of TTIs among Saudi blood donors. METHODOLOGY: This retrospective study included male blood donors aged ≥ 18 years who donated blood at Al-Noor Specialist Hospital in Makkah from January 2017 to December 2022. The blood units were screened for hepatitis B surface antigen (HBsAg) and core antibodies (HBc-IgG), hepatitis C antibodies (HCV-Abs), syphilis, HIV-1 antigen/antibody (HIV-1 Ag/Ab), human T-lymphotropic virus 1, 2 (HTLV-1/2), and malaria. RESULTS: There were 40,287 donors with an average age of 44.33 ± 18.12 years, and 62.3% (n = 25103) were Saudis. The overall rate of TTIs seropositivity was 7.4% (n = 2953); HBc-IgG (6.1%; n = 2473) was the most common, followed by HCV-Abs (0.4%; n = 177), and syphilis (0.34%; n = 136). All cases were negative for malaria, whilst HIV and HTLV positive donors were 0.06% (n = 24) and 0.13% (n = 52), respectively. Syphilis was more prevalent among non-Saudis (0.24%; n = 83) than among Saudis (0.1%; n = 53), whereas anti-HBc antibodies seropositivity was significantly higher among Saudi (3.4%; n = 1373) than non-Saudi donors (2.7%; n = 1100). CONCLUSIONS: Hepatitis B virus was the most frequently detected bloodborne pathogen, followed by hepatitis C virus and syphilis. Hepatitis B virus was also more prevalent among Saudi donors, whilst expatriates had higher rates of syphilis. Additional prospective multicenter studies are needed to accurately determine the prevalence of TTIs in Saudi Arabia.
Sujet(s)
Donneurs de sang , Syphilis , Humains , Arabie saoudite/épidémiologie , Études séroépidémiologiques , Donneurs de sang/statistiques et données numériques , Mâle , Adulte , Études rétrospectives , Adulte d'âge moyen , Jeune adulte , Syphilis/épidémiologie , Syphilis/sang , Adolescent , Réaction transfusionnelle/épidémiologie , Hépatite B/épidémiologie , Infections transmissibles par le sang/épidémiologie , Sujet âgé , Hépatite C/épidémiologieRÉSUMÉ
OBJECTIVES: To ascertain the prevalence of transfusion transmissible infections (TTIs) across diverse donor groups in the Najran province. Additionally, to establish a potential association between the development of TTI and the donors' blood group, as determined by the ABO/Rh blood grouping system. METHODS: Blood donation data of 4120 donors, spanning from January to December 2020, were retrospectively reviewed. The blood were screened for TTI markers, including hepatitis B surface antigen (HBsAg), anti-hepatitis B core (anti-HBc), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency viruses 1 and 2 (anti-HIV1&2), anti-human T-lymphotropic virus types 1 and 2 (anti-HTLV-1&2), and syphilis antigen. RESULTS: Positive TTI markers were detected in 10.9% of the donors. The most detected TTI marker was anti-HBc (8.9%), followed by HBsAg (0.7%). Other markers were individually detected in <1% of the donors. Anti-HBc-positive was significantly elevated among non-Saudi blood donors. There was an association between age groups and anti-HCV (p=0.002), anti-HTLV (p=0.004) and syphilis antigen (p=0.02) markers positivity. The AB positive blood group exhibited the most positivity for TTI markers, followed by O positive blood group. Similarly, association was found between ABO group and HBsAg (p=0.01), anti-HBc (p=0.001), and anti-HCV (p<0.001) markers positivity. CONCLUSION: Emphasis on implementing robust screening measures for donated blood is underscored by this study. There is the need for future study to extensively evaluate TTI status to enhance our understanding of the trend in TTI.
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Système ABO de groupes sanguins , Donneurs de sang , Antigènes de surface du virus de l'hépatite B , Humains , Adulte , Antigènes de surface du virus de l'hépatite B/sang , Arabie saoudite/épidémiologie , Mâle , Donneurs de sang/statistiques et données numériques , Études rétrospectives , Femelle , Adulte d'âge moyen , Marqueurs biologiques/sang , Syphilis/épidémiologie , Syphilis/sang , Jeune adulte , Réaction transfusionnelle/épidémiologie , Réaction transfusionnelle/sang , Prévalence , Adolescent , Hépatite B/épidémiologie , Hépatite B/sang , Anticorps de l'hépatite B/sang , Infections à VIH/épidémiologie , Infections à VIH/sangRÉSUMÉ
OBJECTIVES: To analyze the rate of gestational syphilis (GS) based on temporal trends over 11 years, as well as the spatial distribution of GS in Brazil, based on the identification of spatial clusters. METHODOLOGY: An ecological, using Brazil and its regions as an analysis unit, based on gestational syphilis data reported in the Notifiable Diseases Information System (SINAN), from 2011 to 2020. Thematic maps were built for spatial data analysis, and the Prais-Winsten autoregressive model was used to verify the trend. Spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of distribution of GS across Brazilian municipalities, using a 5% significance level. RESULTS: Gestational syphilis experienced a considerable increase in cases during the studied period, with a peak of 37,436 cases in 2018. The spatial distribution of the disease is heterogeneous in the country. A growing trend was observed in all states of Brazil, except for Espírito Santo, where it remained stationary, with a monthly variation of 10.32%. CONCLUSION: The spatial and temporal trend analysis point to syphilis as an important public health problem. The numbers are alarming and show the urgent need for measures to prevent and control syphilis during pregnancy.
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Complications infectieuses de la grossesse , Syphilis , Humains , Brésil/épidémiologie , Grossesse , Femelle , Syphilis/épidémiologie , Complications infectieuses de la grossesse/épidémiologie , Analyse spatiale , Analyse spatio-temporelleRÉSUMÉ
It is accepted to explain increasing of venereal diseases during years of the Revolution by degradation of morality and general disorder of system of state administration and sanitary services in Russia. The cross-verification of information presented in scientific publications and primary information sources makes it possible to look into following issues: degree of venereal (syphilitic) contamination of population of pre-revolutionary Russia; influence on sanitary statistics by erroneous diagnostics and convictions of Zemstvo medicine about predominantly non-sexual path of transmission of syphilis pathogen in Russian countryside; dynamics and sources of venereal morbidity in wartime. The high indicators of pre-revolutionary statistics of venereal infections could be affected by diagnostic errors. The "village syphilis" encountered in public milieu could be completely different disease not sexually transmitted and not chronic form of disease. The primary documents allow to discuss increasing of the number of venereal patients during war years, that however, does not reach catastrophic numbers that can be found even in scientific publications. This is also confirmed by data of Chief Military Sanitary Board of the Red Army for 1920s and statistical materials of People's Commissariat of Health Care of the RSFSR. The high morbidity was demonstrated by same Gubernias that were problematic before the Revolution and only later by those ones through which during the war years passed army masses. In Russia, total level of syphilis morbidity after the end of Civil War occurred to be more than twice lower than in pre-war 1913 and continued to decrease under impact of sanitary measures of Soviet public health.
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Maladies sexuellement transmissibles , Syphilis , Humains , Histoire du 20ème siècle , Russie/épidémiologie , Maladies sexuellement transmissibles/histoire , Maladies sexuellement transmissibles/épidémiologie , Syphilis/histoire , Syphilis/épidémiologie , Morbidité/tendancesRÉSUMÉ
BACKGROUND: Acquired syphilis continues to affect millions of people around the world. It is crucial to study it in the context of HIV Pre-Exposure Prophylaxis (PrEP) to achieve the goals set out in the 2030 Agenda since the literature suggests increased risk behaviors for sexually transmitted infections. This study aimed to investigate the incidence and factors associated with acquired syphilis among PrEP users. MATERIALS AND METHODS: This retrospective cohort included data on PrEP users from all over Brazil from 2018 to 2020, retrieved from the national antiretroviral logistics system. We calculated the proportion of syphilis before PrEP, the incidence during the user's follow-up, reinfections, and their possible associated factors. We conducted descriptive, bivariate, and multivariate analysis, estimating the crude Relative Risk, adjusted Odds Ratio (aOR), and their respective confidence intervals (95%CI). RESULTS: Most of the 34,000 individuals who started PrEP were male (89.0%), white (53.7%), self-identified as male (85.2%), homosexual, gay, or lesbian (72.2%), and had 12 schooling years or more (67.8%). Of these, 8.3% had syphilis in the six months before starting PrEP, and 4% had it in the first 30 days of using the prophylaxis. We identified a loss-to-follow-up rate of 41.7%, although the loss and the cohort shared similar characteristics. The proportion of missed syphilis tests was high: 33.4% in the 30 days and 38.8% in the follow-up period. In the 19,820 individuals effectively monitored, the incidence of acquired syphilis was 19.1 cases per 100 person-years, and 1.9% of users had reinfection. The rate of missed syphilis tests at the 30-day follow-up was 33.4%, and the total follow-up test period was 38.8%. The multivariate analysis identified female gender (aOR 0.3; 95%CI 0.2-0.5), being white or Black (aOR 0.9; 95%CI 0.7-0.9 and aOR 0.7; 95%CI 0.7-0.99, respectively) as protective factors for syphilis. Being homosexual, gay, lesbian (aOR 2.7; 95%CI 2.0-3.7), or having a history of syphilis in the six months before PrEP (aOR 2.2; 95%CI 1.9-2.5) were risk factors for syphilis during PrEP use. Behaviors related to the risk of syphilis included accepting something in exchange for sex (aOR 1.6; 95%CI 1.3-1.9), irregular condom use (use in less than half of sexual intercourse sessions; aOR 1.7; 95%CI 1.53-2.1) and recreational drug use (poppers; aOR 1.5; 95%CI 1.53-2.1). CONCLUSION: Syphilis in the context of PrEP has high rates and is associated with sociodemographic and behavioral factors. We recommend additional studies targeting prevention in this population to curb these figures.
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Infections à VIH , Prophylaxie pré-exposition , Syphilis , Humains , Syphilis/épidémiologie , Syphilis/prévention et contrôle , Mâle , Infections à VIH/épidémiologie , Infections à VIH/prévention et contrôle , Adulte , Femelle , Incidence , Facteurs de risque , Études rétrospectives , Brésil/épidémiologie , Adulte d'âge moyen , Jeune adulte , Adolescent , Agents antiVIH/usage thérapeutiqueRÉSUMÉ
Based on the distinctive spatial diffusion characteristics observed in syphilis transmission patterns, this paper introduces a novel reaction-diffusion model for syphilis disease dynamics, incorporating general incidence functions within a heterogeneous environment. We derive the basic reproduction number essential for threshold dynamics and investigate the uniform persistence of the model. We validate the model and estimate its parameters by employing the multi-objective Markov Chain Monte Carlo (MCMC) method, using real syphilis data from the years 2004 to 2018 in China. Furthermore, we explore the impact of spatial heterogeneity and intervention measures on syphilis transmission. Our findings reveal several key insights: (1) In addition to the original high-incidence areas of syphilis, Xinjiang, Guizhou, Hunan and Northeast China have also emerged as high-incidence regions for syphilis in China. (2) The latent syphilis cases represent the highest proportion of newly reported cases, highlighting the critical importance of considering their role in transmission dynamics to avoid underestimation of syphilis outbreaks. (3) Neglecting spatial heterogeneity results in an underestimation of disease prevalence and the number of syphilis-infected individuals, undermining effective disease prevention and control strategies. (4) The initial conditions have minimal impact on the long-term spatial distribution of syphilis-infected individuals in scenarios of varying diffusion rates. This study underscores the significance of spatial dynamics and intervention measures in assessing and managing syphilis transmission, which offers insights for public health policymakers.
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Syphilis , Syphilis/transmission , Syphilis/épidémiologie , Humains , Chine/épidémiologie , Taux de reproduction de base/statistiques et données numériques , Incidence , Chaines de Markov , Modèles épidémiologiques , Prévalence , Méthode de Monte CarloRÉSUMÉ
This report summarizes incidence rates and trends of sexually transmitted infections (STIs) from 2015 through 2023 among active component service members of the U.S. Armed Forces. The data compiled for this report are derived from the medical surveillance of chlamydia, gonorrhea, and syphilis as nationally notifiable diseases. Case data for 2 additional STIs, human papilloma virus (HPV) and genital herpes simplex virus (HSV), are also presented. The crude total case rates of chlamydia and gonorrhea initially rose by an average of 6.7% and 9.8% per year, respectively, until 2019. From 2020 onwards, rates steadily declined. By 2023, chlamydia rates had dropped by approximately 39%, while gonorrhea rates had fallen by more than 40% for female, and 19% for male, service members. Initially syphilis increased, on average, 10% annually from 2015 to 2019, then declined in 2020, but resumed its upward trend through 2023, nearly doubling the 2015 rate in 2023. The total crude annual incidence rates of genital HPV and HSV exhibited downward trends in general over the surveillance period, decreasing by 30.7% and 24.7%, respectively. Age- and gender-adjusted case rates for chlamydia, gonorrhea, and syphilis remain elevated within the U.S. Armed Forces compared to the general U.S. population, which may be due to factors that include mandatory STI screening, more complete reporting, incomplete adjustment for age distribution, and inequitable comparisons between the military active duty and general U.S. populations. Social restrictions enacted during the COVID-19 pandemic may have contributed to declines in true case rates and screening coverage.
Sujet(s)
Infections à Chlamydia , Gonorrhée , Herpès génital , Personnel militaire , Surveillance de la population , Maladies sexuellement transmissibles , Syphilis , Humains , États-Unis/épidémiologie , Personnel militaire/statistiques et données numériques , Femelle , Mâle , Adulte , Incidence , Gonorrhée/épidémiologie , Maladies sexuellement transmissibles/épidémiologie , Syphilis/épidémiologie , Infections à Chlamydia/épidémiologie , Jeune adulte , Herpès génital/épidémiologie , Infections à papillomavirus/épidémiologie , COVID-19/épidémiologie , Adulte d'âge moyenRÉSUMÉ
BACKGROUND: Venereal syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (TPA), is surging worldwide, underscoring the need for a vaccine with global efficacy. Vaccine development requires an understanding of syphilis epidemiology and clinical presentation as well as genomic characterization of TPA strains circulating within at-risk populations. The aim of this study was to describe the clinical, demographic, and molecular features of early syphilis cases in Cali, Colombia. METHODS AND FINDINGS: We conducted a cross-sectional study to identify individuals with early syphilis (ES) in Cali, Colombia through a city-wide network of public health centers, private sector HIV clinics and laboratory databases from public health institutions. Whole blood (WB), skin biopsies (SB), and genital and oral lesion swabs were obtained for measurement of treponemal burdens by polA quantitative polymerase chain reaction (qPCR) and for whole-genome sequencing (WGS). Among 1,966 individuals screened, 128 participants met enrollment criteria: 112 (87%) with secondary (SS), 15 (12%) with primary (PS) and one with early latent syphilis; 66/128 (52%) self-reported as heterosexual, while 48 (38%) were men who have sex with men (MSM). Genital ulcer swabs had the highest polA copy numbers (67 copies/µl) by qPCR with a positivity rate (PR) of 73%, while SS lesions had 42 polA copies/µl with PR of 62%. WB polA positivity was more frequent in SS than PS (42% vs 7%, respectively; p = 0.009). Isolation of TPA from WB by rabbit infectivity testing (RIT) was achieved in 5 (56%) of 9 ES WB samples tested. WGS from 33 Cali patient samples, along with 10 other genomic sequences from South America (9 from Peru, 1 from Argentina) used as comparators, confirmed that SS14 was the predominant clade, and that half of all samples had mutations associated with macrolide (i.e., azithromycin) resistance. Variability in the outer membrane protein (OMP) and vaccine candidate BamA (TP0326) was mapped onto the protein's predicted structure from AlphaFold. Despite the presence of mutations in several extracellular loops (ECLs), ECL4, an immunodominant loop and proven opsonic target, was highly conserved in this group of Colombian and South American TPA isolates. CONCLUSIONS: This study offers new insights into the sociodemographic and clinical features of venereal syphilis in a highly endemic area of Colombia and illustrates how genomic sequencing of regionally prevalent TPA strains can inform vaccine development.
Sujet(s)
Syphilis , Treponema pallidum , Humains , Treponema pallidum/génétique , Treponema pallidum/immunologie , Treponema pallidum/isolement et purification , Colombie/épidémiologie , Syphilis/épidémiologie , Syphilis/microbiologie , Études transversales , Mâle , Adulte , Femelle , Vaccins antibactériens/immunologie , Variation génétique , Développement de vaccin , Jeune adulte , Adulte d'âge moyen , Séquençage du génome entier , AnimauxRÉSUMÉ
Background: The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. Objectives: The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. Methods: We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Results: Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ϱ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. Conclusion: The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.
Sujet(s)
Banques de sang , Donneurs de sang , Infections à VIH , Hépatite B , Hépatite C , Hôpitaux d'enseignement , Syphilis , Humains , Mâle , Femelle , Donneurs de sang/statistiques et données numériques , Burundi/épidémiologie , Études transversales , Adulte , Prévalence , Syphilis/épidémiologie , Infections à VIH/épidémiologie , Infections à VIH/transmission , Hépatite B/épidémiologie , Hépatite B/transmission , Banques de sang/statistiques et données numériques , Facteurs de risque , Hépatite C/épidémiologie , Adulte d'âge moyen , Jeune adulte , Réaction transfusionnelle/épidémiologie , AdolescentRÉSUMÉ
Background: Antiretroviral therapy (ART) has been shown to reduce human immunodeficiency virus (HIV) viral replication and ultimately achieve viral suppression and eliminate HIV transmission. However, little is known about the impact of viral suppression on high-risk behaviors and sexually transmitted infections (STIs). Objective: This study aimed to assess the rates of current syphilis infection in virally suppressed people living with HIV (PLWH) and whether with the duration of ART can reduce the current syphilis infection in eastern China. Method: We conducted a cross-sectional survey of PLWH in Zhejiang Province, China, in 2022. PLWH who were on ART >6 months and were virally suppressed (viral load <50 copies/mL) were included in the study. Data were collected from the National Epidemiological Database of Zhejiang Province and all participants were tested for viral load and current syphilis. Multivariable logistic regression was used to identify risk factors associated with current syphilis infection. Result: A total of 30,744 participants were included in the analysis. 82.7% of participants were male, the mean age was 44.9 ± 14.1 years, 84.9% had received ART in a hospital setting, the mean time on ART was 5.9 ± 3.1 years and 5.6% of participants were infected with current syphilis. Multivariable logistic regression showed that being male [adjusted odds ratio (aOR): 2.12, 95% confidence interval (CI): 1.69-2.66], high level of education (aOR: 1.23, 95% CI: 1.02-1.49), homosexual route of HIV infection (aOR: 1.80, 95% CI: 1.60-2.04), non-local registered residence (aOR: 1.29, 95% CI: 1.11-1.51), had history of STIs before HIV diagnosis (aOR: 1.95, 95 % CI: 1.75-2.18) and treatment provided by a municipal hospital (aOR: 2.16, 95% CI: 1.31-3.55) were associated with increased risk of current syphilis infection. Being married (aOR: 0.67, 95% CI: 0.58-0.76) was associated with a decreased risk of current syphilis infection. Conclusion: Our findings revealed a high rate of current syphilis infection among virally suppressed PLWH in eastern China. Duration of ART did not reduce the prevalence of current syphilis infection. Targeted interventions to reduce current syphilis infection should be prioritized for subgroups at higher risk.
Sujet(s)
Infections à VIH , Syphilis , Charge virale , Humains , Syphilis/épidémiologie , Études transversales , Mâle , Adulte , Infections à VIH/épidémiologie , Infections à VIH/complications , Femelle , Chine/épidémiologie , Adulte d'âge moyen , Facteurs de risqueRÉSUMÉ
Syphilis is a multistage sexually transmitted disease caused by Treponema pallidum ssp. pallidum. In the Czech Republic, there are around 700-800 new syphilis cases annually, continuously increasing since 2012. This study analyzed a total of 1228 samples from 2004 to 2022. Of the PCR-positive typeable samples (n = 415), 68.7% were fully-typed (FT), and 31.3% were partially-typed. Most of the identified isolates belonged to the SS14-clade and only 6.3% were the Nichols-like cluster. While in the beginning of sample collection isolates have been macrolide-susceptible, recent isolates are completely resistant to macrolides. Among the FT samples, 34 different allelic profiles (APs) were found. Most of the profiles (n = 27) appeared just once in the Czech population, while seven profiles were detected more than twice. The most frequent APs belonged to two separate groups of SS14-like isolates, including group of 1.3.1 (ST 1) and 1.26.1 (ST 25) profiles, and the second group containing 1.1.8 (ST 3), 1.1.1 (ST 2), and 1.1.3 (ST 11) (representing 57.5%, and 25.3% of all detected APs, respectively). Both groups consistently differed in 6 nucleotide positions in five genes (TP0150, TP0324, TP0515, TP0548, and TP0691) coding amino-acid replacements suggesting that one or more of these differences could be involved in the higher success of the first group.