ObjectiveThe present study aims to identify reasons behind the lower political priority of mother-to-child transmission (MTCT) of syphilis compared with HIV, despite the former presenting a much larger and growing burden than the latter, in China, over the 20 years prior to 2010.MethodsWe undertook a comparative policy analysis, based on informant interviews and documentation review of control of MTCT of syphilis and HIV, as well as nonparticipant observation of relevant meetings/trainings to investigate agenda-setting prior to 2010.ResultsWe identified several factors contributing to the lower priority accorded to MTCT of syphilis: relative neglect at a global level, dearth of international financial and technical support, poorly unified national policy community with weak accountability mechanisms, insufficient understanding of the epidemic and policy options, and a prevailing negative framing of syphilis that resulted in significant stigmatization.ConclusionA dual elimination goal will only be reached when prioritization of MTCT of syphilis is enhanced in both the international and national agendas.
19S-IgM-FTA-ABS makes congenital syphilis case classification simpler and faster for newborns. In areas where 19S-IgM-FTA-ABS is not available, comparing newborn RPR titres with maternal titres can be an alternative method. Meanwhile, positive follow-up results act as treatment indicators for older infants. As congenital syphilis definitions vary over the country, the Shenzhen programme suggested a practical model for surveillance and treatment in areas with or without available 19S-IgM-FTA-ABS testing.
BackgroundTo compare choroidal thickness in patients with adult-onset foveomacular vitelliform dystrophy (AOFVD) with healthy subjects and to correlate choroidal thickness with age, gender and spherical equivalent.MethodsA prospective, observational study of 37 eyes (15 eyes in AOFVD group and 22 eyes in control group) was conducted. Images were acquired by enhanced depth imaging optical coherence tomography (EDI-OCT). Choroidal thickness measurements were performed in the subfoveal region and at 500, 1000 and 1500 µm intervals from the foveal center to nasal and to temporal regions for subsequent averaging of values.ResultsThe AOFVD group consisted of four male eyes (28.6 %) and 10 female eyes (71.4 %); age was 33–62 years; spherical equivalent (SE) ranged from −1.50 to 1.50 spherical diopters (SD); mean subfoveal thickness was 325.6 µm, ranging from 186 to 420 µm; and the average of thicknesses was 309.4 µm, ranging from 188 to 413 µm. The control group consisted of 12 male eyes (54.5 %) and 10 female eyes (45.5 %); age was 27–62 years; SE ranged from −2.50 to 0.50 SD; subfoveal thickness was 294.8 µm, ranging from 213 to 481 µm; and the average of thicknesses was 279.4 µm, ranging from 201 to 458 µm.ConclusionsThe AOFVD group and the control group showed similar choroidal thickness by correcting for age, SE and gender. Not yet known, completely, which biochemical and vascular flow alterations of the choroid, and which functional RPE changes may play a role in the pathogenesis of this disease. EDI-OCT, incorporated in some SD-OCT devices, allows higher quality assessment of the choroid. In this article, choroidal thickness of patients with AOFVD, a rare disease with a not fully understood pathogenesis, was assessed.
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