Prevalence and incidence estimates for syphilis, chlamydia, gonorrhea, and congenital syphilis in Colombia, 1995–2016

Abstract

Objectives To estimate adult (15–49 years old) prevalence and incidence of active syphilis, gonorrhea, and chlamydia, and incidence of congenital syphilis (CS) and adverse birth outcomes (ABOs) in Colombia, over 1995–2016. Methods The Spectrum-STI epidemiological model tool estimated gonorrhea and chlamydia prevalences as moving averages across prevalences observed in representative general population surveys. For adult syphilis, Spectrum-STI applied segmented polynomial regression through prevalence data from antenatal care (ANC) surveys, routine ANC-based screening, and general population surveys. CS cases and ABOs were estimated from Spectrum's maternal syphilis estimates and proportions of women screened and treated for syphilis, applying World Health Organization case definitions and risk probabilities. Results The Spectrum model estimated prevalences in 2016 of 0.70% (95% confidence interval (CI): 0.15%-1.9%) in women and 0.60% (0.1%-1.9%) in men for gonorrhea and of 9.2% (4.4%-15.4%) in women and 7.4% (3.5%-14.7%) in men for chlamydia, without evidence for trends over 1995–2016. The prevalence of active syphilis in 2016 was 1.25% (1.22–1.29%) in women and 1.25% (1.1%-1.4%) in men, decreasing from 2.6% (2.1%-3.2%) in women in 1995. Corresponding CS cases in 2016 (including cases without clinical symptoms) totaled 3 851, of which 2 245 were ABOs. Annual CS and ABO estimates decreased over 2008–2016, reflecting decreasing maternal prevalence and increasing cases averted through ANC-based screening and treatment. Conclusions The available surveillance and monitoring data synthesized in Spectrum-STI— and the resulting first-ever national STI estimates for Colombia—highlighted Colombia's persistently high STI burden. Adult syphilis and congenital syphilis are estimated to be falling, reflecting improving screening efforts. Strengthened surveillance, including with periodic screening in low-risk populations and future refined Spectrum estimations, should support planning and implementation of STI prevention and control, including CS elimination.

Desigualdades na tendência da sífilis congênita no município de Niterói, Brasil, 2007 a 2016

“…Outros países das Américas mostraram que é possível reduzir e até eliminar a transmissão vertical da sífilis (34,35). O Ministério da Saúde recomenda que sejam instituídos comitês de investigação para prevenção da transmissão vertical em locais que apresentem elevado número de casos de SC (8).…”

The Spectrum-STI Groups model: syphilis prevalence trends across high-risk and lower-risk populations in Yunnan, China

“…FSW and MSM together accounted for 9.3% of Yunnan's estimated prevalent cases in 2017. This is lower than the share of these key groups in past Spectrum-STI estimates 35,36,40 , and in HIV incidence estimates [41][42][43][44] , which reflects that both the estimated prevalence of syphilis in FSW and Yunnan's key population size estimates are lower than in other countries 7,9,45,46 . The size estimate of FSW was based on self-identified sex workers; and almost certainly is an under-estimate of the total number of women who engage in transactional sex work.…”

“…The 2017 syphilis prevalence estimate in Yunnan for women 15 to 49 was 0.26% (0.17-0.34%) and for men 0.28% (0.20-0.36%). These levels are low compared to other East and Central Asia countries 15 , and relative to countries with similar per capita incomes [34][35][36] . Given the low prevalence, Yunnan is in a position where it could meet the WHO criteria for eliminating congenital syphilis, provided coverages of ANC attendance, of ANC-based syphilis screening and of syphilis treatment among women diagnosed during ANC are all 95% or higher 37 .…”

World Health Organization Global Health Sector Strategy on Sexually Transmitted Infections: An Evidence-to-Action Brief for Colombia

“…In May of 2017, WHO conducted an STI surveillance workshop in Bogota with the Ministry of Health, to estimate the current and historic STI burden trends using the Spectrum STI estimation model (8–10). Colombia was the first South American country to implement this new surveillance tool, developed by Avenir Health within its broader suite of health planning software tools that is available for free through online download.…”