Mobility restrictions during the COVID-19 pandemic and reduced outpatient HIV and syphilis testing in Brazil

Social and individual vulnerability factors associated with syphilis among populations living on islands in the Brazilian Amazon

BACKGROUND

The repercussions of the syphilis epidemic differ according to populations. Identifying and acknowledging the differences and specificities of populations is fundamental in the design and implementation of policies aimed at assisting the groups most vulnerable to syphilis.

OBJECTIVE

To estimate the prevalence of antibodies against Treponema pallidum and associated vulnerability factors among riverside populations of a capital city in the Brazilian Amazon.

METHODS

Cross-sectional study was conducted among residents of the periurban islands in Belém, northern Brazil, from August 2020 to January 2021. The inclusion criterion was being a resident of the riverside communities of the Combú Environmental Protection Area, aged 18 years or over. The participants responded to questionnaire and were tested for syphilis using rapid test. Data were analyzed using multiple logistic regression by Minitab version 20® software.

RESULTS

Overall, a total of 325 riverine were included. Age varied from 18 to 91 years (average 40 years). Prevalence of markers for syphilis was 5.9% (95% CI: 3.3%-8.4%). The multiple regression showed that as age increases, the chances of having syphilis also increase (p = 0.001; aOR: 1.04) and riverside dwellers with more than one sexual partner in the last 6 months had more than four chances of having syphilis compared to people who had only one sexual partner (p = 0.007; aOR: 4.20).

CONCLUSION

Syphilis circulates among traditional populations in the Amazon and is associated with factors of social and individual vulnerability.

Adverse pregnancy outcomes and associated risk factors among pregnant women with syphilis during 2013-2018 in Hunan, China

Objective

To investigate the adverse pregnancy outcomes and associated risk factors among pregnant women with syphilis.

Design

Pregnant women with syphilis in the registry for the prevention of mother-to-child transmission of AIDS, syphilis and hepatitis B in Hunan Province, China, from January 1, 2013 to December 31, 2018 were included in the study.

Results

Among the 14,219 pregnant women with syphilis, 11,346 had definite pregnancy outcomes and were in singleton pregnancy. The risk factors related to adverse pregnancy outcomes include the age of pregnant women with syphilis <20 years old (aOR = 1.274, 95% CI: 1.088-1.493) or ≥ 35 years old (aOR = 1.402, 95% CI: 1.167-1.686), not married (aOR = 1.855, 95% CI: 1.453-2.367), initial syphilis detection in the late pregnancy (aOR = 1.266, 95% CI: 1.032-1.555), diagnosis of syphilis in the late pregnancy (aOR = 5.806, 95% CI: 1.796-18.770), diagnosis of syphilis during labor (aOR = 4.102, 95% CI: 1.263-13.330), husband/sexual partner infected with syphilis (aOR = 1.222, 95% CI: 1.068-1.398), untreated (aOR = 6.756, 95% CI: 5.586-8.197), and nonstandard medication (aOR = 3.300, 95% CI: 2.841-3.846).

Conclusion

The prevalence of adverse pregnancy outcomes among pregnant women with syphilis in Hunan Province, China from 2013 to 2018 was relatively high. The adverse pregnancy outcomes associated with syphilis could be reduced by early detection and standard treatment of syphilis for pregnant women and their husbands/sexual partners.