Syphilis in China: results of a national surveillance programme

Chen, Zhi Qiang; Zhang, Guo Cheng; Gong, Xiang Dong; Lin, Charles C.; Gao, Xing; Liang, Guo Jun; Yue, Xiao Li; Chen, Xiang Sheng; Cohen, Myron S.

doi:10.1016/s0140-6736(07)60074-9

Cited by 270 publications

(272 citation statements)

References 27 publications

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“…First, the study was only implemented in 6 urban regions located in South China, and care must be taken when generalizing the findings to other areas. At the same time, other research has suggested that China's primary and secondary syphilis cases are substantially greater in urban regions than in rural areas [13,15] Second, although every effort was made to make the intervention and control groups as comparable as possible, they were not identical. The intervention group had a higher syphilis prevalence than the control group at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Reported primary and secondary syphilis cases have increased over the past 5 years in many parts of South China [13][14][15]. The study took place from June 2009 to March 2011 in 6 southern cities: Jiangmen and Maoming in Guangdong Province, Wuzhou and Hezhou in Guangxi Province, and Qionghai and Sanya in Hainan Province (Figure 1).…”

Section: Study Design and Participantsmentioning

confidence: 99%

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The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China

Wang

Yin

et al. 2012

Journal of Infectious Diseases

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Background. Syphilis has made a rapid resurgence in China, especially among high-risk groups including female sex workers (FSWs).Methods. Two cities in each of 3 provinces in South China were chosen and allocated to intervention or control arms. The intervention consisted of enhancing community-based syphilis screening outreach intervention with comprehensive sexually transmitted infection services at designated clinics while the control maintained routine intervention activities. Generalized linear modeling was used to examine effect of the intervention on incident syphilis infection.Results. A total of 8275 women were eligible, and 3597 women enrolled (n = 2011 in control arm, n = 1586 in intervention arm) in the study. The median follow-up duration was 375 days (interquartile range, 267-475). Syphilis incidence density in the intervention group was reduced by 70% (95% confidence interval, 53%-81%) compared with the incidence in the control arm. The syphilis prevention intervention benefits were robust among FSWs at low-tier venues, individuals with less than high school education, migrants, and women who did not report condom use during the last episode of sex.Conclusions. Integrated sexually transmitted infection and human immunodeficiency virus prevention strategies substantially reduce syphilis incidence among FSWs, especially among those at low-tier venues. This intervention suggests the need for scaling up comprehensive FSW programs in China.

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Section: Discussionmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China

Wang

Yin

et al. 2012

Journal of Infectious Diseases

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“…The congenital syphilis (CS) incidence in China increased from 0.01 per 100 000 live births in 1991 to 19.7 per 100 000 live births in 2005, 1 resulting in an average of more than one syphilitic neonatal birth per hour in 2008. 2 The Chinese Ministry of Health recently announced a comprehensive 10-year National Syphilis Prevention and Control Plan (NSCP), which aimed to reduce the number of newly reported CS cases to less than 30 per 100 000 live births by 2015 and continuously reduce the number to 15 per 100 000 live births by 2020.…”

Section: Received 1 August 2014 Accepted 10 September 2014 Publishementioning

confidence: 99%

Over reporting of congenital syphilis in Guangzhou, China

Tang

Dai

et al. 2015

Sex. Health

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Abstract. The purpose of this study was to evaluate the rationality of congenital syphilis (CS) cases reported by physicians in hospitals of various levels in Guangzhou, China. The over-reporting rate was calculated. The results suggested that 49.1% (54 out of 110) of the CS cases reviewed were identified as cases that should be reported; 18 of the 54 CS case were confirmed CS cases and 50.9% (56 out of 110) were identified as over reported. Factors associated with CS case misclassification were analysed. To decrease the incidence of CS, antenatal care management and rapid plasma reagin titres should be provided and the follow up for children should be raised.Additional keywords: case report, child, epidemiology, neonate, review, STIs. The congenital syphilis (CS) incidence in China increased from 0.01 per 100 000 live births in 1991 to 19.7 per 100 000 live births in 2005, 1 resulting in an average of more than one syphilitic neonatal birth per hour in 2008. 2 The Chinese Ministry of Health recently announced a comprehensive 10-year National Syphilis Prevention and Control Plan (NSCP), which aimed to reduce the number of newly reported CS cases to less than 30 per 100 000 live births by 2015 and continuously reduce the number to 15 per 100 000 live births by 2020. 3 Guangzhou, the capital of Guangdong province in southern China, has experienced a dramatic CS increase from 38.19 per 100 000 live births in 2000 to 243.61 per 100 000 live births in 2011. 4 However, owing to the different professional backgrounds of the clinicians from various hospitals, the diagnostic misclassification was inevitable and the current incidence of CS may not be accurate. Data on evaluating the reported syphilis cases are limited in China. The present work aimed to evaluate the evidence based on which CS cases were diagnosed and reported.The data pertaining to the 110 CS cases in Guangzhou in 2012 were obtained from National Notifiable Disease Reporting System (NNDRS) and reviewed by sexually transmitted diseases (STD) experts using both clinical and laboratory parameters according to both syphilis case definition and case reporting guidelines issued by the Ministry of Health, China. 5 Briefly, reported CS cases are divided into CS case probable and CS case confirmed. The CS case probable is defined as an infant, who was born from a mother with untreated syphilis or incompletely treated syphilis, or a child who had sera reactive non-Treponema antibodies regardless of clinical syphilitic findings. The CS case confirmed is defined as a child who is a probable CS case with a four-fold higher non-specific Treponema pallidum antibody in the blood than that of the child's mother, or a neonate with T. pallidum isolated from lesions, placenta, umbilical cord or autopsy material, or a baby with a reactive immunoglobulin M (IgM) antibody test or a child with positive syphilitic findings on a bone X-ray and an abnormal cerebrospinal fluid (CSF) venereal diseases research laboratory test or cell count/protein. Data on evaluating rationality of r...

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“…In recent years, syphilis has reemerged as a significant public health problem in many countries, including China. Nationwide surveillance data indicate that the incidence rate of syphilis in China in 1993 was 0.2 per 100,000 persons, whereas that for primary and secondary syphilis was 5.7 per 100,000 persons in 2005 (1). According to nationwide surveillance data, there were 327,433 new cases of syphilis in China in 2009 (24.7 per 100,000 persons).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Patients with Primary and Late Latent Syphilis Patients Who Were Initially Non-Reactive to the Rapid Plasma Reagin Test

Zheng

2013

Jpn J Infect Dis

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SUMMARY:We aimed at determining the characteristics of patients with primary and late latent syphilis who were non-reactive on initial screening by rapid plasma reagin (RPR) but reactive by treponemal tests. We collected the RPR test results of all primary and late latent syphilis patients in our hospital from December 2000 to March 2012. The characteristics of syphilis patients who were non-reactive by RPR testing were compared to those of reactive patients. Multiple logistic regression was used to identify factors associated with non-reactive RPR results. Among primary syphilis patients, 37 (16.5z) were non-reactive on initial RPR and were compared with the 187 reactive cases. Age À35 years was an independent factor associated with a non-reactive result in primary cases (odds ratio [OR], 95z confidence intervals [CI] ＝ 3.55 [1.39-9.07]). Of the late latent patients, 61 (8.8z) were non-reactive by RPR and 636 were reactive. Age À34 years was also an independent factor associated with a non-reactive result in late latent cases (OR [95z CI] ＝ 4.30 [2.28-8.12]). This study suggests that RPR testing alone is insufficient to diagnose primary and late latent infections, especially in middle-aged and elderly individuals. Syphilis detection was lower for patients with primary syphilis than for those with late latent syphilis based on the results of the RPR.

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Syphilis in China: results of a national surveillance programme

Abstract: The results suggest that a range of unique biological and social forces are driving the spread of syphilis in China. A national campaign for detection and treatment of syphilis, and a credible prevention strategy, are urgently needed.

Cited by 270 publications

References 27 publications

The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China

The Effect of a Structural Intervention for Syphilis Control Among 3597 Female Sex Workers: A Demonstration Study in South China

Over reporting of congenital syphilis in Guangzhou, China

Characteristics of Patients with Primary and Late Latent Syphilis Patients Who Were Initially Non-Reactive to the Rapid Plasma Reagin Test

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