Identifying and interpreting spatiotemporal variation in diagnoses of infectious syphilis among men, England: 2009 to 2013

Petersen, Jakob; Gibin, Maurizio; Sile, Bersabeh; Simms, Ian

doi:10.1136/sextrans-2015-052306

Cited by 9 publications

(17 citation statements)

References 17 publications

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“…Newer epidemiological methods such as space-time clustering have been used to investigate syphilis epidemiology in the UK and the Netherlands. These identified previously undetected outbreaks among HIV-positive and HIV-negative MSM [ 15 , 43 ]. Such analyses could support syphilis control, management and guide public health interventions.…”

Section: Outbreaksmentioning

confidence: 99%

The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe

et al. 2019

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Syphilis can cause severe complications and sequelae. Following a decrease in reported cases in European Union/European Economic Area (EU/EEA) and other high-income countries in the 1980s and 1990s as a result of the HIV epidemic and ensuing changes in sexual behaviour, trends started to increase in the 2000s in a number of EU/EEA Member States with higher rates among men and a large proportion of cases reported among men who have sex with men (MSM), particularly HIV-positive MSM. Trends in EU/EEA Member States vary however with some countries continuing to report decreases in the number of reported cases (mostly in the Eastern part of EU/EEA) whereas many Western European countries report increasing numbers of cases. Increasing rates among women, although still relatively low, have been observed in a number of countries leading to concerns around mother-to-child transmission of syphilis and congenital syphilis. Similar overall trends are observed in other high-income countries with the exception of Japan where rates among heterosexual men and women have been rising at alarming levels. Control of syphilis requires use of comprehensive, evidence-based strategies which take into account lessons learned from previous control efforts as well as consideration of biomedical interventions.

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Section: Outbreaksmentioning

confidence: 99%

The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe

et al. 2019

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“…Data were obtained from reports of CS made to Public Health England (PHE) National Infection Service; diagnoses of infectious syphilis reported to the genitourinary medicine clinic activity dataset (GUMCAD) sexually transmitted infections (STI) surveillance system, and mid-year population estimates for England [ 4 , 5 ]. Three analyses were undertaken: simulation modelling with 100,000 simulations based on a Poisson distribution of CS cases reported since 2010; time-series analyses (TSA) were used to identify exceedances in ST-syphilis case-frequencies by sex, sexual orientation and area for the period from January 2011 to September 2016 [ 6 ]. The 152 English upper-tier local authorities (LA) were categorised into one of following syphilis epidemiological areas (SEA): (i) incident areas: LAs where the mothers of the CS cases lived; (ii) endemic areas: LAs with established spatiotemporal clusters of ST-syphilis in men [ 6 ]; (iii) rest of England: all other LAs in England.…”

Section: Data Sources and Analysesmentioning

confidence: 99%

“…Three analyses were undertaken: simulation modelling with 100,000 simulations based on a Poisson distribution of CS cases reported since 2010; time-series analyses (TSA) were used to identify exceedances in ST-syphilis case-frequencies by sex, sexual orientation and area for the period from January 2011 to September 2016 [ 6 ]. The 152 English upper-tier local authorities (LA) were categorised into one of following syphilis epidemiological areas (SEA): (i) incident areas: LAs where the mothers of the CS cases lived; (ii) endemic areas: LAs with established spatiotemporal clusters of ST-syphilis in men [ 6 ]; (iii) rest of England: all other LAs in England.…”

Section: Data Sources and Analysesmentioning

confidence: 99%

Factors associated with four atypical cases of congenital syphilis in England, 2016 to 2017: an ecological analysis

et al. 2017

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Four isolated cases of congenital syphilis born to mothers who screened syphilis negative in the first trimester were identified between March 2016 and January 2017 compared with three cases between 2010 and 2015. The mothers were United Kingdom-born and had no syphilis risk factors. Cases occurred in areas with recent increases in sexually-transmitted syphilis among women and men who have sex with men, some behaviourally bisexual, which may have facilitated bridging between sexual networks.

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“…Endemic areas consisted of MSOAs that had a high diagnosis rate for every six month period in 2012 and 2013. To avoid large endemic areas masking small clusters a two-stage procedure was used [ 21 ]. After endemic areas had been excluded, potential clusters were identified using a retrospective spatial-temporal SaTScan analysis ( S1 Text ) [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Potential clusters were detected at the 95% confidence level and a discrete Poisson model was used to adjust for age, gender, ethnicity, and IMD rank. Population weighted centroids for each MSOA were used to identify clusters containing up to 1% of the population instead of the SaTScan 50% default setting [ 21 ]. Data for MSOAs contained within a cluster were aggregated.…”

Section: Methodsmentioning

confidence: 99%

Spatial clusters of gonorrhoea in England with particular reference to the outcome of partner notification: 2012 and 2013

et al. 2018

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BackgroundThis study explored spatial-temporal variation in diagnoses of gonorrhoea to identify and quantify endemic areas and clusters in relation to patient characteristics and outcomes of partner notification (PN) across England, UK.MethodsEndemic areas and clusters were identified using a two-stage analysis with Kulldorff’s scan statistics (SaTScan).ResultsOf 2,571,838 tests, 53,547 diagnoses were gonorrhoea positive (positivity = 2.08%). The proportion of diagnoses in heterosexual males was 1.5 times that in heterosexual females. Among index cases, men who have sex with men (MSM) were 8 times more likely to be diagnosed with gonorrhoea than heterosexual males (p<0.0001). After controlling for age, gender, ethnicity and deprivation rank, 4 endemic areas were identified including 11,047 diagnoses, 86% of which occurred in London. 33 clusters included 17,629 diagnoses (34% of total diagnoses in 2012 and 2013) and spanned 21 locations, some of which were dominated by heterosexually acquired infection, whilst others were MSM focused. Of the 53,547 diagnoses, 14.5% (7,775) were the result of PN. The proportion of patients who attended services as a result of PN varied from 0% to 61% within different age, gender and sexual orientation cohorts. A third of tests resulting from PN were positive for gonorrhoea. 25% of Local Authorities (n = 81, 95% CI: 20.2, 29.5) had a higher than expected proportion for female PN diagnoses as compared to 16% for males (n = 52, 95% CI: 12.0, 19.9).ConclusionsThe English gonorrhoea epidemic is characterised by spatial-temporal variation. PN success varied between endemic areas and clusters. Greater emphasis should be placed on the role of PN in the control of gonorrhoea to reduce the risk of onward transmission, re-infection, and complications of infection.

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Identifying and interpreting spatiotemporal variation in diagnoses of infectious syphilis among men, England: 2009 to 2013

Cited by 9 publications

References 17 publications

The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe

The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe

Factors associated with four atypical cases of congenital syphilis in England, 2016 to 2017: an ecological analysis

Spatial clusters of gonorrhoea in England with particular reference to the outcome of partner notification: 2012 and 2013

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