Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium – 1992 to 2012

Kenyon, Chris; Lynen, Lutgarde; Florence, Éric; Caluwaerts, Séverine; Vandenbruaene, M; Apers, Ludwig; Soentjens, Patrick; Esbroeck, Marjan Van; Bottieau, Emmanuel

doi:10.2807/1560-7917.es2014.19.45.20958

Cited by 52 publications

(66 citation statements)

References 23 publications

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“…The following exclusion criteria were applied; 1) patients who visited the clinic for a second opinion or those who were referred to other facilities on their first/second visit, because some baseline data were likely missing and the follow-up period was short in these patients, 2) patients younger than 20 years of age, because the Ethical Guidelines for Medical and Human Research Involving Human Subjects published by the Japanese Ministry of Health, Labour and Welfare require a written consent by parents/guardians for patients under age of 20 and it is impractical to obtain such consent for this study. Based on the results of baseline data analysis, we also excluded the following patients; 3) patients who had a confirmed active syphilis at baseline based on serum Rapid Plasma Reagin (RPR) titer ≥1:8 and positive Treponema pallidum Latex Hemagglutination Assay (TPHA) [8], and 4) patients who lacked follow-up syphilis test. At our clinic, the follow-up syphilis tests were generally performed at least every year and at the discretion of the treating physician.…”

Section: Methodsmentioning

confidence: 99%

“…The diagnosis of syphilis was based on both serum RPR ≥8 and positive TPHA result [8], either with or without clinical symptoms/signs suggestive of syphilis. At our clinic, written informed consent is obtained from each patient to routinely store blood samples at the first and subsequent visits, thus we had the stored samples collected from each patient at least every three months [7].…”

Section: Methodsmentioning

confidence: 99%

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Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

et al. 2016

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BackgroundThe epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown.MethodsThe incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods.ResultsOf 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5–52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008–2009: 48.2/1,000 person-years, 2010–2011: 51.1/1,000 person-years, 2012–2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (<33 years versus >40, HR 4.0, 95%CI 2.22–7.18, p<0.001), history of syphilis at baseline (HR 3.0, 95%CI 2.03–4.47, p<0.001), positive anti-amoeba antibody (HR 1.8, 95%CI 1.17–2.68, p = 0.006), and high baseline CD4 count (CD4 ≥350 /μL versus CD4 <200, HR 1.6, 95%CI 1.00–2.53, p = 0.050) as risk factors for incident syphilis. Incidence of syphilis was particularly high among young patients (age <33 years: 60.1/1,000 person-years). Interestingly, 37% of patients with incident syphilis were asymptomatic.ConclusionsAlthough incidence of syphilis did not increase during the observation period, it was high among HIV-1-infected MSM, especially among young HIV-1-infected MSM and those with history of syphilis, in Tokyo. Regular screening for syphilis needs to be strictly applied to this population.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

et al. 2016

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“…The threshold quantity

R_{0}

measures the average number of new syphilis infections generated by a single infected individual in a completely susceptible population . It is the geometric mean of the reproduction numbers for women (

R_{F}

) and men (

R_{M}

).…”

Section: Mathematical Analysismentioning

confidence: 99%

Mathematics of a sex‐structured model for syphilis transmission dynamics

Gumel

Lubuma

Sharomi

et al. 2018

Math Methods in App Sciences

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Communicated by: J. Banasiak MSC Classification: 34A34; 37N25; 92B05; 92D30 Syphilis, a major sexually transmitted disease, continues to pose major public health burden in both underdeveloped and developed nations of the world.This study presents a new 2-group sex-structured model for assessing the community-level impact of treatment and condom use on the transmission dynamics and control of syphilis. Rigorous analysis of the model shows that it undergoes the phenomenon of backward bifurcation. In the absence of this phenomenon (which is shown to arise because of the reinfection of recovered individuals), the disease-free equilibrium of the model is shown to be globally asymptotically stable when the associated reproduction number is less than unity. Furthermore, the model can have multiple endemic equilibria when the reproduction threshold exceeds unity. Numerical simulations of the model, using data relevant to the transmission dynamics of the disease in Nigeria, show that, with the assumed 80% condom efficacy, the disease will continue to persist (ie, remain endemic) in the population regardless of the level of compliance in condom usage by men. Furthermore, detailed optimal control analysis (using Pontraygin's maximum principle) reveals that, for situations where the cost of implementing the controls (treatment and condom-use) considered in this study is low, channelling resources to a treatment-only strategy is more effective than channelling them to a condom-use only strategy. Furthermore, as expected, the combined condom-treatment strategy provides a higher population-level impact than the treatment-only strategy or the condom-use only strategy. When the cost of implementing the controls is high, the 3 strategies are essentially equally as ineffective.

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“…It is estimated that recently even 40% of new cases of syphilis regard patients that have been treated for syphilis before. Interestingly, the problem of reinfections especially regards the HIV-positive and MSM [35][36][37].…”

Section: Serological Tests In Diagnosing Reinfectionsmentioning

confidence: 99%

Syphilis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 1: early and late syphilis

Wojas‐Pelc¹,

Pastuszczak²,

Serwin³

et al. 2018

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Syphilis (lues) is a systemic bacterial disease caused by Treponema pallidum subsp. pallidum, which is mainly sexually transmitted or can be acquired by an unborn foetus via the placenta. Due to its numerous symptoms, including various cutaneous and mucosal manifestations, diagnosis and treatment should be performed by dermatology and venereology experts. The incidence of syphilis has been incresing in the last years and syphilis has become a significant epidemiological problem in contemporary medicine. Contrary to a number of other infectious diseases, etiological agents of syphilis have never been cultured. Thus, diagnostic standards are based on indirect methods, such as serological tests. They are also used for monitoring treatment efficacy. Parenteral penicillin remains the gold standard in therapy of syphilis. Part 1 of recommendations discusses in detail the clinical presentation, diagnostics, and treatment of early and late syphilis, excluding central nervous system syphilis and syphilis in pregnancy. streszczenie Kiła (syphilis, lues) jest układową chorobą bakteryjną wywołaną przez krętka bladego (Treponema pallidum subsp. pallidum) przenoszoną głów

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Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium – 1992 to 2012

Cited by 52 publications

References 23 publications

Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

Mathematics of a sex‐structured model for syphilis transmission dynamics

Syphilis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 1: early and late syphilis

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