Relevance of healthcare reimbursement data to monitor syphilis epidemic: an alternative surveillance through the national health insurance database in France, 2011–2013

Ngangro, Ndeindo Ndeikoundam; Viriot, Delphine; Lucas, E.; Boussac-Zarebska, M.; Lot, Florence; Dupin, Nicolas; Ruche, Guy La

doi:10.1136/bmjopen-2017-020336

Cited by 8 publications

(3 citation statements)

References 21 publications

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“…This trend is opposite to most reports. In France, syphilis reported cases have consistently increased since the early 2000s [ 1 , 3 , 23 ] though the prevalence of early infection remained stable between 2015 and 2016 [ 3 ]. The significant opposite trend reported in the present cohort of HIV-positive MSM patients could be explained by enrollment bias.…”

Section: Discussionmentioning

confidence: 99%

“…Sexually transmitted diseases (STIs) are a major public healthcare concern in sexually active patients and mostly in men who have sex with men (MSM) and HIV-positive patients. Trends in STIs prevalence are variable worldwide depending on health-care facilities, STIs prevalence, patient’s behavior, STI screening by providers, and STI treatment of infected persons and their partners [ 1 , 2 ]. Furthermore, STI trends in HIV-positive MSM could have be influenced by the “undetectable = untransmittable” (U = U) campaigns.…”

Section: Introductionmentioning

confidence: 99%

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Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening

Farfour

Dimi²,

Chassany

et al. 2021

PLoS ONE

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The burden of STIs is particularly high in HIV-infected MSM patients. A recent increase in STIs prevalence has been noticed in the US and western European countries. We aim to assess trends in asymptomatic STIs following the publication of recommendations for STIs screening, i.e. Chlamydia (CT) and gonorrhea (NG). Seventeen centers located in the Paris area participated in the study. All asymptomatic HIV-infected MSM patients attending a follow up consultation were proposed to participated in the study. Asymptomatic patients were included over 2 periods: period 1 from April to December 2015 and period 2 from September to December 2017. Etiologic diagnosis of STIs including hepatitis B, C, syphilis, was performed using a serological test, including a non-treponemal titer with a confirmatory treponemal assay for syphilis. CT and NG were screened using a nucleic acid amplification test (NAATs) on 3 anatomical sites, i.e. urine, rectal and pharyngeal. Overall, 781 patients were included: 490 and 291 in periods 1 and 2 respectively. Asymptomatic CT, NG, and syphilis were diagnosed in 7.5%, 4.8% and, 4.2% respectively. The rate of patients having a multisite asymptomatic infection was 10.2% and 21.1% for CT and NG respectively. The most frequently involved anatomical sites for CT and NG asymptomatic infections were anorectal (66.1% and 55.2% respectively) and pharyngeal (47.4% and 60.5% respectively). CT and NG asymptomatic infection increased by 1.3- and 2-fold respectively between the two periods while syphilis decreased by 3 folds. Our results encourage to reconsider multisite screening for CT and NG in asymptomatic HIV positive MSM as the yield of screening urinary samples only might be low. Despite the more systematic STI screening of asymptomatic HIV positive MSM the prevalence of STI is increasing in MSM in France. Therefore, this strategy has not led to alter CT and NG transmission. The decrease of syphilis might involve self-medication by doxycycline, and the intensification of syphilis screening.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening

Farfour

Dimi²,

Chassany

et al. 2021

PLoS ONE

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“…The World Health Organization (WHO) estimated that approximately 82.4 million new gonorrhea infections and 7.1 million new syphilis infections occurred worldwide in 2020 [1]. In France, the reported numbers of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis and rectal lymphogranuloma venereum (LGV) infections have been on the rise ever since their resurgence in the late 1990s [2][3][4][5]. Speci cally, in 2016, the country had an estimated 267 097 cases and 49 628 cases of diagnosed CT and NG infections, respectively [6].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with bacterial sexually transmitted infection screening uptake and diagnosis among men who have sex with men in France

KOUNTA,

CHAZELLE,

OUSSEINE

et al. 2023

Preprint

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Background The prevalence of syphilis, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) in men who have sex with men (MSM) is very high. As these bacterial sexually transmitted infections (bSTIs) are frequently asymptomatic, they are often undiagnosed and therefore untreated. We aimed to characterize the profile of MSM who reported bSTI screening and diagnosis in the previous 12 months, and to identify the factors associated with a diagnosis of a bSTI among MSM in France. Methods We used data from Enquête Rapport au Sexe (ERAS), a large French national anonymous cross-sectional online survey among MSM conducted from 26 February to 11 April 2021. After comparing MSM screened and diagnosed in the previous year with those who were not, a binary logistic regression model was used to compare MSM diagnosed with at least one bSTI with those who were not. Results Of the 13 300 survey respondents, 6 263 (47.1%) MSM reported screening for at least one bSTI in the previous 12 months. Of these, 1 060 (16.9%) were diagnosed for at least one bSTI during their most recent screening. Specifically, 446 (7.1%) MSM were diagnosed with NG, 427 (6.8%) with CT, and 402 (6.4%) for syphilis. The following self-reported factors were associated with a greater likelihood of bSTI diagnosis: younger age, a lower educational level, frequenting MSM meeting places, not currently using pre-exposure prophylaxis (PrEP) but willing to take preventive treatment against bSTIs, low health literacy, more than one sexual male partner, practicing chemsex, and condomless anal intercourse with casual male partners (the latter three factors concerning the previous six months). Conclusions A large proportion of MSM were diagnosed for at least one bSTI. This result provides an insight into bSTI screening uptake and diagnosis among MSM in France, and could inform future decisions about how to plan effective bSTI screening and diagnosis programs for this population.

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Evaluation of the Elecsys Syphilis electrochemiluminescence immunoassay as a first-line screening test in the reverse algorithms for syphilis serodiagnosis

Lee

Lim

et al. 2019

International Journal of Infectious Diseases

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With the development of the automated treponemal test, new syphilis serodiagnosis algorithms, reverse algorithm, and European Centre for Disease Prevention and Control (ECDC) algorithm have been recommended recently. We investigated the efficacy of an electrochemiluminescence immunoassay (ECLIA) as an initial screening test in the reverse and ECDC algorithms. Methods: Samples from 4,771 subjects were included in this study. We performed rapid plasma reagin (RPR), ECLIA, and Treponema pallidum particle agglutination (TPPA) according to these three algorithms. The fluorescent treponemal antibody absorbed (FTA-ABS) test was additionally applied for discordant cases between the RPR and ECLIA results. The FTA-ABS results and the consensus of three algorithms were considered a gold standard. Results: A total of 208 subjects were diagnosed with syphilis. The traditional algorithm had a sensitivity of 25.96%, specificity of 100%, and accuracy of 96.77%. Both the reverse and ECDC algorithms showed the same diagnostic performance, sensitivity of 95.19%, specificity of 99.96%, and accuracy of 99.75%. The agreements between the traditional algorithm and the other algorithms were 96.9% with a kappa value of 0.415. Conclusions: The diagnostic accuracy of the reverse and ECDC algorithms using the ECLIA as a first-line screening test was superior to that of the traditional algorithm.

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Relevance of healthcare reimbursement data to monitor syphilis epidemic: an alternative surveillance through the national health insurance database in France, 2011–2013

Cited by 8 publications

References 21 publications

Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening

Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening

Factors associated with bacterial sexually transmitted infection screening uptake and diagnosis among men who have sex with men in France

Evaluation of the Elecsys Syphilis electrochemiluminescence immunoassay as a first-line screening test in the reverse algorithms for syphilis serodiagnosis

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