An Update on the Global Epidemiology of Syphilis

Kojima, Noah; Klausner, Jeffrey D.

doi:10.1007/s40471-018-0138-z

Cited by 260 publications

(262 citation statements)

References 174 publications

(137 reference statements)

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“…This bacterium is primarily transmitted by sexual exposure or through vertical transmission during pregnancy. Syphilis is still a public health problem worldwide and low-income countries have endemic rates of syphilis among their general populations while middle-or high-income countries have concentrated epidemics of syphilis in specific populations, for example, sex workers [3]. The World Health Organization (WHO) estimates that around 6 million new cases of syphilis occur every year among adults aged between 15 and 49 years [4].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

et al. 2020

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Background: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. Methods: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). Results: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. Conclusions: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.

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Section: Introductionmentioning

confidence: 99%

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

et al. 2020

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“…Similarly, syphilis has been widely spread among HIV-positive individuals in the last few years, especially in men who have sex with men (MSM) [3,4]. There is no doubt that the high rate of HBV, HCV, and syphilis among HIV-positive individuals has become a global public health problem [5,6].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Zhang¹,

Ren²,

Chang³

2020

IJERPH

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Human immunodeficiency virus (HIV)-infected patients are at a higher risk for co-infection with Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Treponema pallidum (TP; the agent causing syphilis) than the general population. The prevalence of HBV, HCV, and syphilis has geographic differences and varies from region to region among HIV-positive individuals. A retrospective study was carried out on HIV-positive individuals between June 2011 and June 2016 in Shaanxi Province. Univariate and multivariate logistic regression analyses using stepwise regression analysis regarding risk factors for HIV-HBV, HIV-HCV, and HIV-syphilis co-infection. HBV-HCV, HCV-syphilis, HBV-syphilis, and HBV-HCV-syphilis co-infection rates were 1.7%, 2.2%, 2.6%, and 0.1%, respectively. The rate of ineffective hepatitis B vaccine immunization was as high as 30.2% among HIV-positive individuals. Ethnicity (OR = 31.030, 95% CI: 11.643-82.694) and HIV transmission routes (OR = 134.024, 95% CI: 14.328-1253.653) were the risk factors for HCV infection in HIV-positive individuals. Among the HIV-positive individuals with the antibodies of TP, the rate of homosexual transmission was also higher, but heterosexual transmission was lower (OR = 0.549 95% CI: 0.382-0.789) The HIV-infected patients in Shaanxi Province had the characteristics of low active detection rate and late diagnosis. The high rate of ineffective vaccination against HBV suggests a need for improved vaccination services.

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“…The relationship of pinta to the infections caused by Treponema pallidum subspecies, however, is little known. Treponemal infection has long been the topic of speculation concerning its origin, past distribution, clinical presentation, nature of the causative agent(s), and epidemiology of the currently recognized clinical phenotypes (e.g., Giacani & Lukehart, ; Kojima & Klausner, ; Mitjà et al, ). Because syphilis was perceived to be a new condition that suddenly appeared in Europe in the late 15th century, debate about its origin has persisted for more than five centuries (see reviews by Baker & Armelagos, ; Cook & Powell, ; Harper, Zuckerman, Harper, Kingston, & Armelagos, ), giving rise to the competing Columbian, Pre‐Columbian, Unitarian, and Evolutionary hypotheses.…”

Section: Introductionmentioning

confidence: 99%

Advancing the understanding of treponemal disease in the past and present

Baker

Crane-Kramer

Dee

et al. 2020

American J Phys Anthropol

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Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations.Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time. K E Y W O R D S archaeological biogeochemistry,

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An Update on the Global Epidemiology of Syphilis

Abstract: Continued vigilance and investment is needed to address syphilis worldwide. The epidemiology of syphilis differs in high-income and low- and middle-income counties.

Cited by 260 publications

References 174 publications

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

Advancing the understanding of treponemal disease in the past and present

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