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da Silva TPR, Schreck RSC, de Oliveira DCB, Mascarenhas LV, Luvisaro BMO, Camargo BTS, Martins EF, de Freitas GL, Matozinhos FP. Spatial and trend analysis of gestational syphilis cases in Brazil from 2011 to 2020: an ecological study. BMC Public Health 2024; 24:1859. [PMID: 38992653 PMCID: PMC11241899 DOI: 10.1186/s12889-024-19286-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024] Open
Abstract
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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Affiliation(s)
- Thales Philipe Rodrigues da Silva
- Department of Women's Health Nursing, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
- Graduate Nursing Program, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rafaela Siqueira Costa Schreck
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil
| | | | | | | | | | - Eunice Francisca Martins
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil
| | - Giselle Lima de Freitas
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil
| | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil.
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Costa IB, Pimenta IDSF, Aiquoc KM, Oliveira ÂGRDC. Congenital syphilis, syphilis in pregnancy and prenatal care in Brazil: An ecological study. PLoS One 2024; 19:e0306120. [PMID: 38917233 PMCID: PMC11198837 DOI: 10.1371/journal.pone.0306120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
The aim of this research was to evaluate the incidence of congenital syphilis and the ratio between congenital syphilis and syphilis in pregnant women in Brazil according to socioeconomic indicators (inadequate water supply and sanitation; illiteracy at 15 years of age or older; household income per capita; proportion of poor people; Gini index; human development index; and average health expenditure per inhabitant by the health system) and prenatal quality-of-care indicators. We conducted an ecological study using a sample composed of 257 municipalities, each with ≥ 100,000 inhabitants. Data was collected from four public databases: the Brazilian Institute of Geography and Statistics, comprising socioeconomical data from the 2010 census; and the data of 2019 available in the databases of the Department of Informatics of the Brazilian Health System, Information and Management of Primary Care, and the Electronic Citizen Information System. Descriptive analysis of dependent and independent variables and bivariate analysis by Negative Binomial regression were carried out. The mean incidence of congenital syphilis was 38% higher in municipalities with a Human Development Index up to 0.785 (ratio of means [RM] = 1.38; p = 0.049) and 57% higher among populations where less than 50% of primary healthcare services provided a rapid test for syphilis (RM = 1.57; p < 0.001). The ratio between congenital syphilis and syphilis in pregnant women was 29% higher in municipalities with a low household income per capita (RM = 1.29; p < 0.001) and 28% higher in locations where less than 50% of the primary healthcare services provided a rapid test for syphilis (RM = 1.28; p < 0.001). There was no statistical significance of the quality of prenatal care compared to the outcomes. This result underscores the challenges in detecting syphilis infections among pregnant women during prenatal care, consequently increasing the risk of vertical transmission of the disease to the fetus. Traits of inequality in the occurrence of congenital syphilis also draw attention to strategies to reduce health inequities and improve prenatal care.
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Affiliation(s)
- Izabelle Bezerra Costa
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Kezauyn Miranda Aiquoc
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ângelo Giuseppe Roncalli da Costa Oliveira
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Odontology, Federal University of Rio Grande do Norte, Natal, Brazil
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Salomè S, Cambriglia MD, Montesano G, Capasso L, Raimondi F. Congenital Syphilis: A Re-Emerging but Preventable Infection. Pathogens 2024; 13:481. [PMID: 38921779 PMCID: PMC11206692 DOI: 10.3390/pathogens13060481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
Congenital syphilis presents a significant global burden, contributing to fetal loss, stillbirth, neonatal mortality, and congenital infection. Despite the target established in 2007 by the World Health Organization (WHO) of fewer than 50 cases per 100,000 live births, the global incidence is on the rise, particularly in low- and middle-income regions. Recent data indicate a rate of 473 cases per 100,000 live births, resulting in 661,000 total cases of congenital syphilis, including 355,000 adverse birth outcomes such as early fetal deaths, stillbirths, neonatal deaths, preterm or low-birth-weight births, and infants with clinical congenital syphilis. Alarmingly, only 6% of these adverse outcomes occurred in mothers who were enrolled, screened, and treated. Unlike many neonatal infections, congenital syphilis is preventable through effective antenatal screening and treatment of infected pregnant women. However, despite available screening tools, affordable treatment options, and the integration of prevention programs into antenatal care in various countries, congenital syphilis remains a pressing public health concern worldwide. This review aims to summarize the current epidemiology, transmission, and treatment of syphilis in pregnancy, as well as to explore global efforts to reduce vertical transmission and address the reasons for falling short of the WHO elimination target.
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Affiliation(s)
- Serena Salomè
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (M.D.C.); (G.M.); (L.C.); (F.R.)
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Festa L, Prado MDF, Jesuino ACS, Balda RDCX, Tayra Â, Sañudo A, Tancredi MV, Silva MAD, Pinto VM, Costa-Nobre DT, Kiffer CRV, Luppi CG. Underreporting of unfavorable outcomes of congenital syphilis on the Notifiable Health Conditions Information System in the state of São Paulo, Brazil, 2007-2018. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2022664. [PMID: 37466564 PMCID: PMC10355990 DOI: 10.1590/s2237-96222023000200007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/20/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE to describe the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo, Brazil, 2007-2018. METHODS this was a descriptive study of cases of abortion, fetal and non-fetal deaths due to congenital syphilis reported on the Notifiable Health Conditions Information System (Sistema de Informação de Agravos de Notificação - SINAN), and those of congenital syphilis registered in any line in the Death Certificate, on the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM), by means of probabilistic and deterministic linkage. RESULTS of the 27,713 cases of congenital syphilis reported, 1,320 progressed to death (871 fetal deaths, 449 infant deaths) and were matched to the SIM; 355 deaths (259 fetal deaths, 96 infant deaths) were not included on SINAN; there was an increase in unfavorable outcomes,11.4% for infant deaths due to congenital syphilis, 3.0% for fetal deaths and 1.9% for abortions. CONCLUSION the use of different relationship techniques proved to be adequate to identify the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo.
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Affiliation(s)
- Larissa Festa
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil
| | - Marli de Fátima Prado
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | | | | | - Ângela Tayra
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Adriana Sañudo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Mariza Vono Tancredi
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Maria Aparecida da Silva
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | - Valdir Monteiro Pinto
- Secretaria de Estado da Saúde de São Paulo, Centro de Referência e Treinamento em DST/Aids, São Paulo, SP, Brazil
| | | | | | - Carla Gianna Luppi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
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Gamberini C, Juliana NCA, de Brouwer L, Vogelsang D, Al-Nasiry S, Morré SA, Ambrosino E. The association between adverse pregnancy outcomes and non-viral genital pathogens among women living in sub-Saharan Africa: a systematic review. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1107931. [PMID: 37351522 PMCID: PMC10282605 DOI: 10.3389/frph.2023.1107931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023] Open
Abstract
Adverse pregnancy outcomes are the main causes of maternal and neonatal morbidity and mortality, including long-term physical and psychological sequelae. These events are common in low- and middle-income countries, particularly in Sub Saharan Africa, despite national efforts. Maternal infections can cause complications at any stage of pregnancy and contribute to adverse outcomes. Among infections, those of the genital tract are a major public health concern worldwide, due to limited availability of prevention, diagnosis and treatment approaches. This applies even to treatable infections and holds true especially in Sub-Saharan Africa. As late as 2017, the region accounted for 40% of all reported treatable non-viral genital pathogens worldwide, many of which have been independently associated with various adverse pregnancy outcomes, and that include Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum. Two databases (PubMed and Embase) were examined to identify eligible studies published up to October 2022. This study reviewed findings on the association between infections by treatable non-viral genital pathogens during pregnancy and adverse pregnancy outcomes among women living in Sub-Saharan Africa. Articles' title and abstract were screened at first using keywords as "sexually transmitted infections", "non-viral", "adverse pregnancy outcome", "Africa", "sub-Saharan Africa", "pregnant women", "pregnancy", and "pregnancy outcome". Subsequently, according to the eligibility criteria, potential articles were read in full. Results showed that higher risk of preterm birth is associated with Treponema pallidum, Chlamydia trachomatis and Candida albicans infections. Additionally, rates of stillbirth, neonatal death, low birth weight and intrauterine growth restriction are also associated with Treponema pallidum infection. A better insight on the burden of non-viral genital pathogens and their effect on pregnancy is needed to inform antenatal care guidelines and screening programs, to guide the development of innovative diagnostic tools and other strategies to minimize transmission, and to prevent short- and long-term complications for mothers and children.
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Affiliation(s)
- Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | - Naomi C. A. Juliana
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | - Lenya de Brouwer
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - Dorothea Vogelsang
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - Salwan Al-Nasiry
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Department of Obstetrics and Gynecology, Research School GROW for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Servaas A. Morré
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad, UP, India
- Dutch Chlamydia trachomatis Reference Laboratory on Behalf of the Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands
- Research School GROW for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
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Elgalib A, Lau R, Al-Habsi Z, Shah S, Al-Rawahi B, Memish ZA, Lee SS, Al-Abri S. Elimination of mother-to-child transmission of HIV, syphilis and viral hepatitis B: A call for renewed global focus. Int J Infect Dis 2023; 127:33-35. [PMID: 36574535 DOI: 10.1016/j.ijid.2022.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ali Elgalib
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Richard Lau
- Burrell St Clinic, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
| | - Zeyana Al-Habsi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Samir Shah
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Bader Al-Rawahi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Ziad A Memish
- Research and Innovation Centre, King Saud Medical City, Ministry of Health, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Shui Shan Lee
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China; International Society for Infectious Diseases.
| | - Seif Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman; International Society for Infectious Diseases.
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Peng LW, Gao YJ, Cui YL, Xu H, Gao ZX. Missed opportunities for screening congenital syphilis early during pregnancy: A case report and brief literature review. Front Public Health 2023; 10:1073893. [PMID: 36684903 PMCID: PMC9853042 DOI: 10.3389/fpubh.2022.1073893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
Congenital syphilis is a significant public health problem. Pregnant women infected with Treponema pallidum present with various clinical manifestations, mainly including skin or visceral manifestations. The extensive clinical manifestations of T. pallidum infection mimic those of many other diseases during pregnancy, which may lead to delayed diagnosis and serious consequences. We report a case of fetal T. pallidum infection and premature delivery in a woman whose syphilis screening was negative at 16 weeks of gestation. Despite presenting to the dermatologist at 24 weeks of gestation with maculopapular rash which is usually associated with secondary syphilis, the diagnosis of syphilis was not considered. This case shows that even if early syphilis screening of pregnant women is negative, they may still get infected with T. pallidum later on in pregnancy. Therefore, in patients presenting with a rash without an obvious cause, T. pallidum infection should be excluded. The health status of patients' spouses should be assessed during pregnancy. Additionally, perinatal health education is necessary for women and their spouses during pregnancy. The abovementioned factors could reduce the probability of T. pallidum infection in pregnant women and their infants.
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Affiliation(s)
- Lei-Wen Peng
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Yu-Jie Gao
- Department of Laboratory Medicine, Meishan Women and Children's Hospital, Alliance Hospital of West China Second University Hospital, Sichuan University, Meishan, China
| | - Ya-li Cui
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
- Department of Laboratory Medicine, Meishan Women and Children's Hospital, Alliance Hospital of West China Second University Hospital, Sichuan University, Meishan, China
| | - Huang Xu
- Department of Laboratory Medicine, Meishan Women and Children's Hospital, Alliance Hospital of West China Second University Hospital, Sichuan University, Meishan, China
| | - Zheng-Xiang Gao
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
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Dantas JDC, Marinho CDSR, Pinheiro YT, da Silva RAR. Temporal Trend of Gestational Syphilis between 2008 and 2018 in Brazil: Association with Socioeconomic and Health Care Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16456. [PMID: 36554342 PMCID: PMC9778377 DOI: 10.3390/ijerph192416456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The increased number of cases in recent years has turned syphilis into a global public health problem. In 2020, 115,371 cases of acquired syphilis were reported (detection rate of 54.5 cases/100,000 inhabitants) in Brazil. In that same period, the country notified 61,441 cases of gestational syphilis (detection rate of 21.6 per 1000 live births). The number of syphilis cases points to the need to reinforce surveillance, prevention, and infection control actions, which is a worrying scenario for government organizations. This study aims to describe the temporal trend of gestational syphilis from 2008 to 2018 in Brazilian regions and to associate its detection rate with socioeconomic and health care indicators. We conducted an ecological study of temporal trends using secondary data from the Department of Informatics of the Unified Health System. The temporal trend was analyzed using the Joinpoint Regression program. The annual percent change (APC) and 95% confidence intervals (95%CI) were estimated and tested; statistical significance was assessed using the Monte Carlo permutation test. Correlations were assessed using Pearson's correlation coefficient, and statistical significance was calculated using Pearson's product-moment correlation. The gestational syphilis detection rate increased between 2008 and 2018. The South region showed the greatest trend, whereas the Midwest region presented the lowest trend. The following variables were significantly correlated with the gestational syphilis detection rate: Municipal Human Development Index, illiteracy rate, percentage of primary health care coverage, and proportion of doctors, nurses, and basic health units per inhabitant. Health policies are needed to mitigate social vulnerabilities and strengthen primary health care.
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Affiliation(s)
- Janmilli da Costa Dantas
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
| | | | - Yago Tavares Pinheiro
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
| | - Richardson Augusto Rosendo da Silva
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
- Center of Health Sciences, Department of Nursing, Federal University of Rio Grande do Norte, Natal 59078-900, Brazil
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Pícoli RP, Cazola LHDO. Missed opportunities in preventing mother-to-child transmission of syphilis in the indigenous population in central Brazil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2022. [DOI: 10.1590/1806-9304202200040006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Abstract Objectives: to estimate the detection rate of syphilis in pregnant women, the occurrence of congenital syphilis, and the rate of mother-to-child transmission of syphilis, in addition to analyzing missed opportunities in the prevention of mother-to-child transmission in the indigenous population. Methods: descriptive study of cases of pregnant indigenous women with syphilis resulting or not in a case of congenital syphilis. The data were obtained from the Sistema de Informação de Agravos de Notificação (Information System of Notifable Diseases), the records of the Infecções Sexualmente Transmissíveis do Distrito Sanitário Especial Indígena (Sexually Transmitted Infections in the Special Indigenous Health District), and the medical records of pregnant indigenous women in 2015. The database and the calculation of syphilis rates in pregnant women, congenital syphilis, and mother-to-child transmission were carried out. Data on prenatal, diagnosis and treatment of syphilis during pregnancy were collected from the medical records. Results: the detection rate of syphilis in pregnant women reached 35.2/1,000 live births (LB), the occurrence of congenital syphilis encompassed 15.7/1.000 LB, and the rate of mother-to-child transmission was 44.8%. Six (24%) pregnant women started prenatal care in the first trimester and seven (28%) attended seven or more consultations. The diagnosis of syphilis was late and only nine (36%) women were properly treated. Conclusions: failures in the diagnosis and the adequate treatment of pregnant women with syphilis compromised the prevention of mother-to-child transmission of the disease.
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Lannoy LH, Santos PC, Coelho R, Dias-Santos AS, Valentim R, Pereira GM, Miranda AE. Gestational and congenital syphilis across the international border in Brazil. PLoS One 2022; 17:e0275253. [PMID: 36282795 PMCID: PMC9595568 DOI: 10.1371/journal.pone.0275253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Brazil lacks data from syphilis in its border areas. We aimed to describe the spatial and temporal distribution of acquired syphilis (AS), in pregnancy (SP) and congenital syphilis (CS) in Brazilian municipalities in the arches border contexts. METHODS An ecological, cross-sectional study was conducted from 2010 to 2020. The study was based on the cases of syphilis available in the Notifiable Diseases Information System (SINAN), and on the Primary Health Care Information System. The detection rates of AS and SP, and the incidence of CS were estimated, and the time series was analyzed. Data between the border arches were compared. RESULTS In 2020, data showed 7,603 cases of AS (detection rate 64.8/100,000 inhabitants), 3,960 cases of SP (detection rate of 21.6/1,000 live births) and 836 cases of CS (incidence of 4.6/1,000 live births) in the border region. Between 2010 and 2020, the mean annual increase of detection rate of SP was 53.4% in Brazil, 48.0% in the border region, 59.6% in the North Arch, 28.8% in the Central and 67.2% in the South. Annual variation on the incidence of CS for the same period was 31.0% in Brazil 38.4% at the border, in the North and South Arcs 18.3% and 65.7% respectively. The Central Arch showed an increase only between 2010 and 2018 (62.7%). A total of 427 (72.6%) municipalities has primary health care coverage ≥ 95% of the population. In 2019, 538 (91.8%) municipalities reported using rapid tests for syphilis, which decreased to 492 (84%) in 2020. In 2019, 441 (75.3%) municipalities reported administering penicillin, and 422 (72%) in 2020. CONCLUSION Our data show syphilis reman problem at the Brazilian border, rates in pregnant are high. It was observed a reduction in the detection rates, SP and the incidence of CS between 2018 and 2020. Syphilis should be included on the agenda of all management levels, aiming at expanding access and quality care.
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Affiliation(s)
- Leonor H. Lannoy
- Post-Graduation Program in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Patrícia C. Santos
- Department of Chronic Diseases and Sexually Transmitted Infections, Secretary of Health Surveillance, Brazilian Ministry of Health, Brasilia, Distrito Federal, Brazil
| | - Ronaldo Coelho
- Department of Chronic Diseases and Sexually Transmitted Infections, Secretary of Health Surveillance, Brazilian Ministry of Health, Brasilia, Distrito Federal, Brazil
| | - Adriano S. Dias-Santos
- Department of Chronic Diseases and Sexually Transmitted Infections, Secretary of Health Surveillance, Brazilian Ministry of Health, Brasilia, Distrito Federal, Brazil
| | - Ricardo Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Gerson M. Pereira
- Department of Chronic Diseases and Sexually Transmitted Infections, Secretary of Health Surveillance, Brazilian Ministry of Health, Brasilia, Distrito Federal, Brazil
| | - Angelica E. Miranda
- Post-Graduation Program in Infectious Diseases, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Analysis of DNA extraction methods for detection of Treponema pallidum: A comparison of three methods. J Microbiol Methods 2021; 192:106383. [PMID: 34826521 DOI: 10.1016/j.mimet.2021.106383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 01/21/2023]
Abstract
Syphilis is a sexually transmitted disease caused by Treponema pallidum. DNA amplification methods have started to be used to facilitate diagnosis at different stages of the disease. The success of such methodologies depends on obtaining DNA from clinical samples in adequate quantity and quality for molecular reactions. There are many DNA extraction kits, but often the molecular analysis process is unfeasible due to its cost and access to imported products. Thus, this study aimed to analyze three methods of extracting DNA from Treponema pallidum from ulcers of patients investigated for syphilis. The three methods, an in house one (sonication) and two commercial ones (LGC, Brazil) and the PureLink Genomic DNA Mini Kit (Thermo Fisher Scientific, USA) were compared to the sequencing of these samples, which were used as a reference. Each method was evaluated based on the detection of T. pallidum by PCR using the tpp47 gene as a target for amplification, DNA quantification and method execution time. When compared to the sequencing, the sensitivity and agreement of the PureLink, sonication and LGC methods to extracted DNA were 100% (K = 1.0), 96.5% (K = 0.96) and 72.4% (K = 0.694), respectively. Specificity was 100% with the three methods. The sonication method was the closest in concentration of DNA to the PureLink method with a similar degree of purity, besides having the lowest cost-benefit ratio. It can be an interesting option for laboratories that work with reduced costs, since it is much more financially viable.
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Benítez J, Yépez MA, Hernández-Carrillo M, Martínez DM, Cubides-Munevar Á, Holguín-Ruiz JA, Muñoz MA. Sociodemographic and clinical characteristics of gestational syphilis in Cali, 2018. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2021; 41:140-152. [PMID: 34669285 PMCID: PMC8631772 DOI: 10.7705/biomedica.6003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/22/2021] [Indexed: 11/21/2022]
Abstract
Introduction: Gestational syphilis is considered an event of public health interest given its impact on mother and child. In Colombia, despite having specific protocols for its notification, diagnosis, and management, there are still limitations in its control. Objectives: To describe the sociodemographic and clinical characteristics, as well as the spatial distribution of gestational syphilis in Cali, Colombia, in 2018. Materials and methods: We conducted a cross-sectional study of 427 gestational syphilis cases reported to the Colombian national epidemiological surveillance system (Sivigila). For the statistical processing, we used the R program, version 3.5.3. We expressed qualitative variables as proportions and quantitative ones through central tendency and dispersion measures, and to establish the spatial distribution we used the Qgis program, version 3.0. Results: The prevalence of gestational syphilis was 17 cases per 1,000 live births (including stillbirths); 57.1% of patients belonged to the subsidized healthcare system and 16.6% had no health insurance; 90.4% of cases were diagnosed during pregnancy; 47.2% of the pregnant women received three doses of penicillin, yet only 57.6% of contacts were treated. Conclusions: The prevalence of gestational syphilis in Cali during 2018 exceeded the national rate with a higher frequency among women in socioeconomic vulnerability conditions consistent with the general spatial distribution. There was a lack of opportunity in the early detection and management of the infection both among pregnant women and their contacts, which hinders the control of the disease and reflects the inadequate application of the comprehensive maternal and perinatal health care route guidelines.
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Affiliation(s)
- Juliana Benítez
- Programa de Ginecología y Obstetricia, Universidad Libre, Cali, Colombia.
| | | | - Mauricio Hernández-Carrillo
- Programa de Ginecología y Obstetricia, Universidad Libre, Cali, Colombia; Posgrado en Ciencias Biomédicas y Psiquiatría, Universidad del Valle, Cali, Colombia.
| | | | - Ángela Cubides-Munevar
- Programa de Ginecología y Obstetricia, Universidad Libre, Cali, Colombia; Grupo de Investigación en Salud Pública, Fundación Universitaria San Martín, Cali, Colombia.
| | - Jorge Alirio Holguín-Ruiz
- Departamento de Salud Pública y Epidemiología, Pontificia Universidad Javeriana, Cali, Colombia; Área de Vigilancia Epidemiológica, Secretaría de Salud Municipal de Cali, Cali, Colombia.
| | - Martín Alonso Muñoz
- Área de Vigilancia Epidemiológica, Secretaría de Salud Municipal de Cali, Cali, Colombia.
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Easterlin MC, Ramanathan R, De Beritto T. Maternal-to-Fetal Transmission of Syphilis and Congenital Syphilis. Neoreviews 2021; 22:e585-e599. [PMID: 34470760 DOI: 10.1542/neo.22-9-e585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Between 2012 and 2018, rates of congenital syphilis increased by 291% in the United States. In 2018, the rate of congenital syphilis was the highest it has been since 1995. Given these concerning epidemiologic trends, this review seeks to summarize the maternal-to-fetal transmission of syphilis to ensure adequate care of affected mothers and their infants. It also serves as a call to reinvest public health resources and reestablish infrastructure to ensure reversal of this concerning trend to stop preventable perinatal deaths, associated morbidities, and long-term consequences of congenital syphilis.
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Affiliation(s)
- Molly Crimmins Easterlin
- Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles
| | - Rangasamy Ramanathan
- Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles
| | - Theodore De Beritto
- Division of Neonatology, Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA
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Shah S, Garg S, Heath K, Ofili O, Bansal Y, Seghers F, Storey A, Taylor M. Estimation of benzathine penicillin G demand for congenital syphilis elimination with adoption of dual HIV/syphilis rapid diagnostic tests in eleven high burden countries. PLoS One 2021; 16:e0256400. [PMID: 34411167 PMCID: PMC8376004 DOI: 10.1371/journal.pone.0256400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND WHO recommends use of rapid dual HIV/syphilis tests for screening pregnant women (PW) during antenatal care to prevent mother-to-child transmission. Scale-up of testing implies a need to accurately forecast and procure benzathine penicillin (BPG) to treat the additionally identified PW with syphilis. METHODS Country-reported ANC coverage, PW syphilis screening and treatment coverage values in 2019 were scaled linearly to EMTCT targets by 2030 (constant increasing slope from 2019 figures to 95% in 2030) for 11 focus countries. Antenatal syphilis screening coverage was substituted with HIV screening coverage to estimate potential contribution of rapid dual HIV/syphilis tests in identifying additional PW with syphilis. BPG demand was calculated for 2019-2030 accordingly. RESULTS The estimated demand for BPG (in 2.4 million unit vials) using current maternal syphilis prevalence and treatment coverage will increase from a baseline of 414,459 doses in 2019 to 683,067 doses (+65%) in 2021 assuming immediate replacement of single HIV test kits with rapid dual HIV/syphilis tests for these 11 countries. Continued scale up of syphilis screening and treatment coverage to reach elimination coverage of 95% will result in an estimated demand increase of 160%, (663,969 doses) from 2019 baseline for a total demand of 1,078,428 BPG doses by 2030. CONCLUSIONS Demand for BPG will increase following adoption of rapid dual HIV/syphilis test kits due to increases in maternal diagnoses of syphilis. To eliminate congenital syphilis, MNCH clinical programs will need to synergize with disease surveillance programs to accurately forecast BPG demand with scale up of antenatal syphilis screening to ensure adequate treatment is available for pregnant women diagnosed with syphilis.
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Affiliation(s)
- Sapan Shah
- Clinton Health Access Initiative (CHAI) India, New Delhi, Delhi, India
| | - Surbhi Garg
- Clinton Health Access Initiative (CHAI) India, New Delhi, Delhi, India
| | - Katherine Heath
- Department of Global Programmes of HIV, Hepatitis, STI, World Health Organization (WHO), Geneva, Switzerland
- Macfarlane Burnet Institute, Melbourne, Australia
| | - Obiageli Ofili
- Clinton Health Access Initiative (CHAI), Boston, Massachusetts, United States of America
| | - Yashika Bansal
- Clinton Health Access Initiative (CHAI) India, New Delhi, Delhi, India
| | - Frederic Seghers
- Clinton Health Access Initiative (CHAI), Boston, Massachusetts, United States of America
| | - Andrew Storey
- Clinton Health Access Initiative (CHAI), Boston, Massachusetts, United States of America
| | - Melanie Taylor
- Department of Global Programmes of HIV, Hepatitis, STI, World Health Organization (WHO), Geneva, Switzerland
- United States Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Sukwa N, Simuyandi M, Chirwa M, Kumwimba YM, Chilyabanyama ON, Laban N, Koyuncu A, Chilengi R. Clinical presentation of congenital syphilis in a rotavirus vaccine cohort study in Lusaka: a case series. J Med Case Rep 2021; 15:149. [PMID: 33789741 PMCID: PMC8015191 DOI: 10.1186/s13256-021-02745-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 02/17/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Despite an otherwise robust national antenatal clinic program, maternal and congenital syphilis remains an important public health issue in Zambia. This case series reports the clinical presentation of seven infants diagnosed with congenital syphilis in Lusaka, Zambia. CASE PRESENTATIONS The cases in this series were incidental findings from a cohort of infants enrolled in a rotavirus vaccine immunogenicity study recruiting infants at 6 weeks of age. As part of clinical care for enrolled participants, we screened mothers of children who presented with adverse events of (i) repeated upper respiratory tract infections/coryza, (ii) skin lesions, and (iii) poor weight gain, for syphilis using rapid plasma reagin test. From a cohort of 214 mother-infant pairs enrolled between September and December 2018, a total of 115 (44.4%) of the mothers reported to have not been screened during antenatal care. Of these, four (3.5%) reported to have tested positive; and only two received treatment. Seven out of 57 (26.6%) children meeting the screening criteria had a positive rapid plasma reagin test result. The mean age at diagnosis was 4.5 months (1.3 months standard deviation), and the common presenting features included coryza (6/7), skin lesions (4/7), conjunctivitis (3/7), pallor/anemia (5/7), wasting (2/7), and underweight (5/7). Three of the seven infants were exposed to human immunodeficiency virus. Following diagnosis, all seven cases received standard treatment according to national treatment guidelines. That is, 6/7 cases received inpatient care with benzylpenicillin for 10 days, while 1/7 was treated as an outpatient and received daily procaine penicillin for 10 days. CONCLUSION These findings suggest that, though screening for syphilis is part of the standard antenatal care in Zambia, it is not offered optimally. There is urgent need to address programmatic shortcomings in syphilis screening and treatment to avoid long-term sequelae. Additionally, clinicians need to raise their index of suspicion and rule out syphilis when confronted with these clinical symptoms, regardless of the mother's human immunodeficiency virus status.
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Affiliation(s)
- Nsofwa Sukwa
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Michelo Simuyandi
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Masuzyo Chirwa
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Yvonne Mutombo Kumwimba
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Obvious N. Chilyabanyama
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Natasha Laban
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Aybüke Koyuncu
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Roma Chilengi
- Enteric Disease and Vaccines Research Unit (EDVRU), Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
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16
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[Ocular manifestations of congenital syphilis. A case report]. J Fr Ophtalmol 2020; 44:e149-e151. [PMID: 33386171 DOI: 10.1016/j.jfo.2020.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022]
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17
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Oliveira VDS, Rodrigues RL, Chaves VB, dos Santos TS, de Assis FM, Ternes YMF, de Aquino ÉC. [High-risk clusters and temporal trends in congenital syphilis infection in Brazil]. Rev Panam Salud Publica 2020; 44:e75. [PMID: 32818032 PMCID: PMC7425818 DOI: 10.26633/rpsp.2020.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/05/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine the occurrence of high-risk clusters for congenital syphilis (CS) in Brazil and describe the temporal trends in the CS infection in the country, comparing children whose mothers received vs. those whose mothers did not receive prenatal care. METHOD This ecological study used data from the National Disease Notification System (Sistema de Informação de Agravos de Notificação, SINAN) and the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC). For cluster analysis, the Kulldorff scan statistic was applied to the population at risk. Statistical significance was determined by the log-likelihood ratio based on Poisson discrete distribution. To analyze the temporal trends of disease detection rates, Prais-Winsten regression was used. The analysis was performed with SatScan 9.4 and Stata 14.0 software. RESULTS Clusters with detection rates of 41.3, 44.4 and 188.1 CS cases/10 000 live births were identified in 2001, 2009 and 2017 respectively. In 2001, the rates were 8 times higher in the clusters than in the remaining country; in 2009, the rates were 3.3 times higher; and in 2017, 2.5 times higher. An increasing trend in CS infection was detected in all regions and federation units. The rates were 8.53 times higher in the children of mothers without prenatal care (243.3 cases/1 000 live births vs. 28.3 cases/1 000 live births in the children of mothers with prenatal care). CONCLUSIONS The identification of municipality clusters at high risk for CS and of increasing trends in CS infection across the country, even in the presence of prenatal care, suggests the need for improvement of public health actions to fight this disease.
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Affiliation(s)
- Vinícius da Silva Oliveira
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Roberta Luiza Rodrigues
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Vinícius Barros Chaves
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Thiago Soares dos Santos
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Flaviane Marques de Assis
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Yves Mauro Fernandes Ternes
- Universidade Federal de Goiás (IPTSP-UFG)Instituto de Patologia Tropical e Saúde PúblicaGoiânia (GO)BrasilUniversidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil.
| | - Érika Carvalho de Aquino
- Universidade Federal de Goiás (IPTSP-UFG)Instituto de Patologia Tropical e Saúde PúblicaGoiânia (GO)BrasilUniversidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil.
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Chitneni P, Beksinska M, Dietrich JJ, Jaggernath M, Closson K, Smith P, Lewis DA, Matthews LT, Smit J, Ndung’u T, Brockman M, Gray G, Kaida A. Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening. Int J STD AIDS 2020; 31:627-636. [PMID: 32403988 PMCID: PMC7357572 DOI: 10.1177/0956462420915395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16-24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18-20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.
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Affiliation(s)
- Pooja Chitneni
- Brigham and Women’s Hospital and Massachusetts General Hospital combined Infectious Diseases Fellowship, Boston, MA, USA
| | - Mags Beksinska
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Janan J. Dietrich
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Manjeetha Jaggernath
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - David A. Lewis
- Westmead Clinical School, Faculty of Medicine and Health & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lynn T. Matthews
- University of Alabama at Birmingham: Division of Infectious Diseases, Birmingham, AL, USA
| | - Jenni Smit
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Thumbi Ndung’u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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Storey A, Seghers F, Pyne-Mercier L, Peeling RW, Owiredu MN, Taylor MM. Syphilis diagnosis and treatment during antenatal care: the potential catalytic impact of the dual HIV and syphilis rapid diagnostic test. Lancet Glob Health 2019; 7:e1006-e1008. [PMID: 31303285 PMCID: PMC6759458 DOI: 10.1016/s2214-109x(19)30248-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 11/21/2022]
Affiliation(s)
- Andrew Storey
- Maternal and Neonatal Health, Clinton Health Access Initiative, Boston, MA 02127, USA.
| | - Frederic Seghers
- Maternal and Neonatal Health, Clinton Health Access Initiative, Boston, MA 02127, USA
| | - Lee Pyne-Mercier
- Maternal, Neonatal and Child Health, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Rosanna W Peeling
- International Diagnostics Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Melanie M Taylor
- Sexually Transmitted Infection Program, World Health Organization, Geneva, Switzerland; Division of Sexually Transmitted Disease Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
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