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Begovac J, Romih Pintar V, Vrsaljko N, Močibob L, Bogdanić N, Zekan Š, Đaković Rode O. Incidence, risk factors, and clinical findings of syphilis among men living with HIV in Croatia during the COVID-19 pandemic. Sci Rep 2023; 13:11784. [PMID: 37479770 PMCID: PMC10361976 DOI: 10.1038/s41598-023-38807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023] Open
Abstract
We conducted a nationwide longitudinal observational study to estimate the incidence of syphilis in a cohort of male persons living with HIV (MLWH) in Croatia in the pre-COVID-19 and COVID-19 years. Data were reviewed and extracted from the clinical database. We analyzed 1187 MLWH (≥ 18 years) in care in Croatia from 2018 to 2021 and used Poisson regression to calculate rates. We observed a 91.4% increase in incidence between 2019 and 2020; the overall rate was 6.0/100 person-years, and the annual rate ranged from 3.3/100 person-years in 2018 to 9.3/100 person-years in 2021. We found higher rates in men who have sex with men, MLWH with a baseline history of syphilis, MLWH with a more recent HIV diagnosis, and a lower rate in those who had clinical AIDS. The rate of syphilis serological testing was 3.5% lower in 2020 compared to 2019. Recurrent syphilis was more likely asymptomatic compared to the first episodes. In conclusion, during the COVID-19 epidemic years, there was a huge increase in syphilis. Results highlight the need for enhanced and novel prevention interventions.
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Affiliation(s)
- Josip Begovac
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Vanja Romih Pintar
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nina Vrsaljko
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Loris Močibob
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nikolina Bogdanić
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Šime Zekan
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Oktavija Đaković Rode
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Meseli SE, Pelit S. Syphilis and dentists: The data about knowledge and awareness of clinicians in Turkey. Int J STD AIDS 2023; 34:408-415. [PMID: 36821515 DOI: 10.1177/09564624231155678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Background: Syphilis may give pathognomonic signs in oral cavity. In order to emerge an awareness about dentists' role in syphilis management, it was aimed to obtain the data from them about their knowledge.Methods: This survey-based, cross-sectional study was conducted with 709 dentists practicing in Turkey. Participants answered 16 statements about syphilis "Transmission Routes," "Extra-oral Clinical Features," "Oral Findings," and "Diagnosis & Treatment" with options yes/no/I do not know. Moreover, they responded to two 5-point Likert type questions about their comfort level and frequency of taking sexual anamnesis. The statistical significance was set at p ≤ .05.Results: The mean age (years) and female/male ratio of the participants were 35.7 ± 10.2 and 449/260, respectively. The average of the correct answers in the survey was 10.38 ± 3.3. "Transmission Routes" had the highest ratio (50.6%) in terms of all questions in a single category that were answered correctly among groups. Dentists practicing at faculties had the highest number of correct answers (p = .003). The total number of correct answers and the number of correct answers in each category were positively related to both the level of comfort and the frequency of taking patient's sexual anamnesis (Oral Findings p = .002; others p ≤ .001).Conclusions: The results of this study indicate that dentists practicing in Turkey lack a significant level of knowledge about syphilis. This highlights the need for further training and education programs for dentists in Turkey.
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Affiliation(s)
- Suleyman E Meseli
- Faculty of Dentistry, Periodontology Department, 187981Istanbul Aydin University, Istanbul, Turkey
| | - Suleyman Pelit
- Sisli Hamidiye Etfal Training and Research Hospital, Medical Microbiology Department, 448249University of Health Sciences, Istanbul, Turkey
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Tumalán-Gil OD, Ruiz-González V, García-Cisneros S, González-Rodríguez A, Herrera-Ortiz A, Olamendi-Portugal M, Sánchez-Alemán MA. High Incidence, Reinfections, and Active Syphilis in Populations Attending a Specialized HIV Clinic in Mexico, a Dynamic Cohort Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:783-791. [PMID: 36175816 PMCID: PMC9886591 DOI: 10.1007/s10508-022-02433-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Syphilis, a sexually transmitted infection, has reemerged in many vulnerable groups around the world. The objective of the current study was to determine the prevalence and incidence of syphilis among people who attended a specialized HIV clinic in Mexico from 2011 to 2015. Databases from the laboratory were analyzed, and the following four groups were formed: people seeking HIV-1 voluntary counseling and testing (VCT), people in prison (PPr), people living with HIV (PLWH), and patients from primary care clinics (others). The diagnosis of syphilis was made using the reverse algorithm; antibody titers were examined to determine the stage of infection. Baseline data were analyzed and, with follow-up information, a retrospective dynamic cohort was formed. Factors associated with the seroprevalence of syphilis and active syphilis were evaluated by the chi-square test. Moreover, risk factors for the incidence of syphilis were described. A total of 81,863 baseline individuals were analyzed. The seroprevalence of syphilis was 9.9% in the VCT group, 8.2% in the PPr group, 37.0% in the PLWH group, and 8.7% in the others group; the prevalence of active syphilis was 1.7-13.1%. A total of 11,124 people were followed up. The incidence (cases per 100 person-years) was 3.5 among the VCT group, 16.0 among the PLWH group, and < 0.1 among both the PPr and others groups, respectively; moreover, the frequency of reinfections was 11.1-24.4%. The high prevalence and incidence of syphilis, active syphilis, and reinfections among men, transgender people, individuals aged 20-39 years, and people with a history of HIV or hepatitis B suggest that it is critical to improve prevention, diagnosis, and treatment measures to stop the reemergence of syphilis. There are also new factors such as methamphetamine use, group sex, or contacting partners over the internet that are associated with syphilis. In addition, HIV preexposure prophylaxis could contribute to the increased incidence of syphilis by providing false security in the prevention of STIs, thereby increasing risky sexual behaviors.
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Affiliation(s)
- Omar David Tumalán-Gil
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México
| | | | - Santa García-Cisneros
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México
| | | | - Antonia Herrera-Ortiz
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México
| | - Maria Olamendi-Portugal
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México
| | - Miguel Angel Sánchez-Alemán
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México.
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Gilligan G, Leonardi N, Garola F, Sanfedele A, Beltramo A, Panico R, Piemonte E. False cheilitis (fausse cheilitis) as a clinical manifestation of oral secondary syphilis. Int J Dermatol 2021; 61:180-183. [PMID: 34289093 DOI: 10.1111/ijd.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 06/18/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Syphilis is the oldest sexually transmitted infectious disease in humanity. In the last decades, it was noted the re-emergence of the disease, and actually it remains an important public health problem. Oral mucosa could be affected by the infection. Oral manifestations are commonly associated with secondary syphilis. It was described that the labial commissure could be involved as a split papule, also known as false cheilitis (FC). However, this clinical manifestation is poorly described in current literature. AIM This brief report aims to determine the frequency of FC in patients diagnosed with secondary syphilis in our institution during the period 2009-2019. MATERIAL & METHODS A cross-sectional retrospective study was conducted using the medical records of the Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina. The cases included were patients with provisional diagnosis of secondary syphilis with oral manifestations, confirmed by laboratory tests. Collection of clinical and serological data was performed. Absolute and relative values were obtained. RESULTS In this study, 58 patients (26 males and 32 females) with an average age of 34.70 years old were included. The frequency of false cheilitis in these patients was 13% (8/58). All these patients with false cheilitis and secondary syphilis were young females with an average age of 25.12 years old. These lesions presented as angular cheilitis with an unilateral pattern with painful fissured papules associated with other oral lesions such as fissures, intraoral papules, tongue depapillation, white or red plaques, and the evidence of submandibular lymphadenopathies when examining the head and neck region. CONCLUSION Our findings suggest that when angular cheilitis presents in young females as a painful, unilateral lesion, in the clinical context of other lesions and lymphadenopathies in the head and neck region, it could represent a suspicious clinical sign of syphilis. Considering the global re-emergence of sexually transmitted diseases, dentists should be aware of the oral clinical manifestations of syphilis as they play a significant role in the early detection of these conditions.
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Affiliation(s)
- Gerardo Gilligan
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nicolás Leonardi
- Faculty of Health Sciences, Universidad Católica de Córdoba, Córdoba, Argentina
| | - Federico Garola
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Agustina Sanfedele
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Agostina Beltramo
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - René Panico
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Piemonte
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
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Adawaye C, Souleymane AO, Fouda AA, Djarma O, Cournil A, Tuaillon E, Mennechet FJD. Syphilis diagnosis and serological response to Benzathine Penicillin G among patients attending HIV clinics in N'Djaména, Chad. Int J Infect Dis 2021; 108:461-464. [PMID: 34051363 DOI: 10.1016/j.ijid.2021.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Syphilis is endemic in the Sub-Saharan zone and disproportionately affects at-risk populations such as men who have sex with men, sex workers and HIV infected individuals. In this study, we measure the impact of syphilis among people living with HIV in the Republic of Chad, where no data are currently available. METHOD Outpatients attending 2 HIV clinics in N'Djamena, Republic of Chad, were tested for syphilis. Subjects who tested positive for both non-treponemal (VDRL) and treponemal (TPHA) received a single dose of Benzathine Penicillin G, 2.4 MU. An additional VDRL test was performed 6 months after treatment to ensure appropriate serological response. RESULTS Of 207 patients included, 29 (14%) tested positive for VDRL at the first visit, with moderate/low antibody titers (ranging from 1/2 to 1/8); 24 (82.6%) of these had treponemal immunization confirmed by TPHA test. Six months after Benzathine Penicillin treatment, 22/24 of the patients (91.6%) tested negative for VDRL, and 2 showed a 4-fold titer decline. CONCLUSION This first study in the Republic of Chad suggests that syphilis infection is frequent among people living with HIV in this country. Systematic screening of syphilis should be considered in this population.
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Affiliation(s)
- Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d'Abéché, Abéché, Republic of Chad.
| | - Adda Oumar Souleymane
- Institut National Supérieur des Sciences et Techniques d'Abéché, Abéché, Republic of Chad
| | | | - Oumaïma Djarma
- Republic of Chad Ministry of Public Health, Republic of Chad
| | - Amandine Cournil
- Pathogenesis and Control of Chronic Infections, Montpellier University Hospital, University of Montpellier, INSERM, EFS, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, Montpellier University Hospital, University of Montpellier, INSERM, EFS, Montpellier, France
| | - Franck J D Mennechet
- Pathogenesis and Control of Chronic Infections, Montpellier University Hospital, University of Montpellier, INSERM, EFS, Montpellier, France.
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Thums MA, Koth VS, de Figueiredo M, Cherubini K, Salum FG. Oral manifestations of syphilis: an epidemiological study in southern Brazil. Aust Dent J 2021; 66:289-294. [PMID: 33656756 DOI: 10.1111/adj.12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Syphilis is an infectious, sexually transmitted disease with varied oral manifestations, that can mimic other lesions. This study aimed to conduct an epidemiological survey of cases of syphilis, diagnosed from oral manifestations, establishing the sociodemographic profile of patients and clinical characteristics of oral lesions. METHODS The medical records of patients with oral lesions of syphilis acquired were reviewed, and 109 cases were selected. RESULTS The mean age of the patients was 34.4 years and, of these, 51% were male. In 105 cases, the disease was diagnosed in the secondary stage; in three cases, in the primary stage; and, in one case, in the tertiary stage. The cases of primary syphilis presented as single and ulcerated nodules, and the case of tertiary syphilis, as a necrotic lesion in the palate. In 86% of cases of secondary syphilis, there were multicentric lesions, presenting as grayish-white plaques (85%), associated or not with erosive and/or ulcerated lesions (33%), mostly affecting the labial mucosa and tongue. In 91.7% of cases painful symptoms were reported. CONCLUSION Considering the increase in syphilis, it is extremely important that dentists recognize its oral manifestations, because early diagnosis and treatment can minimize the risks of complications and transmission.
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Affiliation(s)
- M A Thums
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - V S Koth
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maz de Figueiredo
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - K Cherubini
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
| | - F G Salum
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
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