Syphilis in China: the great comeback

Hesketh, Thérèse; Ye, XJ; Zhu, Weiming

doi:10.3134/ehtj.08.006

Cited by 12 publications

(6 citation statements)

References 55 publications

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“…of studies (No. of data points) Total No of infection/Sample size Pooled prevalence among FSW (95 % CI) Background prevalence among general population (95 % CI) Odds ratio (95 % CI) HBV 18 (24) 848/7,614 10.71 (7.30–15.48) 6.40 (4.45–9.08)* [ 26 ] 1.75 (1.60–1.92) HCV 97 (149) 1,366/114,722 0.96 (0.73–1.25) 0.12 (0.05–0.27)* [ 20 ] 7.99 (3.58–17.83) Syphilis 215 (377) 13,507/245,455 5.24 (4.83–5.69) 0.37 (0.20–0.65)* [ 21 ] 14.89 (10.86–20.40) HSV-2 38 (57) 9,529/30,345 15.77 (11.74–20.85) 5.80 (3.82–7.78)* [ 22 ] 3.05 (2.12–4.39) Trichomonas vaginitis 43 (65) 2,271/24,381 2.12 (1.46–24.21) 2.52 (1.92–3.31)** [ 22 ] 0.83 (0.51–1.35) Chlamydia 96 (125) 7,983/56,548 13.66 (12.11–15.37) 2.60 (1.60–4.10)** [ 23 ] 5.95 (4.42–8.01) Cervix 41 (78) 5,503/33,231 13.56 (11.65–15.73) -- -- Vaginal 3 (4) 402/872 36.80 (19.56–58.23) -- -- PCR 48 (74) 5,839/31,695 15.48(13.70–17.45) -- -- Rapid test 16 (19) 2,144/24,853 10.28(8.20–12.83) -- -- Gonorrhea 116 (149) 3,723/62,430 6.07 (5.29–6.95) 0.16 (0.06–0.39)** [ 23 ] 40.32 (12.99–125.18) …”

Section: Resultsmentioning

confidence: 99%

Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

Chow

Muessig

et al. 2015

BMC Infect Dis

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BackgroundThe 1980’s economic boom has been associated with a rapid expansion of China’s sex industry over the past three decades. Consequently, the spread of sexually transmitted infections (STIs) and hepatitis infections among female sex workers (FSW) has become an important public health issue in China. This study identifies prevalence and risks of hepatitis and STIs in Chinese FSWs.MethodFour electronic databases were searched for Chinese and English language peer-reviewed studies conducted between 01/2000-12/2011 that reported prevalence of hepatitis and STIs (excluding HIV) among Chinese FSW. Following the PRISMA guidelines, meta-analysis was used to estimate pooled prevalence and 95 % confidence intervals for each infection.ResultThree hundred and thirty nine articles (34 in English and 305 in Chinese) investigating 603,647 FSWs in 29 Chinese provinces were included in this review. Over the period 2000–2011, the seroprevalence of active hepatitis B and hepatitis C among FSW were 10.7 % (7.3–15.5 %) and 1.0 % (0.7–1.3 %), respectively. The most prevalent STI was human papillomavirus (HPV, 27.0 % [10.1–55.1 %]), followed by herpes simplex virus-2 (HSV-2, 15.8 % [11.7–20.9 %]), chlamydia (13.7 % [12.1–15.4 %]), gonorrhoea (6.1 % [5.3–7.0 %]), syphilis (5.2 % [4.8–5.7 %]), genital warts (3.3 % [2.5–4.2 %]) and Trichomonas vaginitis (2.1 % [1.5–24.2 %]). Disease burden of both hepatitis and STI among FSW were concentrated in South Central and Southwest China. In particular, chlamydia and syphilis demonstrated a significant declining trend during the studied period (P < 0.05). Compared with the general Chinese population, FSW had significantly higher prevalence of all STIs except Trichomonas vaginitis. Further, compared to the general FSW population, HIV-positive FSW had significantly higher prevalence of syphilis, chlamydia, HSV-2 and Trichomonas vaginitis.ConclusionPrevalence of hepatitis and STIs remained high and mostly stable among Chinese FSW over the period of 2000–2011. Targeted STI and hepatitis surveillance and interventions should be strengthened among Chinese FSWs, especially those who are HIV-positive.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1322-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

Chow

Muessig

et al. 2015

BMC Infect Dis

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“…China has experienced a dramatic resurgence of syphilis during the last two decades. Since sexually transmitted disease (STD) studies in China have reported syphilis prevalence to be about 10 times higher than HIV prevalence in both high-risk and low-risk populations, it is considered the most pressing public health issues[ 24 ]. One study also suggested there was a significant growth in syphilis serologic markers among first-time donors, with 0.41%, 0.45%, and 0.57% positivity from 2008 to 2010[ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and prevalence trends of transfusion transmissible infections among blood donors at four chinese regional blood centers between 2000 and 2010

Xiao

Yin

et al. 2012

J Transl Med

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BackgroundIn China, high prevalence of HBV and HCV parallels with the growing epidemic of syphilis and HIV in the general population poses a great threat to blood safety. This study investigated the prevalence of serologic markers for transfusion transmissible infections (TTIs) among four Chinese blood centers.MethodsWe examined whole blood donations collected from January 2000 through December 2010 at four Chinese blood centers. Post-donation testing of TTIs (HIV, HBV, HCV and syphilis) were conducted using two different enzyme-linked immunosorbent assay kits for each seromarker. The prevalence of serologic markers for TTIs (%) was calculated and additional analysis was conducted to examine donor characteristics associated with positive TTIs serology.ResultsOf the 4,366,283 donations, 60% were from first-time donors and 40% were from repeated donors. The overall prevalence of HIV, HBsAg, HCV and syphilis was 0.08%, 0.86%, 0.51% and 0.47%, respectively. The prevalence profile of TTIs varied among different blood centers and appeared at relatively high levels. Overall, the prevalence of HBsAg and HCV demonstrated a decline trend among four blood centers, while the prevalence of HIV and syphilis displayed three different trends: constantly steady, continually increasing and declining among different centers.ConclusionsThis study reflects the risk of TTIs has been greatly reduced in China, but blood transfusion remains an ongoing risk factor for the spread of blood-borne infections, and further work and improvements are needed to strengthen both safety and availability of blood in China.

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“…Its regional STI epidemic was well documented by local and foreign authorities by the 20 th century, who attributed it to widespread prostitution and economic disparity [17] . Following the decades-long STI suppression campaign from the 1950’s to 1970’s under Maoist health policies, chlamydia, like other STIs, has made a massive resurgence since the economic re-opening of the 1980’s, a phenomenon that has been attributed, among other things, to social change, population mobility, and rising costs of healthcare [ 17 , 18 ]. in which nearly the entire population was rendered susceptible through curative treatments [17] .…”

Section: Methodsmentioning

confidence: 99%

Spatiotemporal analysis of 11 years of Chlamydia trachomatis data from southern China

Smith

Searle

Yang

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: Urogenital Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally. Reviews suggest high and persistently endemic STI epidemics in low and middle income countries. However population-based prevalence estimates in these settings are less common, underscoring the need for analyses of available data to characterize patterns of disease burden. We identified spatio-temporal clusters and key behavioral, social, or environmental factors contribution to transmission in order to inform the prioritization and targeting of evidence based interventions. Methods: Using 11 years of data (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) from the chlamydia case report system of Guangdong, China, we identified county level spatio-temporal hot and cold spots using the Getis-Ord Gi * statistic and discrete Poisson models in SaTScan 9.6. We also estimated associations between observed distribution patterns and area-level demographic, social, and economic factors using quasi-Poisson regression models that controlled for annual counts of certified laboratories to account for fluctuations in location-specific detection capacity. Findings: Cluster analysis indicates an expanding chlamydia epidemic in Guangdong, with cases clustered in regions of greatest economic activity. Greater male-to-female sex ratio (RR, 3.63; 95% CI, 1.41-9.45) and greater urbanicity (RR, 2.44; 95% CI, 1.98-2.99) were predictive of higher chlamydia case occurrence. Interpretation: We found that chlamydia case occurrence in Guangdong province has been accelerating over the past 11 years and that its expansion is tied to indicators of social and economic development. These estimates not only identify high prevalence regions to target but also areas where data gaps potentially remain. The salience of sex ratios and urbanicity may best be understood through the lens of China's modern history of labor migration which has reshaped the gender dynamics and health access landscape of urban China. Future chlamydia control effort s will require a population-based approach focused on reengaging sexually active adults of diverse economic and migratory backgrounds. Funding: This was an unfunded study using routinely collected public health data.

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Syphilis in China: the great comeback

Cited by 12 publications

References 55 publications

Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

Prevalence and prevalence trends of transfusion transmissible infections among blood donors at four chinese regional blood centers between 2000 and 2010

Spatiotemporal analysis of 11 years of Chlamydia trachomatis data from southern China

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