Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Krüger, Carsten; Malleyeck, Isaack

doi:10.1007/s12519-010-0028-z

Cited by 28 publications

(22 citation statements)

References 30 publications

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“…33,34 Additionally, there are approximately 1 million new cases of congenital syphilis annually warranting further research on risk factors for syphilis among women and identification and implementation of effective interventions. 35 Efforts to promote medical male circumcision should emphasize the other reproductive health benefits to men and their female partners, including syphilis prevention, in addition to HIV-1 prevention.…”

Section: Discussionmentioning

confidence: 99%

Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples

Pintye

Baeten

Manhart

et al. 2014

The Lancet Global Health

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Background Male circumcision is a primary HIV-1 prevention intervention for men. It is uncertain whether male circumcision reduces the risk of syphilis among men and their female partners. Methods Using data from a prospective study among HIV-1 serodiscordant heterosexual couples from Kenya and Uganda, we assessed whether male circumcision was associated with incident syphilis in men and in their female partners. Multivariate Andersen-Gill survival methods were used, adjusted for age, sexual behavior, and plasma HIV-1 RNA levels of the HIV-1 infected partner. Findings 4716 HIV-1 serodiscordant couples (37·5% with an HIV-1 infected male) were followed for a median of 2·75 years. At enrollment, 1575 (53·5%) HIV-1 uninfected and 560 (32·4%) HIV-1 infected men were circumcised; an additional 69 (4·2%) HIV-1 infected and 132 (4·8%) HIV-1 uninfected men became circumcised during study follow up. 221 incident syphilis infections were observed: 46 among HIV-1 infected men (incidence 1·10 per 100 person-years), 76 among HIV-1 uninfected men (1·09 per 100 person-years), 54 among HIV-1 infected women (0·77 per 100 person-years) and 45 among HIV-1 uninfected women (1·11 per 100 person-years). Male circumcision was associated with a 42% reduction in incident syphilis in men (adjusted hazard ratio [aHR] 0.58 95% CI 0·37–0·91) including a 62% reduction among HIV-1 infected men (aHR 0·38, 95% CI 0·18–0·81) and a non-significant reduction in incident syphilis among HIV-1 uninfected men (aHR 0·64, 95% CI 0·36–1·11). Among women, circumcision of their male partners was associated with a 59% reduction in incident syphilis (aHR 0.41 95% CI 0.25–0.69), including a 75% reduction among HIV-1 uninfected women (aHR 0·25, 95% CI 0·08–0·76) and a 48% reduction among HIV-1 infected women (aHR 0·52, 95% CI 0·27–0·97). Interpretation In this large prospective cohort study among HIV-1 serodiscordant couples, male circumcision was associated with decreased risk of incident syphilis in men and women. If confirmed, these results suggest that medical male circumcision could substantially reduce incidence of syphilis and its sequelae. Funding Bill & Melinda Gates Foundation (grant OPP47674) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K99HD076679).

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Section: Discussionmentioning

confidence: 99%

Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples

Pintye

Baeten

Manhart

et al. 2014

The Lancet Global Health

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“…Global incidence of congenital syphilis is estimated at 700,000–1.5 million cases per year (Krüger and Malleyeck, 2010). Resource-poor countries are disproportionately affected (Samuel et al, 2007), however, recent resurgences have been reported in nations such as China and Canada (Zhu et al, 2010).…”

Section: Systemic Diseases With Prominent Skin Manifestationsmentioning

confidence: 99%

Dermatologic conditions in internationally adopted children

Whitaker-Worth

Bayart

Benedetti

2015

International Journal of Women's Dermatology

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Over 200,000 children have been adopted into United States (US) families from abroad since the year 2000. Health care providers who care for children adopted internationally should be aware of the spectrum of illnesses seen in this population, and should be prepared to encounter potentially unusual situations. An appreciation for the unique pre-adoption exposures and vulnerabilities inherent in international adoption is critical for proper diagnosis and treatment of this heterogeneous group of children. It is important to consider the impact of potential early childhood stressors such as nutritional, sensory, and emotional deprivation, trauma and abuse, as well as prenatal exposures to drugs, alcohol, and infectious diseases. Providers must also take into account international variation in health care practices, including immunization, treatment, surgical, and hygiene standards. The differential diagnosis for cutaneous eruptions in children adopted internationally is broad and must encompass endemic systemic illnesses with skin manifestations, such as measles, tuberculosis, leprosy, and congenital syphilis, and primary dermatologic diseases such as scabies and bacterial and fungal infections. The importance of maintaining a broad differential and open mind when addressing the dermatologic needs of these children cannot be overemphasized.

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“…I en retrospektiv studie fra Haydom-sykehuset i Tanzania beskrives 14 barn med medfødt syfilis (2). Den typiske hudreaksjonen ved sekundaer syfilis ble ikke sett hos barn yngre enn én måned, og diagnosen var da vanskelig fordi symptomene liknet neonatal sepsis.…”

Section: øKende Forekomst Av Medfødt Syfilis 1590unclassified

Utvikling av svulst på hjernen

Helland¹

2010

Tidsskriftet

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Sekvensiell kjemoterapi best1 590Kombinasjonsbehandling av lymfeknutepositiv brystkreft bør gis i separate sykluser.Kombinert kjemoterapi med antrasykliner og taksaner er gunstig for sykdomsforløp og dødelighet hos kvinner med lymfeknutepositiv brystkreft. Det har hittil vaert uvisst om behandlingen bør gis samtidig eller i serie hver for seg.I en randomisert studie har Swain og medarbeidere sammenliknet 12 ukers samtidig bruk av taksaner i kombinasjon med doksorubicin og cyklofosfamid (ACT) og 24 ukers sekvensiell bruk av de samme cytostatika. Tanken var at samtidig, kortere kombinasjonsbehandling ville ha en synergisk effekt og gi faerre bivirkninger. Over 5 300 pasienter deltok, og resultatene er nylig publisert (1).Pasientene som fikk sekvensiell behandling, hadde bedre resultater både når det gjaldt totaloverlevelse og sykdomsfri overlevelse. Kvinner som gjennomgikk cytostatikaindusert menopause, hadde i så henseende om lag 50 % høyere overlevelse uansett behandling.-Funnet er overraskende, siden det gjaldt både østrogenreseptorpositiv og østrogenre-septornegativ sykdom. Tidligere trodde man dette kun gjaldt hos kvinner med østrogen-reseptorpositiv sykdom. Grunnen til at amenoré har gunstig effekt også hos disse, kan vaere at amenoré gir en individuell indikator på medikamentell toksisitet og dermed er en indikator på økt effekt av cytostatika. Ovarial suppresjon kan også endre det kliniske forløpet av østrogenreseptornegativ sykdom, sier overlege og forsker Mette Kalager ved Kreftregisteret.-Underveis i studien senket man cytostatikadosene på grunn av fem behandlingsrelaterte dødsfall. Det kan forklare hvorfor effekten av 12 ukers ACT-kur var mindre enn forventet. Det er ingen grunn til å endre dagens retningslinjer i Norge med sekvensiell bruk av taksaner til kvinner med små, lymfeknutepositive svulster, sier Kalager. Carro og medarbeidere har nå utført genomvide analyser av høygradige gliomer (1). Kopitallvariasjon alene kunne ikke forklare den mesenkymale fenotypen. Forskningsgruppen benyttet deretter ulike matematiske algoritmer på genuttrykksdata fra 176 høygradige gliomer og identifiserte et nettverk av proteiner som var involvert i aggressiv transformasjon av gliomene. Transkripsjonsfaktorene C/EBPβ og STAT3 viste seg å vaere essensielle proteiner i dette nettverket.-Dette er en solid studie. Forskerne har først identifisert de spesifikke transkripsjonsfaktorene som er involvert, og deretter, ved hjelp av cellelinje-og musemodeller, har de verifisert at disse to funksjonelt er sentrale i gliombiologien, sier overlege Petter Brandal ved Oslo universitetssykehus, Radiumhospitalet. -I cellelinjemodeller fant man også at C/EBP og STAT3 var viktige for mesenkymal differensiering og invasivitet. De bekreftet også at høyt uttrykk av proteinene C/EBP og STAT3 i en separat serie med høygradige gliomer var assosiert med dårlig prognose og mesenkymal fenotype, sier han.-Det er ingen tvil om at det grundige og veloverveide arbeidet som ligger bak dette manuskriptet, gir oss bedre innsikt i biologien i høygradig...

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Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Cited by 28 publications

References 30 publications

Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples

Association between male circumcision and incidence of syphilis in men and women: a prospective study in HIV-1 serodiscordant heterosexual African couples

Dermatologic conditions in internationally adopted children

Utvikling av svulst på hjernen

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