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Baia KLN, Cordeiro ACC, Frade PCR, Gouveia AGN, Resque RL, Pinheiro LML, Fonseca RRS, Machado LFA, Martins LC, Kupek E, Fischer B, Oliveira-Filho AB. Syphilis and Co-Infections with HIV-1, HBV, and HCV among People Who Use Crack-Cocaine in Northern Brazil. Pathogens 2022; 11:1055. [PMID: 36145487 PMCID: PMC9502650 DOI: 10.3390/pathogens11091055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
The rates of syphilis and viral co-infections among people who use crack-cocaine (PWUCC) were assessed in this study. This cross-sectional study relied on biological and self-reported socio-behavioral data from a convenience sample of 990 PWUCC from twenty-six municipalities in the states of Amapá and Pará, northern Brazil. Blood samples were collected to assess the presence of Treponema pallidum using the Rapid Qualitative Test (RQT) and the Venereal Disease Research Laboratory (VDRL). Reactive samples by RQT were used to assess the presence of HBV, HCV, and HIV-1 using Enzyme Immunoassay (EIA) and Polymerase Chain Reaction (PCR). Logistic regression models were used to determine the association of variables assessed with syphilis. In total, 287 (29.0%) of the PWUCC sample had reactive results for syphilis. HBV (15.7%), HCV (5.9%), and HIV-1 (9.8%) were detected among PWUCC with syphilis. Young age, low monthly income and education level, long duration of crack-cocaine use, condomless sex, multiple sex partners, and exchange of sex for money/drugs were associated with syphilis. The present study provides unique insights on the epidemiological status of syphilis among PWUCC in northern Brazil, with multiple implications for improving urgent interventions for diagnosis, prevention, and treatment.
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Affiliation(s)
- Karen Lorena N. Baia
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Ana Caroline C. Cordeiro
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
| | - Paula Cristina R. Frade
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Alanna Gabrielly N. Gouveia
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Rafael Lima Resque
- Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, Brazil
| | - Luiz Marcelo L. Pinheiro
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, Brazil
| | - Ricardo Roberto S. Fonseca
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66077-830, Brazil
| | - Luiz Fernando A. Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66077-830, Brazil
| | - Luisa C. Martins
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, Brazil
| | - Aldemir B. Oliveira-Filho
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
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Eaves ER, Trotter RT, Marquez B, Negron K, Doerry E, Mensah D, Compton-Gore KA, Lanzetta SA, Kruithoff K, Dykman K, Baldwin JA. Possibilities and constraints of rapid online ethnography: Lessons from a rapid assessment of COVID-19 policy for people who use drugs. FRONTIERS IN SOCIOLOGY 2022; 7:959642. [PMID: 36072500 PMCID: PMC9441939 DOI: 10.3389/fsoc.2022.959642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
During the COVID-19 Pandemic, health care provision changed rapidly and funding became available to assess pandemic-related policy change. Research activities, however, were limited to contactless, online delivery. It was clear early on that some elements of online rapid ethnography were feasible and effective, while others would not approach traditional ethnographic depth. We conducted an online Rapid Assessment, Response, and Evaluation (RARE) project from August 2020 to September 2021 to understand how COVID-19 policy impacted people who use drugs. Our interdisciplinary research team conducted online ethnographic interviews and focus groups with 45 providers and community stakeholders, and 19 clients from rural and urban areas throughout Arizona. In addition, 26 webinars, online trainings, and virtual conferences focused on opioid policy and medication for opioid use disorders (MOUD) were opportunities to observe conversations among providers and program representatives about how best to implement policy changes, how to reach people in recovery, and what aspects of the changes should carry forward into better all-around opioid services in the future. Our RARE project was successful in collecting a range of providers' perspectives on both rural and urban implementation of take-home MOUDs as well as a wide view of national conversations, but client perspectives were limited to those who were not impacted by the policies and continued to attend in-person daily clinic visits. We describe challenges to online rapid ethnography and how online research may have allowed for an in-depth, but incomplete picture of how policy changes during COVID-19 policy affected people with opioid use disorders.
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Affiliation(s)
- Emery R. Eaves
- Department of Anthropology, Northern Arizona University, Flagstaff, AZ, United States
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Robert T. Trotter
- Department of Anthropology, Northern Arizona University, Flagstaff, AZ, United States
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Bonnie Marquez
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Kayla Negron
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Eck Doerry
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ, United States
| | - David Mensah
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Kate A. Compton-Gore
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Shana A. Lanzetta
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Kathryn Kruithoff
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Kaitlyn Dykman
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Julie A. Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, United States
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Ford JS, Shevchyk I, Yoon J, Chechi T, Voong S, Tran N, May L. Risk Factors for Syphilis at a Large Urban Emergency Department. Sex Transm Dis 2022; 49:105-110. [PMID: 34471079 DOI: 10.1097/olq.0000000000001543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of syphilis is increasing in the United States. The emergency department (ED) is an important setting to screen and treat underserved populations. To tailor testing protocols to the local population, we aimed to identify risk factors for syphilis positivity in ED patients. METHODS We performed a retrospective analysis of ED patients who were screened for syphilis between November 2018 and August 2020. Patients were screened for Treponema pallidum antibody using a multiplex flow immunoassay, and positive results were confirmed by rapid plasma reagin or T. pallidum particle agglutination. Risk factors for new syphilis diagnoses were identified using multiple logistic regression. RESULTS We screened 1974 patients for syphilis (mean age, 37 ± 16 years; 56% female). We identified 201 patients with new infections without previous treatment. Independent risk factors for a new diagnosis of syphilis included housing status (undomiciled, 23% [60 of 256]; domiciled, 9% [133 of 1559]; adjusted odds ratio [aOR], 1.9 [95% confidence interval {CI}, 1.2-3.0]), history of HIV (positive, 44% [28 of 63]; negative, 9% [173 of 1893]; aOR, 5.8 [95% CI, 3.0-11.2]), tobacco use (positive, 15% [117 of 797]; negative, 4% [29 of 665]; aOR, 2.4 [95% CI, 1.5-3.9]), and illicit drug use (positive, 14% [112 of 812]; negative, 8% [52 of 678]; aOR, 2.2 [95% CI, 1.0-2.5]). CONCLUSIONS Undomiciled housing status, history of HIV, history of tobacco use, and history of illicit drug use were independently associated with a new diagnosis of syphilis in the ED. Broadening targeted syphilis screening algorithms beyond sexually transmitted disease-related complaints could help identify new syphilis cases for treatment.
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Affiliation(s)
| | | | | | | | | | - Nam Tran
- Pathology and Laboratory Medicine, UC Davis Health, Sacramento, CA
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Zhou X, Wu MZ, Jiang TT, Chen XS. Oral Manifestations of Early Syphilis in Adults: A Systematic Review of Case Reports and Series. Sex Transm Dis 2021; 48:e209-e214. [PMID: 34433795 PMCID: PMC8594522 DOI: 10.1097/olq.0000000000001538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Rapid emergence of syphilis and oral sexual behaviors has focused attention on oral syphilis, and published reports of cases with oral syphilis have increased in the recent decades. We performed a systematic literature review by searching articles from PubMed, EMBSE, and Google Scholar, looking for case reports or series that would potentially have the clinical characteristics and outcomes for each individual case with oral syphilis. A total of 145 cases with the infection, from 95 studies, were identified to include in our review. Two main clinical phenotypes (ulcerative lesions and mucous patches) appeared to be of particular relevance to oral manifestations. A solitary ulcer was mostly manifested as the lesion of primary syphilis (91.7%) preferentially located on the upper lip, tongue, palate, and buccal mucosa. The most affected anatomical site in the patients with single location involved was the tongue (37.5%), followed by the lips (29.5%), palates (19.3%), and buccal mucosa (6.8%). It is concluded that oral syphilis has its predominant clinical phenotypes although it can manifest in diverse manners.
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Affiliation(s)
- Xiao Zhou
- From the Department of Orthodontics, Shanghai Jchief Dental Clinic, Shanghai
| | - Min-Zhi Wu
- Department of Dermatology, Suzhou Fifth People’s Hospital, Suzhou
- Department of Dermatology, Soochow University Affiliated Hospital of Infectious Diseases, Jiangsu
| | - Ting-Ting Jiang
- Department of STD Control, Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Dermatology, Nanjing
- Department of STD Control, National Center for STD Control, Nanjing, China
| | - Xiang-Sheng Chen
- Department of STD Control, Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Dermatology, Nanjing
- Department of STD Control, National Center for STD Control, Nanjing, China
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