Trends and Predictors of Syphilis Prevalence in the General Population: Global Pooled Analyses of 1103 Prevalence Measures Including 136 Million Syphilis Tests

Smolak, Alex; Rowley, J; Nagelkerke, Nico; Kassebaum, Nicholas J; Chico, R Matthew; Korenromp, Eline L.; Abu-Raddad, Laith J

doi:10.1093/cid/cix975

Cited by 55 publications

(69 citation statements)

References 25 publications

(30 reference statements)

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“…The summarised and studyspecific risk of bias and precision assessments are shown in the appendix (pp [15][16][17][18][19][20][21][22][23][24][25][26][27] Table 3 shows the metaanalyses' results for the pooled average C trachomatis prevalence for each atrisk popula tion, stratified by type of assay used for infection ascertain ment. Current infection prevalence was estimated at 3•0% (table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Studies applying nucleic acid amplification test (NAAT) and culture to the same biological specimen were included separately given our interest in studying their contribution to hetero geneity in C trachomatis prevalence, and in generating STIestimation correction factors based on assay type. [23][24][25] Studies applying other antigen detection assays to the same biological specimen were included only once based on assay sensitivity (direct fluorescence and enzyme linked immunoassays on genital samples were prioritised over Giemsa staining).…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

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Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Smolak

Chemaitelly

Hermez

et al. 2019

The Lancet Global Health

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Background The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. Methods We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of betweenstudy heterogeneity were determined using meta-regression. Findings We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3•0% (95% CI 2•3-3•8) in general populations, 2•8% (1•0-5•2) in intermediate-risk populations, 13•2% (7•2-20•7) in female sex workers, 11•3% (9•0-13•7) in infertility clinic attendees, 12•4% (7•9-17•7) in women with miscarriage, 12•4% (9•4-15•7) in symptomatic women, and 17•4% (12•5-22•8) in symptomatic men. Pooled prevalence of current rectal infection was 7•7% (4•2-12•0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29•0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. Interpretation C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region.

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Section: Resultsmentioning

confidence: 99%

Section: Implications Of All the Available Evidencementioning

confidence: 99%

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Smolak

Chemaitelly

Hermez

et al. 2019

The Lancet Global Health

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“…After the discovering of penicillin, the disease had almost-but only almost-disappeared from all corners of the world. According to the findings from a remarkable epidemiological study, involving 154 countries, using meta-analyses and meta-regressions, conducted from 1990-2016, showed that the median prevalence for syphilis worldwide was 1.4% [3]. This study also points to a decline of the prevalence rate of syphilis in the general population.…”

mentioning

confidence: 73%

Syphilis: A Tricky Disease that may Pose Some Diagnostic Challenges - A Case Report

Norberto¹,

Dante²

2018

J Infect Dis Epidemiol

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This article reports a case of secondary stage syphilis involving the oral mucosa and the skin (the palms). The lesion's clinical aspects of both sites could possibly be misdiagnosed for some common inflammatory diseases, among them oral lichenoid contact lesion or drug reaction. As a standard procedure, the differential diagnosis required to rule out syphilis. The treponemal and anti-treponemal tests confirmed the diagnosis of syphilis. The patient was successfully treated, but, unfortunately, his partners from sexual encounters were left unaccounted for. People who contract syphilis and are left untreated jeopardize society. This is the main reason why syphilis cannot be easily controlled from spreading.

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“…2-5 The World Health Organization (WHO) Global Health Sector Strategy aims to reduce syphilis and gonorrhoea incidence over 2018-2030 by 90%, and to reduce the incidence of congenital syphilis to <50 cases per 100 000 live births by 2030. 6 China had 448 620 officially reported syphilis cases in 2012, almost doubling the number of cases reported in 2007; additionally, the rate of primary and secondary syphilis in 2012 was 13.44 cases per 100 000 population, increasing by 1.5 times since 2007. 7 China's syphilitic epidemic resurged with the commencement of economic prosperity in the 1980s, [8][9][10] especially in the areas of prosperous south-eastern seaboard.…”

Section: Introductionmentioning

confidence: 98%

Screening for syphilis with dual algorithms: analysis of discordant and concordant serology results in a population with a low prevalence of syphilis

Zhuang

Liu

Tang

et al. 2018

Acad Dermatol Venereol

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The RSA identified more patients with reactive treponemal serology. However, it also yielded an increased likely false-reactive rate compared with the TSA, especially those results with low index values and TRUST-nonreactive serology, were necessary to retest with a second treponemal test. Further testing results with TPPA, VITROS TPA and EuroWB suggested the false-reactive CIA screening results and the likely false-nonreactive TPPA results when the reactive treponemal results screened with RSA were to be identified.

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Trends and Predictors of Syphilis Prevalence in the General Population: Global Pooled Analyses of 1103 Prevalence Measures Including 136 Million Syphilis Tests

Abstract: Syphilis prevalence has been declining in every region by several percentage points per year. Nevertheless, the prevalence by region continued to vary, from as little as 0.1% in the European Region to as high as 3% in the African Region.

Cited by 55 publications

References 25 publications

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression

Syphilis: A Tricky Disease that may Pose Some Diagnostic Challenges - A Case Report

Screening for syphilis with dual algorithms: analysis of discordant and concordant serology results in a population with a low prevalence of syphilis

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