BackgroundThe shortage of benzathine penicillin G (BPG) worldwide presents a major challenge in the treatment of syphilis. Its availability for syphilis treatment has not been adequately evaluated in China.MethodsTwo surveys were conducted among hospitals providing sexually transmitted infection clinical services in Shandong Province in 2012 and 2018. Data on the basic information and BPG availability of the surveyed hospitals and related factors were collected and analyzed using SPSS 17.0.ResultsA total of 433 and 515 hospitals were surveyed in 2012 and 2018, respectively. A significant difference in BPG availability was observed among different levels and types of hospitals both in 2012 (X2 = 9.747, p = 0.008; X2 = 37.167, p = 0.000) and 2018 (X2 = 11.775, p = 0.003; X2 = 28.331, p = 0.000). The BPG availability among surveyed hospitals increased from 45.0% in 2012 to 56.4% in 2018 (X2 = 11.131, p = 0.001). The BPG availability was higher in 2018 than in 2012 among county-level hospitals (52.0% vs. 40.8%, X2 = 7.783, p = 0.005), general western medicine hospitals (62.1% vs. 50.0%, X2 = 6.742, p = 0.009), maternal and child health hospitals (57.1% vs. 26.9%, X2 = 13.906, p = 0.000), and public hospitals (56.8% vs. 45.0%, X2 = 11.361, p = 0.001). However, the county-level availability of BPG (at least one hospital has BPG in a county-level unit) has not improved between 2012 and 2018 (65.93% vs. 70.34%; X2 = 0.563, p = 0.453). The absences of clinical needs, restriction of clinical antibacterial drugs, and lack of qualifications for providing syphilis treatment were the major reasons for the low BPG availability of hospitals.ConclusionsBPG availability for syphilis treatment in Shandong Province remains low and presents disparities among different levels and types of hospitals, although it has been improved in recent years. The low availability of BPG for syphilis treatment in China is related to its clinical use by doctors rather than the market supply. Health care reforms should further improve the availability and accessibility of health services.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-4006-4) contains supplementary material, which is available to authorized users.
Background Availability of laboratory testing is the prerequisite for early diagnosis of syphilis. This study aimed to understand the availability of laboratory testing for syphilis among different hospitals in Shandong province. Methods Basic information on hospitals provided clinical health service for sexually transmitted infections in Shandong province and type of laboratory tests for syphilis provided was collected and analyzed using Chi-square test. Results A total of 410 and 456 hospitals provided sexually transmitted infection (STI) clinical services were surveyed in 2012 and 2018, respectively. Significant differences in the availability of nontreponemal tests were observed among hospitals with different levels (X 2 =6.624, p=0.010) and types (X 2 =17.752, p=0.001) in 2012 but not in 2018. A significant difference in the availability of treponemal tests was observed at different levels in 2012 (X 2 =9.937, p=0.002) but not in 2018. Significant differences in the availability of nontreponemal tests, titre of nontreponemal tests, and treponemal tests were observed among hospitals with different affiliations in 2018 (p=0.000; X 2 =15.274, p=0.000; p=0.021) but not in 2012. The availability of both nontreponemal test and treponemal test for syphilis among hospitals in 2018 was higher than that in 2012 (90.13% vs. 57.56%, X 2 =121.219, p=0.000). Conclusions Further efforts are needed to reduce the disparity in availability of laboratory testing for syphilis among different hospitals in China.
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