Re-emergence of syphilis in women of reproductive age and its association with the increase in congenital syphilis in Mexico during 2010–2019: an ecological study

Abstract

Background Syphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy, causing neonatal syphilis. The objective of this study was to examine trend in syphilis, congenital syphilis, and neonatal deaths among the Mexican population during 2010–2019. Methods An ecological study was carried out to collect information about the incidence of syphilis, the incidence of congenital syphilis, and the incidence of neonatal death from congenital syphilis. The variables were described considering age, sex, Mexican state, and year. Trends across time (calendar year) were analyzed using linear regression, increases were estimated with 95% confidence intervals, and p < 0.05 was considered statistically significant. Results The incidence of syphilis increased by an average of 0.336 cases/100,000 per year and was higher among women aged 15–19 years (0.693 cases). Cases of congenital syphilis increased from 62 cases in 2010 to 372 cases in 2019; furthermore, the increase in syphilis cases among women aged 20 to 24 years was associated with an increase in cases of congenital syphilis. In 2010, 50% of Mexican states did not report cases of congenital syphilis, but in 2018, only 10% did not report cases of congenital syphilis. Between 2010 and 2018, 83 neonatal deaths were reported, with the highest incidence in 2018 (0.88 deaths/100,000 newborns). Conclusion The incidence of congenital syphilis is increasing in Mexico. As a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to address and treat syphilis in various population groups.

New trends in congenital syphilis: epidemiology, testing in pregnancy, and management

“…Mexico reported an increased incidence of over 300% of infectious syphilis cases between 2010 and 2019, most concentrated in the population of reproductive age, with a notable increase in cases in women aged 24–29 years old [10 ▪ ]. Alongside this, an exponential growth in congenital syphilis cases has been reported, with 372 cases reported in 2019 compared with 62 cases in 2010 [10 ▪ ]. In Japan, syphilis cases have increased to levels not seen since the 1970s, including a pronounced increase in cases in heterosexual men and women and a concomitant rise in congenital syphilis cases [16 ▪ ,17].…”

“…Congenital syphilis occurs as a result of syphilis infection in pregnancy, the numbers of which relate to the incidence of infectious syphilis in the general population. During the last decade in particular there has been a resurgence in the incidence of infectious syphilis in a number of middle-income and high-income countries [1,6,7,8 ▪▪ ,9,10 ▪ ,11]. Although syphilis transmission is predominantly via the heterosexual route in lower income countries [7], in the majority of higher income countries it has been most concentrated in populations of MSM [12].…”

“…Cases of congenital syphilis in the United States disproportionately affect African American women [9]. Mexico reported an increased incidence of over 300% of infectious syphilis cases between 2010 and 2019, most concentrated in the population of reproductive age, with a notable increase in cases in women aged 24–29 years old [10 ▪ ]. Alongside this, an exponential growth in congenital syphilis cases has been reported, with 372 cases reported in 2019 compared with 62 cases in 2010 [10 ▪ ].…”

High Incidence, Reinfections, and Active Syphilis in Populations Attending a Specialized HIV Clinic in Mexico, a Dynamic Cohort Study

“…Syphilis increased from 2.03 cases per 100,000 inhabitants in 2010 to 6.09 cases in 2019. Finally, the number of cases of congenital syphilis grew from 62 cases in 2010 to 372 cases in 2019 (García-Cisneros et al, 2021 ). Syphilis is important because of the number of cases and the higher risk of acquiring and transmitting HIV; syphilis increases the risk of contracting HIV by 2.5 times; moreover, coinfection with syphilis and HIV negatively modifies both diseases (Lynn et al, 2004 ).…”

Alta seroprevalencia de sífilis y herpes genital en migrantes en tránsito en Chiapas, México

“…Entre los grupos móviles en América Central y México, el aislamiento social, los impactos socioeconómicos del desplazamiento, las desigualdades de género y el estigma y discriminación configuran un riesgo para adquirir ITS. Adicionalmente, en los últimos años se ha documentado una reemergencia mundial de sífilis (10)(11)(12), detectada principalmente entre personas que viven con VIH (PVV) y hombres que tienen sexo con hombres (HSH) (13). No obstante, permanece la incógnita sobre otros grupos vulnerables como mujeres y población migrante, siendo necesario realizar investigaciones epidemiológicas dirigidas a grupos vulnerables en las estaciones de tránsito de migración.…”