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Wang R, Li X, Hu Z, Jing W, Zhao Y. Spatial Heterogeneity and Its Influencing Factors of Syphilis in Ningxia, Northwest China, from 2004 to 2017: A Spatial Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10541. [PMID: 36078254 PMCID: PMC9518519 DOI: 10.3390/ijerph191710541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Syphilis remains a growing and resurging infectious disease in China. However, exploring the influence of environmental factors on the spatiotemporal distribution of syphilis remains under explore. This study aims to analyze the spatiotemporal distribution characteristics of syphilis in Ningxia, Northwest China, and its potential environmental influencing factors. Based on the standardized incidence ratio of syphilis for 22 administrative areas in Ningxia from 2004 to 2017, spatiotemporal autocorrelation and scan analyses were employed to analyze the spatial and temporal distribution characteristics of syphilis incidence, while a fixed-effect spatial panel regression model identified the potential factors affecting syphilis incidence. Syphilis incidence increased from 3.78/100,000 in 2004 to 54.69/100,000 in 2017 with significant spatial clustering in 2007 and 2009-2013. The "high-high" and "low-low" clusters were mainly distributed in northern and southern Ningxia, respectively. The spatial error panel model demonstrated that the syphilis incidence may be positively correlated with the per capita GDP and tertiary industry GDP and negatively correlated with the number of health facilities and healthcare personnel. Sex ratio and meteorological factors were not significantly associated with syphilis incidence. These results show that the syphilis incidence in Ningxia is still increasing and has significant spatial distribution differences and clustering. Socio-economic and health-resource factors could affect the incidence; therefore, strengthening syphilis surveillance of migrants in the economically developed region and allocating health resources to economically underdeveloped areas may effectively help prevent and control syphilis outbreaks in high-risk cluster areas of Ningxia.
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Affiliation(s)
- Ruonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, 1160 Shengli Street, Xingqing District, Yinchuan 750001, China
| | - Xiaolong Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, 1160 Shengli Street, Xingqing District, Yinchuan 750001, China
| | - Zengyun Hu
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi 830011, China
| | - Wenjun Jing
- School of Statistics, Shanxi University of Finance and Economics, Taiyuan 030006, China
| | - Yu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan 750001, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, 1160 Shengli Street, Xingqing District, Yinchuan 750001, China
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2
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Li W, Han J, Zhao P, Wang D, Sun T, Guo J, He Y, Qu P, Liu Y, Shen C, Wang Y. Predicting asymptomatic neurosyphilis using peripheral blood indicators. BMC Infect Dis 2021; 21:1191. [PMID: 34836501 PMCID: PMC8626879 DOI: 10.1186/s12879-021-06846-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background The high misdiagnosis rate of asymptomatic neurosyphilis (ANS) has long challenged infectious disease clinicians. We aim to develop a model for diagnosing ANS in asymptomatic syphilis (AS) patients without CSF indicators. Results 277 AS patients with HIV-negative and underwent lumbar puncture were enrolled in this horizontal study.The area under the curve for predicting ANS by CSF leukocytes and protein was 0.643 and 0.675 [95% CI, 0.583–0.699VS.0.616–0.729]. Through LRM, the AUC increased to 0.806 [95% CI, 0.732–0.832], and the Youden's index was 0.430. If the score is ≤ 0.159, ANS can be excluded with a predictive value of 92.9%; we can identify ANS while the score is over 0.819, with a predictive value of 91.7% and a specificity of 99.25%. This study showed that the LRM can diagnose ANS in AS patients effectively. Conclusion Given a large number of misdiagnosis ANS patients and CSF results' insufficiency, the model is more practical. Our research will help clinicians track suspected syphilis, especially those who cannot accept the CSF test.
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Affiliation(s)
- Weijie Li
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Jiaqi Han
- ICU, The First Hospital of Tsinghua University, Beijing, China
| | - Pan Zhao
- Department of Infectious Diseases, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Dagang Wang
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Tianhao Sun
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Jie Guo
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Yanqun He
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Pei Qu
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Ying Liu
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Congle Shen
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China
| | - Yajie Wang
- Department of Clinical Laboratory, Beijing Ditan Hospital Capital Medical University, Beijing, China.
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Tang S, Shi L, Chen W, Zhao P, Zheng H, Yang B, Wang C, Ling L. Spatiotemporal distribution and sociodemographic and socioeconomic factors associated with primary and secondary syphilis in Guangdong, China, 2005-2017. PLoS Negl Trop Dis 2021; 15:e0009621. [PMID: 34383788 PMCID: PMC8407558 DOI: 10.1371/journal.pntd.0009621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 08/31/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies exploring the factors associated with the incidence of syphilis have mostly focused on individual-level factors. However, recent evidence has indicated that social-level factors, such as sociodemographic and socioeconomic factors, also affect the incidence of syphilis. Studies on the sociodemographic and socioeconomic factors associated with syphilis incidence are scarce, and they have rarely controlled for spatial effects, even though syphilis shows spatial autocorrelation. Methodology/Principal findings Syphilis data from 21 cities in Guangdong province between 2005 and 2017 were provided by the National Notifiable Infectious Disease Reporting Information System. The incidence time series, incidence map, and space-time scanning data were used to visualize the spatiotemporal distribution. The spatial panel data model was then applied to explore the relationship between sociodemographic factors (population density, net migration rate, male:female ratio, and the number of health institutions per 1,000 residents), socioeconomic factors (gross domestic product per capita, the proportion of secondary/tertiary industry), and the incidence of primary and secondary syphilis after controlling for spatial effects. The incidence of syphilis increased slowly from 2005 (11.91 per 100,000) to 2011 (13.42 per 100,000) and then began to decrease, reaching 6.55 per 100,000 in 2017. High-risk clusters of syphilis tended to shift from developed areas to underdeveloped areas. An inverted U-shaped relationship was found between syphilis incidence and gross domestic product per capita. Moreover, syphilis incidence was significantly associated with population density (β = 2.844, P = 0.006), the number of health institutions per 1,000 residents (β = -0.095, P = 0.007), and the net migration rate (β = -0.219, P = 0.002). Conclusions/Significance Our findings suggest that the incidence of primary and secondary syphilis first increase before decreasing as economic development increases further. These results emphasize the necessity to prevent syphilis in regions at the early stages of economic growth. Syphilis is a sexually transmitted infection that continues to cause morbidity and mortality worldwide. The primary and secondary stages of syphilis are the most transmissive stages in the entire process of the disease. We analyzed primary and secondary (P&S) syphilis data from 2005 to 2017 in Guangzhou, China, provided by the National Notifiable Infectious Disease Reporting Information System. The results showed that the annual incidence rates of P&S syphilis slightly increased from 2005 to 2011 and then began to decrease in 2017. Cases of P&S syphilis were spatially clustered. The high-risk syphilis clusters tended to shift from developed areas to underdeveloped areas. There may be an inverted U-shaped relationship between the level of economic development and the incidence of P&S syphilis, suggesting that the incidence of P&S syphilis first increased before decreasing as the level of economic development increased further. These results emphasize the necessity of preventing syphilis at locations in the early stage of economic growth. Investments in syphilis prevention education for people in regions at early development stages may mitigate the increasing cost of syphilis to future healthcare systems.
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Affiliation(s)
- Shangqing Tang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lishuo Shi
- Clinical Research Center, The sixth affiliated hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wen Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Peizhen Zhao
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (CW); (LL)
| | - Li Ling
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail: (CW); (LL)
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Felipetto LG, Teider-Junior PI, da Silva FFV, Couto ACD, Kmetiuk LB, Martins CM, Ullmann LS, Timenetsky J, Santos APD, Biondo AW. Serosurvey of anti-treponema pallidum (syphilis), anti-hepatitis C virus and anti-HIV antibodies in homeless persons of São Paulo city, southeastern Brazil. Braz J Infect Dis 2021; 25:101602. [PMID: 34389284 PMCID: PMC9392160 DOI: 10.1016/j.bjid.2021.101602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/15/2021] [Accepted: 07/04/2021] [Indexed: 01/19/2023] Open
Abstract
Homeless persons have been considered as one of the most susceptible populations to sexually transmitted infections. In Brazil, these population experienced an increase of 140% from 2012 to 2020. Accordingly, the present study aimed to assess the seroprevalence of anti-Treponema pallidum, anti-HCV, anti-HIV antibodies, and the risk factors associated with homeless persons in a daytime attendance shelter of São Paulo city during the syphilis epidemic in Brazil. Blood samples of 116 volunteers and epidemiological data were conveniently collected in the shelter from June through August 2018. Detection of syphilis, HCV, and HIV antibodies was performed by chemiluminescent microparticle immunoassay (CMIA). CMIA-reagent samples for anti-T. pallidum antibodies were confirmed by Venereal Disease Research Laboratory (VDRL) non-treponemal test. VDRL non-reagent samples were confirmed by treponemal rapid immunochromatographic test. A rapid immunoblot assay confirmed seropositivity to HIV. Overall, anti-T. pallidum antibodies were observed in 29/116 (25.0%), anti-HCV antibodies in 4/116 (3.4%), and anti-HIV antibodies in 2/116 (1.7%) individuals, both co-infected with anti-T. pallidum antibodies. Associated risk factors for syphilis in homeless persons were being born or previously living in another city (p = 0.043) and becoming homeless due to family conflicts (p = 0.035). Besides homeless vulnerability, worldwide shortage of benzathine penicillin supply and increasing of syphilis testing access through rapid testing in primary health care services may have also impacted disease spreading at the time. The prevalence of syphilis found herein is the highest worldwide to date in this population.
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Affiliation(s)
- Laís Giuliani Felipetto
- Federal University of Paraná, Department of Veterinary Medicine, College of Veterinary Science, Curitiba, PR, Brazil
| | - Pedro Irineu Teider-Junior
- Federal University of Paraná, Department of Veterinary Medicine, College of Veterinary Science, Curitiba, PR, Brazil
| | | | - Anahi Chechia do Couto
- Federal University of Paraná, Department of Cellular and Molecular Biology, College of Cellular and Molecular Biology, Curitiba, PR, Brazil
| | - Louise Bach Kmetiuk
- Federal University of Paraná, Department of Cellular and Molecular Biology, College of Cellular and Molecular Biology, Curitiba, PR, Brazil
| | - Camila Marinelli Martins
- State University of Ponta Grossa, Department of Nursing and Public Health, Ponta Grossa, PR, Brazil
| | | | - Jorge Timenetsky
- University of São Paulo, Department of Medical Microbiology, São Paulo, Brazil
| | | | - Alexander Welker Biondo
- Federal University of Paraná, Department of Veterinary Medicine, College of Veterinary Science, Curitiba, PR, Brazil; Federal University of Paraná, Department of Cellular and Molecular Biology, College of Cellular and Molecular Biology, Curitiba, PR, Brazil; Federal University of Paraná, Department of Veterinary Medicine, Curitiba, PR, Brazil.
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Pitilin ÉDB, Gasparin VA, de Resende e Silva DT, Souza JBD, Haag FB. Hospitalizations due to Congenital Syphilis in Neonates: Associated Factors from the Prenatal Care Process. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.4.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To identify the factors associated with hospitalizations due to congenital syphilis in neonates, based on the characteristics of prenatal care.
Materials and method: A quantitative case-control study, conducted by applying a questionnaire to 65 puerperal women with their babies hospitalized from July to November 2017. The data were analyzed using logistic regression, according to the plan proposed in the hierarchical approach.
Results: 20% of the hospitalizations were due to syphilis (cases) and 80% to other causes (control). The vulnerability risk (p = 0.036), previous history of sexually transmitted infection (p = 0,006), use of oral contraceptives (p = 0.011) and parity (p = 0.043) variables were statistically significant. The absence of the partner during the consultation (p = 0.028), failure to perform a rapid test for syphilis (p = 0.035) and educational activity for the partner (p = 0.033) were also associated with the occurrence of the outcome, in addition to the variables of the newborn: low birth weight (p = 0.025), not being on exclusive breastfeeding (p = 0.036) and not having had skin-to-skin contact (p = 0.043).
Conclusions: Congenital syphilis has several risk factors for its occurrence. It was possible to observe that the assistance inequalities existing in care during the prenatal consultations directly reflect on the occurrence of this condition.
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6
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Shi Y, Yang Y, Wang Y, Yang D, Yang Y, Dong S, Li C, Chen Y, Jiang Q, Zhou Y. Prevalence and associated factors of Treponema pallidum infection in a rural area of southwestern China. BMC Public Health 2020; 20:824. [PMID: 32487047 PMCID: PMC7268706 DOI: 10.1186/s12889-020-08952-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Epidemiological data on Treponema pallidum infection are scarce from the southwestern region of China. The purpose of this study was to determine the distribution and determinants of T. pallidum infection in the region. Methods A community-based cross-sectional study of 2608 participants aged ≥14 years was conducted in a rural area of southwestern China in 2014–15. A pretested questionnaire was used to collect sociodemographic characteristics and other factors associated with T. pallidum infection. The diagnoses of T. pallidum, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were determined by commercial test kits. Logistic regression analysis was used to determine the correlates for T. pallidum infection, and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Results The prevalence of T. pallidum infection was 1.2% (95% CI 0.8 to 1.7%). Risk factors varied by gender. In the male group, T. pallidum infection was significantly associated with ever injection drug use (aOR = 9.42, 95% CI 2.47 to 35.87) and HCV infection (aOR = 13.28, 95% CI 3.20 to 51.70). In the female group, correlates for T. pallidum infection included spouse having syphilis (aOR = 126.66, 95% CI 7.58 to 2122.94), ever having blood transfusion (aOR = 10.51, 95% CI 1.58 to 41.21) and HBV infection (aOR = 4.19, 95% CI 1.35 to 10.93). Conclusions The prevalence of T. pallidum infection was high in the rural area of southwestern China. Correlates for T. pallidum infection varied with sex specific. Intervention should be developed for the prevention and control of T. pallidum infection.
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Affiliation(s)
- Ying Shi
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Ya Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yingjian Wang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Dongjian Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yu Yang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Shurong Dong
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Chunlin Li
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China. .,Fudan University Center for Tropical Disease Research, Building 8, 130 Dong'an Road, Xuhui District, Shanghai, 200032, China.
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Liu LL, Liu WN, Jiang XY, Jun-Ren, Chen MH, Liu ZJ, Lin Y, Zhu SG, Lin LR, Zheng WH, Yan JH, Yang TC. Changes of T lymphocyte subsets in patients with HIV-negative symptomatic neurosyphilis. Microb Pathog 2019; 130:213-218. [DOI: 10.1016/j.micpath.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 01/31/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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Silva Neto SED, Silva SSBED, Sartori AMC. Syphilis in pregnancy, congenital syphilis, and factors associated with mother-to-child transmission in Itapeva, São Paulo, 2010 to 2014. Rev Soc Bras Med Trop 2019; 51:819-826. [PMID: 30517537 DOI: 10.1590/0037-8682-0377-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/05/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study describes cases of syphilis in pregnancy (SiP) and congenital syphilis (CS) and identifies factors associated with mother-to-child transmission in patients in Itapeva from January 1, 2010 to December 31, 2014. METHODS Using SiP and CS notification forms and medical records, a cross-sectional study involving 149 pregnant women was conducted. RESULTS Annual SiP detection rates ranged from 16.3-31.4/1000 live births. Most women had prenatal care started at the first trimester of pregnancy with ≥6 visits. Mother-to-child transmission rate was 69.7%. CS incidence rates varied from 9.1-22.3/1000 live births. CONCLUSIONS The results suggest low quality of prenatal care.
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Affiliation(s)
- Sérgio Eleutério da Silva Neto
- Programa de Pós-Graduação em Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Ana Marli Christovam Sartori
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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Liu LL, Zhu SG, Jiang XY, Ren J, Lin Y, Zhang NN, Tong ML, Zhang HL, Zheng WH, Fu HJ, Luo HJ, Lin LR, Yan JH, Yang TC. LncRNA Expression in CD4+ T Cells in Neurosyphilis Patients. Front Cell Infect Microbiol 2017; 7:461. [PMID: 29167762 PMCID: PMC5682391 DOI: 10.3389/fcimb.2017.00461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/18/2017] [Indexed: 12/31/2022] Open
Abstract
Recent studies have shown that several long noncoding RNAs (lncRNAs) are involved in regulating the immune response to cope with pathogenic invasion. To date, the roles of lncRNAs in the CD4+ T cell response to Treponema pallidum (T. pallidum) infection in neurosyphilis patients remain unknown. The mRNA and lncRNA expression profiles of CD4+ T cells that were isolated from neurosyphilis patients and healthy controls were analyzed by microarray. A total of 2258 lncRNAs and 1728 mRNAs were identified as over-expressed or under-expressed, respectively (fold change > 1.5) in the CD4+ T cells of neurosyphilis patients compared to the healthy controls. The lncRNA-mRNA co-expression network showed that 59 lncRNAs showed significant differences along with significantly different mRNAs. Among the 59 gene pairs, the LOC79999 mRNA was positively correlated with the RP11-160E2.16, RP11-160E2.11, and RP11-160E2.19 lncRNAs, and the NKX1-1 mRNA was positively correlated with the RP11-1398P2.1, RP11-160E2.19, and XLOC_003422 lncRNAs. The following five mRNAs were correlated with two differential lncRNAs: DUSP16, AP000349.1, FAM115C, TIMM8A, and SMCHD1. Gene Ontology (GO) analysis revealed that the differentially expressed coding genes were mainly involved in biological processes and the top 4 terms that associated with above-mentioned differentially expressed coding genes were as follows: defense response to fungus, defense response to bacterium, killing of cells of other organism and disruption of cells of another organism. A subsequent pathway analysis was also conducted, and several pathways, including the T cell receptor, MAPK, and TGF-beta signaling pathways, were associated with the differentially expressed mRNAs. This study reveals the differential expression profiles of lncRNAs in the CD4+ T cell response to the T. pallidum infection in neurosyphilis patients. LncRNAs are involved in key biological processes that comprise the CD4+ T cell response to the T. pallidum infection.
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Affiliation(s)
- Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Shao-Gang Zhu
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Xiao-Yong Jiang
- Department of Dermatology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Jun Ren
- Department of Dermatology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Yong Lin
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Ning-Ning Zhang
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Man-Li Tong
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Hui-Lin Zhang
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Wei-Hong Zheng
- Department of Neurology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Hua-Jun Fu
- Department of Neurology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Hai-Juan Luo
- Department of Neurology, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
| | - Jiang-Hua Yan
- Cancer Research Center, Medical College of Xiamen University, Xiamen, China
| | - Tian-Ci Yang
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China
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Xiao Y, Tong ML, Lin LR, Liu LL, Gao K, Chen MJ, Zhang HL, Zheng WH, Li SL, Lin HL, Lin ZF, Yang TC, Niu JJ. Serological Response Predicts Normalization of Cerebrospinal Fluid Abnormalities at Six Months after Treatment in HIV-Negative Neurosyphilis Patients. Sci Rep 2017; 7:9911. [PMID: 28855625 PMCID: PMC5577126 DOI: 10.1038/s41598-017-10387-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 08/07/2017] [Indexed: 12/09/2022] Open
Abstract
This study aimed to determine whether a serological response could predict the normalization of cerebrospinal fluid (CSF) abnormalities at 6 months after treatment in human immunodeficiency virus (HIV)-negative neurosyphilis patients. A total of 123 neurosyphilis patients were recruited at baseline, 58 of these patients undergoing treatment, repeated CSF examinations and serological tests for syphilis at 6 months after treatment were included in the follow-up study. Before treatment, the CSF rapid plasma reagin (RPR) titer, CSF Treponema pallidum particle agglutination (TPPA) titer, CSF leukocyte count, and CSF protein concentration were correlated with both serum RPR and TPPA titers. At 6 months after treatment, 28 and nine patients achieved serological responses of RPR and TPPA tests, respectively. The sensitivities of the serological response of RPR and TPPA tests for identifying the normalization of CSF abnormalities were 60.0∼83.3% and 17.1~22.2%, respectively; and 75.0∼91.3% of patients showing serological response of RPR test also achieved CSF normalization, suggesting that the serological response could predict CSF normalization to some degree. Particularly, in patients with ≥8-fold decreases in the serum RPR titer, the CSF RPR, CSF leukocyte count, and CSF protein concentration had normalized, and follow-up lumbar puncture could be reduced considering the resolution of neurological symptoms.
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Affiliation(s)
- Yao Xiao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China.,Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian Province, China.,Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, Fujian Province, China
| | - Man-Li Tong
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China.,Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Li-Rong Lin
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China.,Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Li-Li Liu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China.,Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Kun Gao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Mei-Jun Chen
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Hui-Lin Zhang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Wei-Hong Zheng
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China
| | - Shu-Lian Li
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, Fujian Province, China
| | - Hui-Ling Lin
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, Fujian Province, China
| | - Zhi-Feng Lin
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, Fujian Province, China
| | - Tian-Ci Yang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China. .,Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China.
| | - Jian-Jun Niu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, China. .,Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, China. .,Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, Fujian Province, China.
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11
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Xiao Y, Tong ML, Liu LL, Lin LR, Chen MJ, Zhang HL, Zheng WH, Li SL, Lin HL, Lin ZF, Xing HQ, Niu JJ, Yang TC. Novel predictors of neurosyphilis among HIV-negative syphilis patients with neurological symptoms: an observational study. BMC Infect Dis 2017; 17:310. [PMID: 28446129 PMCID: PMC5406894 DOI: 10.1186/s12879-017-2339-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/24/2017] [Indexed: 11/24/2022] Open
Abstract
Background Known predictors of neurosyphilis were mainly drawn from human immunodeficiency virus (HIV)-infected syphilis patients, which may not be applicable to HIV-negative populations as they have different characteristics, particularly those with neurological symptoms. This study aimed to identify novel predictors of HIV-negative symptomatic neurosyphilis (S-NS). Methods From June 2005 to June 2015, 370 HIV-negative syphilis patients with neurological symptoms were recruited, consisting of 191 S-NS patients (including 123 confirmed neurosyphilis and 68 probable neurosyphilis patients) and 179 syphilis/non-neurosyphilis (N-NS) patients. Clinical and laboratory characteristics of S-NS were compared with N-NS to identify factors predictive of S-NS. Serum rapid plasma reagin (RPR), Treponema pallidum particle agglutination (TPPA), and their parallel testing format for screening S-NS were evaluated. Results The likelihood of S-NS was positively associated with the serum RPR and TPPA titers. The serum TPPA titers performed better than the serum RPR titers in screening S-NS. The optimal cut-off points to recognize S-NS were serum RPR titer ≥1:4 and serum TPPA titer ≥1:2560 respectively. A parallel testing format of a serum RPR titer ≥1:2 and serum TPPA titer ≥1:1280 screened out 95.8% of S-NS and all confirmed cases of neurosyphilis. S-NS was independently associated with male sex, serum RPR titer ≥1:4, serum TPPA titer ≥1:2560, and elevated serum creatine kinase. Concurrence of these factors increased the likelihood of S-NS. Conclusions Quantitation of serum TPPA is worthwhile and performs better than serum RPR in screening S-NS. Serum RPR, serum TPPA, male sex, and serum creatine kinase can predict S-NS. Moreover, patients with both a serum RPR titer <1:2 and a serum TPPA titer <1:1280 have a low probability of S-NS, suggesting that it is reasonable to reduce lumbar punctures in such individuals.
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Affiliation(s)
- Yao Xiao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China.,Xiamen Hospital of Traditional Chinese Medicine, Xiamen, 361009, China.,Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, 361004, China
| | - Man-Li Tong
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Li-Li Liu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Li-Rong Lin
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Mei-Jun Chen
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Hui-Lin Zhang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Wei-Hong Zheng
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China
| | - Shu-Lian Li
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, 361009, China
| | - Hui-Ling Lin
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, 361009, China
| | - Zhi-Feng Lin
- Xiamen Huli District Maternity and Child Care Hospital, Xiamen, 361009, China
| | - Hui-Qin Xing
- Institute of Neuroscience, Medical College of Xiamen University, Xiamen, 361005, China
| | - Jian-Jun Niu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China. .,Xiamen Zhongshan Hospital, Fujian Medical University, Xiamen, 361004, China.
| | - Tian-Ci Yang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China.
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12
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Dai W, Luo Z, Xu R, Zhao G, Tu D, Yang L, Wang F, Cai Y, Lan L, Hong F, Yang T, Feng T. Prevalence of HIV and syphilis co-infection and associated factors among non-commercial men who have sex with men attending a sexually transmitted disease clinic in Shenzhen, China. BMC Infect Dis 2017; 17:86. [PMID: 28100187 PMCID: PMC5241916 DOI: 10.1186/s12879-017-2187-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/05/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although HIV and syphilis co-infection has been frequently observed in men who have sex with men (MSM), only few studies have focused on it. Different subgroups of MSM might exhibit heterogeneous HIV and syphilis risk profiles, indicating that interventions for HIV and HIV-related co-infections may vary with different subgroups of MSM. However, no previous study has investigated HIV and syphilis co-infection among non-commercial MSM (ncMSM) attending a sexually transmitted disease (STD) clinic. Therefore, this study aimed to explore the prevalence of HIV and syphilis co-infection and associated factors among ncMSM attending an STD clinic in Shenzhen, China. METHODS NcMSM attending the STD clinic of Shenzhen Center for Chronic Disease Control were recruited in this cross-sectional study every Monday between March 2013 and August 2015 using a site based convenience sampling method. An anonymous questionnaire was used to collect data regarding socio-demographic characteristics, risky sexual behaviors and HIV-related knowledge. Blood samples were collected to perform HIV and syphilis tests. RESULTS Totally 533 participants were enrolled in this study and the prevalence of HIV and syphilis co-infection among them was 13.13%. Multivariable analyses indicated that having lived in Shenzhen for less than one year (aOR = 2.80, 95% CI = 1.30-6.05), having first anal sexual intercourse before the age of 18 (aOR = 2.78, 95% CI = 1.29-5.89), having 3 to 5 anal sexual partners in the past six months (aOR = 2.54, 95% CI = 1.19-5.40), playing exclusively receptive (aOR = 6.87, 95% CI = 3.02-15.61) or both insertive and receptive (aOR = 3.65, 95% CI = 1.64-8.09) roles in anal sexual intercourse and not always using condom in anal sexual intercourse (aOR = 2.13, 95% CI = 1.08-4.19) were associated risk factors for HIV and syphilis co-infection, relative to the non-infected ncMSM. Compared with the mono-infected ncMSM, associated risk factors for the co-infection were being unmarried (aOR = 2.47, 95% CI = 1.03-5.89) and playing exclusively receptive role (aOR = 2.44, 95% CI = 1.04-5.73) in anal sexual intercourse. CONCLUSIONS HIV and syphilis co-infection is quite prevalent among the study participants in Shenzhen. Integrated and intensified intervention strategies, specifically targeting at the non-infected and mono-infected ncMSM attending the STD clinic, are needed to reduce HIV and syphilis co-infection. Most importantly, non-infected and mono-infected ncMSM attending the STD clinic with the aforementioned associated risk factors should be given special concern.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Zhenzhou Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Ruiwei Xu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Guanglu Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Dan Tu
- Graduate School, Shenzhen University, Shenzhen, Guangdong China
| | - Lin Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Yumao Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Lina Lan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Fuchang Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Tiejian Feng
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
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