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Alexiou ZW, van Aar F, Hoenderboom BM, Morre SA, Heijne JCM. Trends in Chlamydia trachomatis IgG seroprevalence in the general population of the Netherlands over 20 years. Sex Transm Infect 2024; 100:31-38. [PMID: 37985129 PMCID: PMC10850662 DOI: 10.1136/sextrans-2023-055888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To report sex and age-specific Chlamydia trachomatis (Ct) seroprevalence estimates in the general population of the Netherlands between 1996 and 2017 and identify risk factors associated with Ct seropositivity. METHODS Participants (n=5158, aged 15-59 years) were included from three independent nationwide population-based serosurveillance studies in 1996, 2007 and 2017. Participants completed a questionnaire on demographics and sexual behaviour. Serum antibodies were analysed using Medac Ct IgG ELISA test. Census weights were assigned to achieve seroprevalence estimates representative of the general Dutch population. Weighted seroprevalence estimates were stratified by gender, age and birth cohort. Trends and risk factors in men and women were identified using multivariable logistic regression. RESULTS Weighted overall Ct seroprevalence was 10.5% (95% CI: 9.2% to 12.0%) in women and 5.8% (95% CI: 4.7% to 7.0%) in men. Among women <25 years, there was a non-significant increase in seroprevalence from 5.9% (95% CI 3.7% to 9.2%) in 1996, to 7.6% (95% CI 5.1% to 11.1%) in 2007 and 8.8% (95% CI 5.5% to 13.9%) in 2017. Among women ≥25 years, the seroprevalence significantly decreased from 15.6% (95% CI: 12.2% to 19.7%) in 1996 to 9.5% (95% CI: 7.2% to 12.4%) in 2007 but did not further drop (11.2% (95% CI 8.1% to 15.3%) in 2017). In men, we did not observe trends between study rounds. In both men and women, having a non-Western migration background was a risk factor for seropositivity. In women, having had a prior sexually transmitted infection and ≥2 recent sex partners were risk factors for seropositivity as well. CONCLUSIONS We have not found evidence for a decrease in population seroprevalence in those under 25 years old despite decades of intensified testing-and-treatment efforts in the Netherlands. This suggests further monitoring of Ct burden in the general population is needed. If serum banks are used for this, specifically individuals <25 years old and with diverse migration backgrounds should be included.
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Affiliation(s)
- Zoïe Willemijn Alexiou
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Fleur van Aar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Bernice Maria Hoenderboom
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Servaas Antonie Morre
- Department of Genetics and Cell Biology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Dutch Chlamydia trachomatis Reference Laboratory, Department of Medical Microbiology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad, India
| | - Janneke Cornelia Maria Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Abou Chacra L, Ly C, Hammoud A, Iwaza R, Mediannikov O, Bretelle F, Fenollar F. Relationship between Bacterial Vaginosis and Sexually Transmitted Infections: Coincidence, Consequence or Co-Transmission? Microorganisms 2023; 11:2470. [PMID: 37894128 PMCID: PMC10609101 DOI: 10.3390/microorganisms11102470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
Sexually transmitted infections (STIs) are a serious global problem, causing disease, suffering, and death. Although bacterial vaginosis (BV) is not considered to be an STI, it may be associated with an increased risk of contracting a wide range of STIs. We sought to assess the link between the different microorganisms involved in STIs and BV. A total of 290 vaginal swabs from 290 women sent for diagnostic purposes to the clinical microbiology laboratory of the Marseille University Public Hospitals were tested by specific qPCR targeting STI-causing microorganisms and BV. Of these 290 swabs, 15.2% (44/290) were diagnosed with at least one STI-causing microorganism and 17.2% (50/290) with BV. The prevalence of STIs was significantly higher in women with BV (28%, 14/50) than in those without (20.4%, 51/240). The prevalence of co-infections involving two STI-causing microorganisms was significantly more frequent in women with BV than in those without (18% [8/50] vs. 2% [5/250]; p < 0.001). The prevalence of monoinfections and polyinfections with STI-causing microorganisms was lower in women without BV than in those with (8.8% [21/240] vs. 28% [14/50]), p < 0.001 and 2% (5/240) vs. 8% (4/50), p = 0.05, respectively). Our data suggest that a correlation between BV and STI may exist, with a higher prevalence of both monoinfections and polyinfections involving STI-causing microorganisms in women with BV. Further research is needed to better understand BV and its links to STIs.
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Affiliation(s)
- Linda Abou Chacra
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
| | - Claudia Ly
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
| | - Alissa Hammoud
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Rim Iwaza
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Florence Bretelle
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
- Department of Gynaecology and Obstetrics, Gynépole, La Conception, AP-HM, 13005 Marseille, France
| | - Florence Fenollar
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
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Sawras V, Deuffic-Burban S, Préau M, Spire B, Yazdanpanah Y, Champenois K. Assessing complex interventions: a systematic review of outcomes used in randomised controlled trials on STI partner notification in high-income countries. BMC Public Health 2023; 23:1838. [PMID: 37735382 PMCID: PMC10512513 DOI: 10.1186/s12889-023-16763-9] [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: 01/11/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Partner notification interventions are complex and assessing their effectiveness is challenging. By reviewing the literature on the effectiveness of partner notification interventions, our aim was to evaluate the choice, collection, and interpretation of outcomes and their impact on study findings. METHODS We conducted a systematic review of individual-level randomised controlled trials evaluating the effectiveness of partner notification interventions for bacterial STIs, HIV or sexually transmitted HCV in high-income countries since 2000. Partner notification interventions included assisted patient referral interventions and expedited treatment. The content analysis was carried out through a narrative review. RESULTS In the 9 studies that met the inclusion criteria, 16 different outcomes were found. In most studies, one or two outcomes assessing partner notification practices were associated with an outcome reflecting STI circulation through index case reinfections. These outcomes assessed the main expected effects of partner notification interventions. However, partner notification is composed of a succession of actions between the intervention on the index case and the testing and/or treatment of the notified partners. Intermediate outcomes were missing so as to better understand levers and barriers throughout the process. Potential changes in participants' sexual behaviour after partner notification, e.g. condom use, were outcomes reported in only two studies assessing interventions including counselling. Most outcomes were collected through interviews, some weeks after the intervention, which might lead to desirability and attrition biases, respectively. Assessment of the effectiveness of partner notification interventions on partner testing/treatment was limited by the collection of data from index cases. Few data describing index cases and their partners were provided in the studies. Additional data on the number and type of exposed partners and the proportion of partners already aware of their infection before being notified would help to interpret the results. CONCLUSIONS These insights would help to understand why and under what conditions the intervention is considered effective and therefore can be replicated or adapted to other populations and contexts.
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Affiliation(s)
- Victoire Sawras
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
| | - Sylvie Deuffic-Burban
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
| | - Marie Préau
- Institut de Psychologie, Université Lumière Lyon 2, Inserm, U1296, Lyon, France
| | - Bruno Spire
- Aix Marseille Univ, Inserm, IRD, SESSTIM, ISSPAM, Marseille, France
| | - Yazdan Yazdanpanah
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
- Service de maladies infectieuses et tropicales, Hôpital Bichat Claude Bernard, Paris, F-75018, France
| | - Karen Champenois
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France.
- Inserm IAME - Faculté de Médecine Bichat, 16 rue Henri Huchard, Paris, 75018, France.
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López Corbeto E, Lugo Colón R, Montoro Fernández M, Casabona Barbara J. [Epidemiological situation of post-pandemic sexually transmitted infections in Catalonia, Spain]. Med Clin (Barc) 2023; 161:95-100. [PMID: 37244853 PMCID: PMC10209783 DOI: 10.1016/j.medcli.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND The growing trend of STIs in recent years was altered after the outbreak of the SARS-CoV-2 pandemic. OBJECTIVES Describe the impact of the SARS-CoV-2 pandemic on STI declarations received during the pre-pandemic to pandemic period and estimate the number of STI cases expected for the pandemic period. MATERIAL AND METHODS Descriptive analysis of STI declarations received during the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. The influence of the number of positive cases of SARS-CoV-2 with the number of positive cases of STIs during the months of the pandemic was studied using a correlation model. Using the Holt-Wilson time series model, an estimate was made of the number of STI cases expected for the pandemic period. RESULTS The global incidence rate for all STIs in 2020 decreased by 18.3% compared to 2019. Chlamydia and syphilis presented a greater reduction in their incidence from 2019 to 2020 of 22.7% and 20.9%, respectively and 9.5% and 2.5% for gonorrhea and LGV. Estimates showed that in 2020 there would have been 44.6% more STIs than those declared. The proportions according to sex, country of birth and sexual orientation changed significantly in chlamydia and gonorrhea. CONCLUSIONS The measures adopted for the prevention of SARS-CoV-2 infections were able to achieve an initial decrease in STI cases in 2020, however, this change was not maintained during 2021, which ended with higher incidences recorded to date.
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Affiliation(s)
- Evelin López Corbeto
- Centro de estudios Epidemiológicos sobre las ITS y Sida de Cataluña (CEEISCAT), Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España.
| | - Rossie Lugo Colón
- Centro de estudios Epidemiológicos sobre las ITS y Sida de Cataluña (CEEISCAT), Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
| | - Marcos Montoro Fernández
- Centro de estudios Epidemiológicos sobre las ITS y Sida de Cataluña (CEEISCAT), Barcelona, España
| | - Jordi Casabona Barbara
- Centro de estudios Epidemiológicos sobre las ITS y Sida de Cataluña (CEEISCAT), Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España; Departament de Pediatria, d'Obstetrícia, Ginecologia i de Medicina Preventiva i Salut Pública. Universitat Autónoma de Barcelona, Cerdanyola del Vallès, Barcelona, España
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Marcus U, Veras M, Casabona J, Caceres CF, Lachowsky N, Schink SB, Schmidt AJ. Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents. BMC Public Health 2023; 23:1008. [PMID: 37254096 DOI: 10.1186/s12889-023-15946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/20/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are in general more vulnerable to sexually transmitted infections (STIs) than the heterosexual men population. However, surveillance data on STI diagnoses lack comparability across countries due to differential identification of MSM, diagnostic standards and methods, and screening guidelines for asymptomatic infections. METHODS We compared self-reported overall diagnostic rates for syphilis, gonorrhea, and chlamydia infections, and diagnostic rates for infections that were classified to be symptomatic in the previous 12 months from two online surveys. They had a shared methodology, were conducted in 68 countries across four continents between October 2017 and May 2018 and had 202,013 participants. RESULTS Using multivariable multilevel regression analysis, we identified age, settlement size, number of sexual partners, condom use for anal intercourse, testing frequency, sampling rectal mucosa for extragenital testing, HIV diagnosis, and pre-exposure prophylaxis use as individual-level explanatory variables. The national proportions of respondents screened and diagnosed who notified some or all of their sexual partners were used as country-level explanatory variables. Combined, these factors helped to explain differences in self-reported diagnosis rates between countries. The following differences were not explained by the above factors: self-reported syphilis diagnoses were higher in Latin America compared with Europe, Canada, Israel, Lebanon, and the Philippines (aORs 2.30 - 3.71 for symptomatic syphilis compared to Central-West Europe); self-reported gonorrhea diagnoses were lower in Eastern Europe and in Latin America compared with all other regions (aORs 0.17-0.55 and 0.34 - 0.62 for symptomatic gonorrhea compared to Central-West Europe); and self-reported chlamydia diagnoses were lower in Central East and Southeast Europe, South and Central America, and the Philippines (aORs 0.25 - 0.39 for symptomatic chlamydia for Latin American subregions compared to Central West Europe). CONCLUSIONS Possible reasons for differences in self-reported STI diagnosis prevalence likely include different background prevalence for syphilis and syndromic management without proper diagnosis, and different diagnostic approaches for gonorrhea and chlamydia.
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Affiliation(s)
- Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany.
| | - Maria Veras
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr Cesario Mota Jr 61, São Paulo, SP, 01221-020, Brazil
| | | | - Carlos F Caceres
- Centre for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nathan Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
- Community Based Research Centre Society, Vancouver, BC, Canada
| | - Susanne B Schink
- Department of Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
| | - Axel J Schmidt
- Sigma Research, London School of Hygiene and Tropical Medicine, London, UK
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Widyasari K, Kim S. Rapid Antigen Tests during the COVID-19 Era in Korea and Their Implementation as a Detection Tool for Other Infectious Diseases. Bioengineering (Basel) 2023; 10:322. [PMID: 36978713 PMCID: PMC10045740 DOI: 10.3390/bioengineering10030322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Rapid antigen tests (RATs) are diagnostic tools developed to specifically detect a certain protein of infectious agents (viruses, bacteria, or parasites). RATs are easily accessible due to their rapidity and simplicity. During the COVID-19 pandemic, RATs have been widely used in detecting the presence of the specific SARS-CoV-2 antigen in respiratory samples from suspected individuals. Here, the authors review the application of RATs as detection tools for COVID-19, particularly in Korea, as well as for several other infectious diseases. To address these issues, we present general knowledge on the design of RATs that adopt the lateral flow immunoassay for the detection of the analyte (antigen). The authors then discuss the clinical utilization of the authorized RATs amidst the battle against the COVID-19 pandemic in Korea and their role in comparison with other detection methods. We also discuss the implementation of RATs for other, non-COVID-19 infectious diseases, the challenges that may arise during the application, the limitations of RATs as clinical detection tools, as well as the possible problem solving for those challenges to maximize the performance of RATs and avoiding any misinterpretation of the test result.
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Affiliation(s)
- Kristin Widyasari
- Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Sunjoo Kim
- Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea
- Department of Laboratory Medicine, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea
- Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea
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Wu X, Zhou X, Chen Y, Zhai K, Sun R, Luo G, Lin YF, Li Y, Yang C, Zou H. The impact of COVID-19 lockdown on cases and deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C in China: an interrupted time series analysis. JMIR Public Health Surveill 2023; 9:e40591. [PMID: 36634257 DOI: 10.2196/40591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/07/2022] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND China has implemented nationwide lockdown to contain COVID-19 from an early stage. Previous studies of the impact of COVID-19 on sexually transmitted diseases (STDs) and diseases caused by blood-borne viruses (BBVs) in China have yielded widely disparate results, and study on deaths attributable to STDs and BBVs are scarce. OBJECTIVE We aimed to elucidate the impact of COVID-19 lockdown on the cases, deaths, and case-fatality ratios of STDs and BBVs. METHODS We extracted the monthly cases and deaths data for AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C between January 2015 and December 2021 from the notifiable disease reporting database on the official website of the National Health Commission of China. We used descriptive statistics to summarize the number of cases and deaths, and calculated incidence and case-fatality ratios before and after implementing nationwide lockdown (January 2020). We used negative binominal segmented regression models to estimate the immediate and long-term impacts of lockdown on cases, deaths, and case-fatality ratios in January 2020 and December 2021, respectively. RESULTS A total of 14,800,330 cases and 127,030 deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C were reported from January 2015 to December 2021, with an incidence of 149.11/100,000 before lockdown and 151.41/100,000 after lockdown , and a case-fatality ratio of 8.21/1000 before lockdown and 9.50/1000 after lockdown . In the negative binominal model, AIDS cases (-23.4%; 0.766, 0.626-0.939) and deaths (-23.9%; 0.761, 0.647-0.896), gonorrhea cases (-34.3%; 0.657, 0.524-0.823), syphilis cases (-15.4%; 0.846, 0.763-0.937), hepatitis B cases (-17.5%; 0.825, 0.726-0.937) and hepatitis C cases (-19.6%; 0.804, 0.693-0.933) showed significant decreases in January 2020. Gonorrhea, syphilis and hepatitis C showed small increases in the number of deaths or case-fatality ratios in January 2020. By December 2021, the cases, deaths, and case-fatality ratios for each disease had either reached or remained below expected levels. CONCLUSIONS COVID-19 lockdown may have contributed to fewer reported cases of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C, and more reported deaths or case-fatality ratios of gonorrhea, syphilis and hepatitis C in China. CLINICALTRIAL
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Affiliation(s)
- Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Yuanyi Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Ke Zhai
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Ruoyao Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Chongguang Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, PR China, No. 66, Gongchang Road, Guangming District, Shenzhen, Guangdong 518107, P.R. China, Shenzhen, CN
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Suresh A, Jose R, Sasidharanpillai S, Chathoth AT, Ajithkumar K. Linear trends over 20 years in sexually transmitted infections among patients attending a tertiary care centre in north Kerala, India. Indian J Dermatol Venereol Leprol 2023; 89:60-64. [PMID: 33871209 DOI: 10.25259/ijdvl_1038_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 12/01/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Worldwide, a declining trend is observed in sexually transmitted infections of bacterial origin which is reflected as a rise in the proportion of viral sexually transmitted infections. AIMS To find out the clinical referral patterns of sexually transmitted infections among patients who attended the sexually transmitted infection clinic attached to Dermatology and Venereology Department of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and to study the linear trends in the pattern of sexually transmitted infections over 20 years. METHODS After clearance from the institutional ethics committee, a retrospective study was conducted among patients who attended the sexually transmitted infection clinic of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and were diagnosed to have sexually transmitted infections. RESULTS During the 20 year study period 5227 patients, attended the sexually transmitted infection clinic of our institution. Diagnosis of sexually transmitted infection was made in 2470 (47.3%) cases. Predominant sexually transmitted infections were herpes genitalis (964, 39%), condyloma acuminata (921, 37.9%) and syphilis (418, 17.2%). Viral sexually transmitted infections (1885, 76.3%) outnumbered bacterial sexually transmitted infections (575, 23.3%). A declining trend was noted for both bacterial and viral sexually transmitted infections over the 20 year period, which was more marked for the former. But the latter years of the study documented a rising trend in total sexually transmitted infections including bacterial sexually transmitted infections. LIMITATIONS The study does not reflect the status of sexually transmitted infections in the general population since it was conducted in a tertiary referral center. CONCLUSION The disturbing ascending trend recorded in sexually transmitted infections including syphilis during the final years of the 20-year period needs to be watched closely, to plan future strategies.
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Affiliation(s)
- Archana Suresh
- Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala, India
| | - Reeshma Jose
- Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala, India
| | - Sarita Sasidharanpillai
- Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala, India
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Zheng Y, Yu Q, Lin Y, Zhou Y, Lan L, Yang S, Wu J. Global burden and trends of sexually transmitted infections from 1990 to 2019: an observational trend study. THE LANCET. INFECTIOUS DISEASES 2022; 22:541-551. [PMID: 34942091 DOI: 10.1016/s1473-3099(21)00448-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a major public health issue worldwide, but there is a paucity of literature on their burden and trends globally. We aimed to assess the global disease burden and trends of STIs from 1990 to 2019. METHODS In this observational trend study, we collected data on incident cases, age-standardised incidence rate, and disability-adjusted life-years (DALYs), and calculated age-standardised DALY rates, for five STIs (syphilis, chlamydia, gonorrhoea, trichomonas, and genital herpes) between 1990 and 2019, by sex, geographical region, and cause using data exclusively from the Global Burden of Disease study 2019. The estimated annual percentage changes in the age-standardised incidence rate and age-standardised DALY rate were calculated to quantify the changing trend. FINDINGS Globally, the age-standardised incidence rate of STIs showed a decreasing trend with an estimated annual percentage change of -0·04 (95% uncertainty interval [UI] -0·08 to 0·00) from 1990 to 2019, reaching 9535·71 per 100 000 person-years (8169·73 to 11 054·76) in 2019. The age-standardised DALY rate showed a decreasing trend with an estimated annual percentage change of -0·92 (-1·01 to -0·84) and reached 22·74 per 100 000 person-years (14·37 to 37·11) in 2019. The sub-Saharan African region had the highest age-standardised incidence rate (19 973·12 per 100 000 person-years, 17 382·69 to 23 001·57) and age-standardised DALY rate (389·32 per 100 000 person-years, 154·27 to 769·74). Adolescents had the highest incidence rate (18 377·82 per 100 000 person-years, 14 040·38 to 23 443·31) and showed stable total STI trends, except for an upward trend of syphilis between 2010 (347·65 per 100 000 person-years, 203·58 to 590·69) and 2019 (423·16 per 100 000 person-years, 235·70 to 659·01). Male individuals had a higher age-standardised incidence rate (10 471·63 per 100 000 person-years, 8892·20 to 12 176·10) than female individuals (8602·40 per 100 000 person-years, 7358·00 to 10001·18), whereas female individuals had a higher age-standardised DALY rate (33·31 per 100 000 person-years, 21·05 to 55·25) than male individuals (12·11 per 100 000 person-years, 7·63 to 18·93). INTERPRETATION Although most countries showed a decrease in age-standardised rates of incidence and DALYs for STIs, the absolute incident cases and DALYs increased from 1990 to 2019. Therefore, STIs still represent a global public health challenge, especially in sub-Saharan Africa and Latin America, which warrants more attention and health prevention service. FUNDING Mega-Project of National Science and Technology for the 13th Five-Year Plan of China and the National Natural Science Foundation of China.
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Affiliation(s)
- Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qi Yu
- Department of Cardiology and Endodontics, The Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuqing Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lei Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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A case of secondary syphilis manifesting as a pulmonary pseudo-tumour with nephrotic syndrome. Afr J Thorac Crit Care Med 2021; 27. [PMID: 34430868 PMCID: PMC8327680 DOI: 10.7196/ajtccm.2021.v27i2.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/13/2022] Open
Abstract
The global incidence of primary and secondary syphilis is increasing in high-risk groups. However, pulmonary syphilis remains exceedingly rare with less than 30 cases recorded since 1967. Of these cases, none have recorded the presence of both pulmonary and renal involvement with nephrotic syndrome. Diagnosis of pulmonary syphilis remains a challenge, and there is no consensus on treatment. We report a case of a 46-year-old male with secondary pulmonary syphilis and concomitant nephrotic syndrome.
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Juher D, Rojas D, Saldaña J. Robustness of behaviorally induced oscillations in epidemic models under a low rate of imported cases. Phys Rev E 2020; 102:052301. [PMID: 33327062 DOI: 10.1103/physreve.102.052301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
This paper is concerned with the robustness of the sustained oscillations predicted by an epidemic ODE model defined on contact networks. The model incorporates the spread of awareness among individuals and, moreover, a small inflow of imported cases. These cases prevent stochastic extinctions when we simulate the epidemics and, hence, they allow to check whether the average dynamics for the fraction of infected individuals are accurately predicted by the ODE model. Stochastic simulations confirm the existence of sustained oscillations for different types of random networks, with a sharp transition from a nonoscillatory asymptotic regime to a periodic one as the alerting rate of susceptible individuals increases from very small values. This abrupt transition to periodic epidemics of high amplitude is quite accurately predicted by the Hopf-bifurcation curve computed from the ODE model using the alerting rate and the infection transmission rate for aware individuals as tuning parameters.
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Affiliation(s)
- David Juher
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, Girona 17003, Catalonia, Spain
| | - David Rojas
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, Girona 17003, Catalonia, Spain
| | - Joan Saldaña
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, Girona 17003, Catalonia, Spain
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Akwasi AG, Naomi G, Reindolf A, Prince P, Enoch A, Emmanuel A, Wisdom M, John EK, Tsiboe AK. Knowledge on and attitude towards Sexually Transmitted Infections: A qualitative study of people with physical disabilities in a peri-urban district of Ghana. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1736249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Adjei Gyimah Akwasi
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Gyamfi Naomi
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Anokye Reindolf
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Peprah Prince
- Department of Gerontology, Sheffield Hallam University Sheffield UK
| | - Acheampong Enoch
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Acheampong Emmanuel
- School of Medical and Health Sciences, Graduate Research School, Edith Cowan University Joondalup Australia
| | - Mprah Wisdom
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Essien Kojo John
- Centre for Disability and Rehabilitation Studies, Department of Community Health, Kwame Nkrumah University of Science and Technology Kumasi Ghana
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van Dulm E, Marra E, Kroone MM, van Dijk AE, Hogewoning AA, Schim van der Loeff MF. Sexually transmissible infections among female sex workers in Amsterdam between 2011 and 2016: does risk vary by work location? Sex Health 2020; 17:368-376. [PMID: 32731918 DOI: 10.1071/sh19153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
Background Female sex workers (FSW) are at risk for sexually transmissible infections (STI). This study aimed to investigate whether the risk for chlamydia and gonorrhoea differs by work location among FSW in Amsterdam. Additionally, trends in STI positivity rates between 2011 and 2016 were assessed. METHODS This was a retrospective analysis of routinely collected clinical data during STI consultations of FSW by the Prostitution and Healthcare Centre (P&G292). Work location was categorised as window prostitution, escorts/homeworkers, clubs/brothels/private houses/massage salons and other. RESULTS In total, 7558 STI consultations of 2529 FSW in the period 2011-16 were included. Positivity rates for chlamydia and gonorrhoea were 6.6% and 2.0%, respectively. Infectious hepatitis B virus, syphilis and HIV were diagnosed in <0.2% of consultations. Positivity rates of chlamydia and rectal gonorrhoea differed significantly by work location (P < 0.001). Genital and rectal chlamydia and rectal gonorrhoea were significantly less likely among women working in window prostitution, except for the other-group. Risk factors for STI did not vary by work location. Among women working in window prostitution, positivity rates for oropharyngeal and genital chlamydia and genital gonorrhoea were significantly decreasing between 2011 and 2016 (P trend <0.05). CONCLUSIONS The higher STI positivity among escorts/homeworkers and FSW in clubs/brothels/private houses/massage salons emphasises the need for extra attention to improve condom use and STI testing in this group. Factors associated with STI did not vary by work location, thus interventions, including those used by P&G292, to reduce STI risk, can be used for women at all work locations.
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Affiliation(s)
- Eline van Dulm
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands; and Corresponding author.
| | - Elske Marra
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
| | - Michelle M Kroone
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
| | - Anna E van Dijk
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
| | - Arjan A Hogewoning
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands; and Department of Dermatology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands; and Amsterdam Infection and Immunity Institute (AI&I), Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
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Abstract
The bacterium Neisseria gonorrhoeae causes the sexually transmitted infection (STI) gonorrhoea, which has an estimated global annual incidence of 86.9 million adults. Gonorrhoea can present as urethritis in men, cervicitis or urethritis in women, and in extragenital sites (pharynx, rectum, conjunctiva and, rarely, systemically) in both sexes. Confirmation of diagnosis requires microscopy of Gram-stained samples, bacterial culture or nucleic acid amplification tests. As no gonococcal vaccine is available, prevention relies on promoting safe sexual behaviours and reducing STI-associated stigma, which hinders timely diagnosis and treatment thereby increasing transmission. Single-dose systemic therapy (usually injectable ceftriaxone plus oral azithromycin) is the recommended first-line treatment. However, a major public health concern globally is that N. gonorrhoeae is evolving high levels of antimicrobial resistance (AMR), which threatens the effectiveness of the available gonorrhoea treatments. Improved global surveillance of the emergence, evolution, fitness, and geographical and temporal spread of AMR in N. gonorrhoeae, and improved understanding of the pharmacokinetics and pharmacodynamics for current and future antimicrobials in the treatment of urogenital and extragenital gonorrhoea, are essential to inform treatment guidelines. Key priorities for gonorrhoea control include strengthening prevention, early diagnosis, and treatment of patients and their partners; decreasing stigma; expanding surveillance of AMR and treatment failures; and promoting responsible antimicrobial use and stewardship. To achieve these goals, the development of rapid and affordable point-of-care diagnostic tests that can simultaneously detect AMR, novel therapeutic antimicrobials and gonococcal vaccine(s) in particular is crucial.
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Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance. Sex Transm Dis 2019; 45:237-242. [PMID: 29465698 DOI: 10.1097/olq.0000000000000741] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although syphilis rates have been relatively high in Italy for more than 15 years, no data on the molecular types of Treponema pallidum subspecies pallidum circulating in this country are yet available. Likewise, no data on how widespread is resistance to macrolide or tetracycline antibiotics in these strains exist. Such data would, however, promote comprehensive studies on the molecular epidemiology of syphilis infections in Italy and inform future interventions aiming at syphilis control in this and other European countries. GOALS AND STUDY DESIGN Swabs from oral, genital, cutaneous, or anal lesions were obtained from 60 syphilis patients attending dermatology clinics in Milan, Turin, Genoa, and Bologna. Molecular typing of T. pallidum DNA was performed to provide a snapshot of the genetic diversity of strains circulating in Northern Italy. Samples were also screened for mutations conferring resistance to macrolides and tetracyclines. RESULTS T. pallidum DNA was detected in 88.3% (53/60) of the specimens analyzed. Complete and partial T. pallidum typing data were obtained for 77.3% (41/53) and 15.0% (8/53) of samples, respectively, whereas 4 samples could not be typed despite T. pallidum DNA being detected. The highest strain type heterogeneity was seen in samples from Bologna and Milan, followed by Genoa. Minimal diversity was detected in samples from Turin, despite the highest number of typeable samples collected there. Resistance to macrolides was detected in 94.3% (50/53) of the strains, but no known mutations associated with tetracycline resistance were found. CONCLUSIONS Genetic diversity among T. pallidum strains circulating in Northern Italy varies significantly among geographical areas regardless of physical distance. Resistance to macrolides is widespread.
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Dareng EO, Adebamowo SN, Famooto A, Olawande O, Odutola MK, Olaniyan Y, Offiong RA, Pharoah PP, Adebamowo CA. Prevalence and incidence of genital warts and cervical Human Papillomavirus infections in Nigerian women. BMC Infect Dis 2019; 19:27. [PMID: 30616634 PMCID: PMC6323853 DOI: 10.1186/s12879-018-3582-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 12/03/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Genital warts are important causes of morbidity and their prevalence and incidence can be used to evaluate the impact of HPV vaccination in a population. METHODS We enrolled 1020 women in a prospective cohort study in Nigeria and followed them for a mean (SD) of 9 (4) months. Nurses conducted pelvic examinations and collected ectocervical samples for HPV testing. We used exact logistic regression models to identify risk factors for genital warts. RESULTS The mean age of study participants was 38 years, 56% (535/962) were HIV-negative and 44% (427/962) were HIV-positive. Prevalence of genital warts at enrolment was 1% (4/535) among HIV-negative women, and 5% (23/427) among HIV-positive women. Of 614 women (307 HIV negative and 307 HIV positive women) for whom we could compute genital wart incidence, it was 515 (95% CI:13-2872) per 100,000 person-years in HIV-negative and 1370 (95% CI:283-4033) per 100,000 person-years in HIV-positive women. HIV was associated with higher risk of prevalent genital warts (OR:7.14, 95% CI:2.41-28.7, p < 0.001) while higher number of sex partners in the past year was associated with increased risk of incident genital warts (OR:2.86, 95% CI:1.04-6.47. p = 0.04). HPV11 was the only HPV associated with prevalent genital warts in this population (OR:8.21, 95% CI:2.47-27.3, p = 0.001). CONCLUSION Genital warts are common in Nigeria and our results provide important parameters for monitoring the impact of future HPV vaccination programs in the country. HIV infection and number of sexual partners in past year were important risk factors for prevalent and incident genital warts respectively.
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Affiliation(s)
- Eileen O Dareng
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Sally N Adebamowo
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 725 W. Lombard St. Suite 445, Baltimore, MD, 21201, USA
| | | | | | | | - Yinka Olaniyan
- Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria
| | - Richard A Offiong
- Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Paul P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Clement A Adebamowo
- Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 725 W. Lombard St. Suite 445, Baltimore, MD, 21201, USA.
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
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Bjekić M, Šipetić-Grujičić S, Begović-Vuksanović B, Rafailović N, Vlajinac H. Syphilis Resurgence in Belgrade, Serbia, in the New Millennium: An Outbreak in 2014. Cent Eur J Public Health 2018; 25:277-281. [PMID: 29346849 DOI: 10.21101/cejph.a4525] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014. METHOD Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts. RESULTS During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection. CONCLUSIONS Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment.
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Affiliation(s)
- Milan Bjekić
- City Institute for Skin and Venereal Diseases, Belgrade, Serbia
| | | | | | | | - Hristina Vlajinac
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Reis M, Ramiro L, Camacho I, Tomé G, Gaspar de Matos M. Trends in Portuguese Adolescents’ Sexual Behavior from 2002 to 2014: HBSC Portuguese Study. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2018. [DOI: 10.1159/000486014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Zett C, Lima LH, Vianello S, Ferreira A, de Andrade GC, Farah ME, Belfort R. En-Face Optical Coherence Tomography of Acute Syphilitic Posterior Placoid Chorioretinopathy. Ocul Immunol Inflamm 2017; 26:1264-1270. [PMID: 28976235 DOI: 10.1080/09273948.2017.1347265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report a unique case series of acute syphilitic posterior placoid chorioretinopathy (ASPPC) correlating en-face optical coherence tomography (OCT) with standard imaging modalities. METHODS In this retrospective case series, multimodal imaging was performed in three ASPPC patients at the time of disease presentation. RESULTS Clinical and laboratory findings were consistent with the diagnosis of ASPPC. In all the study patients, multiple hyperreflective dot-like lesions distributed in the macular area and observed with en-face OCT at the level of retinal pigment epithelium (RPE) corresponded to the nodular RPE elevations on cross-sectional OCT and to the hyperautofluorescent spots on fundus autofluorescence. In addition, the cross-sectional OCT scans showed disorganization of the outer retinal bands and punctate choroidal hyperreflectivity. CONCLUSION By combining en-face OCT with multimodal imaging analysis, we propose that a primary inflammation at the level of the choroid may be the pathogenic mechanism for the occurrence of outer retinal band abnormalities.
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Affiliation(s)
- Claudio Zett
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,b Department of Ophthalmology, Pontificia Universidad Católica de Valparaíso , Valparaíso , Chile
| | - Luiz H Lima
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Silvana Vianello
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Adriano Ferreira
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Gabriel Costa de Andrade
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Department of Ophthalmology, Instituto da Visão - IPEPO , São Paulo , Brazil
| | - Michel E Farah
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Department of Ophthalmology, Instituto da Visão - IPEPO , São Paulo , Brazil
| | - Rubens Belfort
- a Department of Ophthalmology and Visual Science - Paulista School of Medicine , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Department of Ophthalmology, Instituto da Visão - IPEPO , São Paulo , Brazil
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Oscillations in epidemic models with spread of awareness. J Math Biol 2017; 76:1027-1057. [PMID: 28755134 DOI: 10.1007/s00285-017-1166-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 07/16/2017] [Indexed: 10/19/2022]
Abstract
We study ODE models of epidemic spreading with a preventive behavioral response that is triggered by awareness of the infection. Previous studies of such models have mostly focused on the impact of the response on the initial growth of an outbreak and the existence and location of endemic equilibria. Here we study the question whether this type of response is sufficient to prevent future flare-ups from low endemic levels if awareness is assumed to decay over time. In the ODE context, such flare-ups would translate into sustained oscillations with significant amplitudes. Our results show that such oscillations are ruled out in Susceptible-Aware-Infectious-Susceptible models with a single compartment of aware hosts, but can occur if we consider two distinct compartments of aware hosts who differ in their willingness to alert other susceptible hosts.
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Prevalence of Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae Based on Data Collected by a Network of Clinical Microbiology Laboratories, in Italy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 901:47-57. [PMID: 26691509 DOI: 10.1007/5584_2015_5015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Bacterial and protozoal sexually transmitted infections (STIs), such as Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae, may cause acute symptoms, chronic infections and severe long-term complications. The complications of these infections in women include pelvic inflammatory disease, chronic pelvic pain, tubal infertility, ectopic pregnancy, and infertility. Moreover, infection during pregnancy is associated with premature rupture of the membranes, low birth weight and miscarriage.In Italy, Chlamydia trachomatis and Trichomonas vaginalis infections are not subject to mandatory reporting; while gonorrhoea is subject to mandatory reporting.To extend surveillance to STIs that are widespread yet often asymptomatic and to improve the knowledge on the epidemiology of these infections in Italy, in 2009 the "Centro Operativo AIDS of the Istituto Superiore di SanitÁ", in collaboration with the Association of Italian Clinical Microbiologists (AMCLI, Associazione Microbiologi Clinici Italiani), launched the sentinel STIs surveillance system based on a network of 13 clinical microbiology laboratories.The main objective of the surveillance was to assess the prevalence and risk factors associated with Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoea infections among individuals attending microbiology laboratories in Italy.
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Dudareva-Vizule S, Haar K, Sailer A, Jansen K, Hamouda O, Wisplinghoff H, Tiemann C, Pape E, Bremer V. Establishment of a voluntary electronic Chlamydia trachomatis laboratory surveillance system in Germany, 2008 to 2014. ACTA ACUST UNITED AC 2017; 22:30459. [PMID: 28205505 PMCID: PMC5316906 DOI: 10.2807/1560-7917.es.2017.22.6.30459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on prevalence are available. CT screening has been offered free of charge to pregnant women since 1995 and to all women under 25 years since 2008. For symptomatic women and men, diagnostic testing is covered by statutory health insurance. We describe the establishment of a nationwide, laboratory-based, voluntary sentinel that electronically collects information on all performed CT tests with test results, test reason and patient information. The sentinel represents one third of all performed CT tests in Germany. In the period from 2008 to 2014, 3,877,588 CT tests were reported, 93% in women. Women aged 20–24 years and men aged 25–29 years were the most frequently tested age groups. The overall proportion of positive tests (PPT) among women was 3.9% and among men 11.0%. The highest PPT among women was in the age groups 15–19 (6.8%) and 20–24 years (5.9%), and among men in the age groups 20–24 (19.2%), 15–19 (15.4%) and 25–29 years (14.8%). The PPT for CT was high among women and men younger than 25 years. Prevention is urgently needed. Monitoring of CT infection in Germany should be continued.
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Affiliation(s)
- Sandra Dudareva-Vizule
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.,Charité University Medicine, Berlin, Germany
| | - Karin Haar
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Andrea Sailer
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Klaus Jansen
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Osamah Hamouda
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Hilmar Wisplinghoff
- Wisplinghoff Laboratories, Cologne, Germany.,Institute for Medical Microbiology, University of Cologne, Cologne, Germany.,Institute for Microbiology, University Witten/Herdecke, Witten, Germany
| | | | - Eberhard Pape
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Viviane Bremer
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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- The Chlamydia trachomatis laboratory sentinel team is listed at the end of the article
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23
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Pinto VM, Tancredi MV, Silva RJDCD, Khoury Z, Buchalla CM. Prevalence and factors associated with Chlamydia trachomatis infection among women with HIV in São Paulo. Rev Soc Bras Med Trop 2017; 49:312-8. [PMID: 27384828 DOI: 10.1590/0037-8682-0169-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/09/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to estimate the prevalence and risk factors associated with Chlamydia trachomatis (CT) infection among women with HIV in São Paulo. METHODS This cross-sectional study included women with HIV who were receiving care from sixteen public health services in São Paulo (October 2013 to March 2014). All participants answered a questionnaire regarding their sociodemographic, behavioral, and clinical characteristics. A urine sample was tested for CT and Neisseria gonorrhoeae (NG) using the polymerase chain reaction. The chi-square test and a logistic regression model were used to test the associations with CT or NG infections. RESULTS We evaluated 853 women and ultimately included 836 (98%) women. The mean age was 40.5 ± 0.34 years, and the prevalences of CT and NG infections were 1.8% and 0.5%, respectively. CT infection was associated with CD4+ T-cell counts of <350 cells/mm3 [adjusted odds ratio (ORadj): 24.5], age of 18-25 years (ORadj: 23.2), the non-use of condoms during the last 6 months (ORadj: 10.2), a self-reported history of a sexually transmitted infection (ORadj: 9.4), and having two or more sexual partners during the last year (ORadj: 6.1). CONCLUSIONS Although we observed a low prevalence of CT infection among women with HIV, younger age was associated with a high risk of infection. Therefore, it may be appropriate to include screening for CT as part of the routine care for this population.
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Affiliation(s)
- Valdir Monteiro Pinto
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil.,Programa Municipal de DST/AIDS, Secretaria Municipal de Saúde de São Paulo, São Paulo, São Paulo, Brasil
| | - Mariza Vono Tancredi
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil
| | - Roberto Jose de Carvalho da Silva
- Programa Estadual de DST/AIDS, Centro de Referência e Treinamento em DST/AIDS, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brasil
| | - Zarifa Khoury
- Programa Municipal de DST/AIDS, Secretaria Municipal de Saúde de São Paulo, São Paulo, São Paulo, Brasil
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Lima LH, de Andrade GC, Vianello S, Zett C, Farah ME, Belfort R. Multimodal imaging analyses of hyperreflective dot-like lesions in acute syphilitic posterior placoid chorioretinopathy. J Ophthalmic Inflamm Infect 2017; 7:1. [PMID: 28083861 PMCID: PMC5233604 DOI: 10.1186/s12348-016-0119-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Retrospective review of one acute syphilitic posterior placoid chorioretinitis (ASPPC) case with serological evidence of syphilis who had ocular signs and symptoms not attributable to other diseases. Enface and spectral-domain optical coherence tomographySD-OCT were analyzed at the time of presentation and at 1-month visit following initiation of treatment. The study patient underwent standard treatment for neurosyphilis. RESULTS Ophthalmic examination and imaging studies were consistent with the diagnosis of ASPPC. The patient age was 33 year-old and the baseline visual acuity was 20/400 and 20/80 in the right and left eyes, respectively. At presentation, SD-OCT scans showed disruption and loss of the ellipsoid zone (EZ), small nodular elevations on retinal pigment epithelium (RPE) and punctate hyperreflectivity in the choroid. Enface OCT at the level of RPE and EZ demonstrated multiple hyperreflective dot-like lesions simmetrically distributed within the macular area. These dot-like lesions corresponded to the small nodular elevations on RPE and to disruption/loss of EZ observed with SD-OCT. One month after neurosyphilis therapy, the visual acuity improved and the outer retinal changes partially reversed in both eyes. CONCLUSIONS We report the outer retinal findings and its correlation using both en-face and SD-OCT in a patient with ASPPC. En-face OCT imaging provides a more precise outer retinal layers analyses allowing a better understanding of the ASPPC pathophysiology.
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Affiliation(s)
- Luiz H Lima
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. .,Federal University of São Paulo (UNIFESP), Rua Botucatu, 821, Vila Clementino, São Paulo, SP 04023-062, Brazil.
| | | | - Silvana Vianello
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Claudio Zett
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Michel E Farah
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Rubens Belfort
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
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25
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Chanal J, Fouéré S, Yassir-Oria F, Spenatto N, Bouscarat F, Picot E, Martinet P, Vernay-Vaisse C, Pelletier F, Courtieu C, Baclet V, Bernier C, Aymar-Moulene D, Dupuis-Fourdan F, Passeron A, Bara-Passot C, Pinault AL, Misery L, Janier M, Dupin N. [CONDYDAV: A multicentre observational study of patients presenting external genital warts in France]. Ann Dermatol Venereol 2016; 143:675-681. [PMID: 27659388 DOI: 10.1016/j.annder.2016.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Since 2007 in France, human papilloma virus (HPV) vaccination has been licensed for use as a vaccine against HPV 6, 11, 16 and 18. The impact on the epidemiology of external genital warts (EGWs) in a large population remains unclear. OBJECTIVES To determine epidemiologic and clinical features of patients presenting EGWs in France in the era of HPV vaccination. PATIENTS AND METHODS In this prospective, observational study, we analyzed clinical features and treatments between January 1st, 2012 and March 31, 2012 for patients consulting for EGWs at 15 STI clinics throughout France. RESULTS A total of 372 men and 111 women were included; mean age 31.2 years. The women were younger than the men (31.7 and 28.9 years respectively P<0.05). Among the patients, 416 (85.7%) were heterosexual, 13 bisexual and 54 (11.2%) homosexual, including one female. Males reported more sexual partners in the last 12 months (more than 3 partners in 32.6% versus 11.9%, P<0.01). Among the men, 230 had involvement of the penis alone and 46 had involvement of the anus alone. Seventy-six patients had EGWs of the anus, and of these 26 were MSM. In females, 76 had an infection of the vulva alone and 22 co-infection of the vulva and anus. MSM and females were at higher risk than heterosexual males for anal involvement (P<0.0001 and P=0.004, respectively). Three women had been vaccinated: two with Gardasil® and one with Cervarix®. Cryotherapy was the preferred treatment. CONCLUSION With the advent of HPV vaccination, a global strategy for the prevention and treatment of EGW should be implemented.
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Affiliation(s)
- J Chanal
- Département de dermatologie, CIDDIST Tarnier, hôpital Cochin, 89, rue d'Assas, 75006 Paris, France.
| | - S Fouéré
- Centre des MST, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Yassir-Oria
- CIDDIST, hôpital de la Croix-Rousse, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - N Spenatto
- Centre des IST, hôpital la Grave, 7, place Lange, 31300 Toulouse, France
| | - F Bouscarat
- CIDDIST, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - E Picot
- Département de dermatologie, hôpital Saint-Eloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - P Martinet
- CDAG/CIDDIST Saint-Adrien, 10, rue Saint-Adrien, 13008 Marseille, France
| | | | - F Pelletier
- Département de dermatologie, hôpital Jean-Mermoz, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - C Courtieu
- Département de dermatologie, hôpital Jean-Mermoz, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - V Baclet
- CIDDIST, centre hospitalier de Tourcoing, 155, rue du Président-Coty, 59200 Tourcoing, France
| | - C Bernier
- CIDDIST de Nantes, 44000 Nantes, France
| | - D Aymar-Moulene
- Conseil départemental des Bouches-du-Rhône, 52, avenue de Saint-Just, 13004 Marseille, France
| | - F Dupuis-Fourdan
- Département de médecine interne, centre hospitalier régional, 1, rue de la Porte-Madeleine, 45000 Orléans, France
| | | | - C Bara-Passot
- Département de dermatologie, centre hospitalier Le Mans, 194, avenue Rubillard, 72037 Le Mans, France
| | | | - L Misery
- Département de dermatologie, hôpital universitaire, 2, avenue Maréchal-Foch, 29200 Brest, France
| | - M Janier
- Centre des MST, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - N Dupin
- Département de dermatologie, CIDDIST Tarnier, hôpital Cochin, 89, rue d'Assas, 75006 Paris, France.
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Abstract
In industrialized countries, the incidence of syphilis has decreased dramatically since the discovery of penicillin in the 1940s. However, syphilis and congenital syphilis are far from eradicated, especially in low- and middle-income countries. Syphilis in pregnant women is a cause of adverse pregnancy outcomes that can be prevented by screening for syphilis and early treatment in pregnancy. Several studies have found screening of pregnant women for syphilis to be a highly cost-effective intervention, even if the prevalence of syphilis is low. Obstacles to universal screening of pregnant women include low awareness of syphilis and low quality of antenatal care and healthcare in general in many low- and middle-income countries. For these settings, we need simpler and more reliable serological tests for syphilis, but we also need to strengthen health services in general to ensure sustainable antenatal care services to ensure sustainability of syphilis screening programmes.
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Affiliation(s)
- Anne Buvé
- Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Begium, Tel.: + 32 3247 6533; Fax: + 32 3247 6532
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27
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Carmona-Gutierrez D, Kainz K, Madeo F. Sexually transmitted infections: old foes on the rise. MICROBIAL CELL (GRAZ, AUSTRIA) 2016; 3:361-362. [PMID: 28357374 PMCID: PMC5354564 DOI: 10.15698/mic2016.09.522] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 08/30/2016] [Indexed: 12/30/2022]
Abstract
Sexually transmitted infections (STIs) are commonly spread via sexual contact. It is estimated that one million STIs are acquired every day worldwide. Besides their impact on sexual, reproductive and neonatal health, they can cause disastrous and life-threatening complications if left untreated. In addition to this personal burden, STIs also represent a socioeconomic problem, deriving in treatment costs of tremendous proportions. Despite a substantial progress in diagnosis, treatment and prevention, the incidence of many common STIs is increasing, and STIs continue to represent a global public health problem and a major cause for morbidity and mortality. With this Special Issue, Microbial Cell provides an in-depth overview of the eight major STIs, covering all relevant features of each infection.
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Affiliation(s)
- Didac Carmona-Gutierrez
- Institute of Molecular Biosciences, NAWI Graz, University of Graz,
Humboldtstr. 50, 8010 Graz, Austria
| | - Katharina Kainz
- Institute of Molecular Biosciences, NAWI Graz, University of Graz,
Humboldtstr. 50, 8010 Graz, Austria
| | - Frank Madeo
- Institute of Molecular Biosciences, NAWI Graz, University of Graz,
Humboldtstr. 50, 8010 Graz, Austria
- BioTechMed-Graz, Humboldtstr. 50, 8010 Graz, Austria
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28
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Tsachouridou O, Skoura L, Christaki E, Kollaras P, Sidiropoulou E, Zebekakis P, Vakirlis E, Margariti A, Metallidis S. Syphilis on the rise: A prolonged syphilis outbreak among HIV-infected patients in Northern Greece. Germs 2016; 6:83-90. [PMID: 27622160 DOI: 10.11599/germs.2016.1093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/03/2016] [Accepted: 08/13/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. METHODS This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients' data. RESULTS Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p=0.008; OR: 9.4, 95%CI: 4.49, 19.64, p<0.001, respectively). Origin from a country other than Greece (p=0.005), and homosexual contact (p=0.003), were separate risk factors for syphilis in the general population in the same area. CONCLUSION Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician's suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients.
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Affiliation(s)
- Olga Tsachouridou
- MD, PhD, Resident in Internal Medicine, Research Associate in Infectious Diseases 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki Greece
| | - Lemonia Skoura
- MD, PhD, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Christaki
- MD, PhD, 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki Greece
| | - Panagiotis Kollaras
- MD, 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki Greece
| | - Eleni Sidiropoulou
- MD, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Zebekakis
- MD, PhD, 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki Greece
| | - Efstratios Vakirlis
- MD, PhD, Dermatology and Venereal Hospital of Thessaloniki, Medical School, Aristotle University of Thessaloniki Greece
| | - Apostolia Margariti
- MSc, National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Symeon Metallidis
- MSc, National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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29
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Angelova M, Kovachev E, Tsankova V, Koleva I, Mangarova S. Role and Importance of Chlamydia Trachomatis in Pregnant Patients. Open Access Maced J Med Sci 2016; 4:410-412. [PMID: 27703564 PMCID: PMC5042624 DOI: 10.3889/oamjms.2016.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/25/2016] [Accepted: 07/05/2016] [Indexed: 12/04/2022] Open
Abstract
AIM: The aim of this study was to assess the prevalence of chlamydial infection among pregnant women and to determine the role of this infection in the fetus. MATERIAL AND METHODS: In the first phase of this study were reported 58 pregnant women with a positive test for active chlamydial infection by applying immunofluorescence. In the second phase of the study were reported pregnant with premature burst membranes (PBM), postnatal complications associated with chlamydial infection as puerperal endometritis, and newborns are monitored for low birth weight and growth retardation at birth. RESULTS: With a positive test are 58 patients in the first trimester or pregnancy registration in our consultation. After regimen with Sumamed (2 x 500 mg for three days and after 10 days again same scheme for them and their partner) at the beginning of the third trimester, the PCR test was made again. Of these, 5 were positive again, participants are between 20 and 30 years old. With premature rupture of OM are 20 patients. There was no increased incidence of premature births. Infants born to infected mothers have a higher risk of developing respiratory symptoms in the first 60 days of life. 3 of them have low for his age bodyweight. CONCLUSIONS: The scarcity of data on manifestations of chlamydial infection during pregnancy and neonatal outcomes justifies this study. Early diagnosis for registration of pregnancy and timely treatment of chlamydial infection as well as scrutinising the infection during the third trimester of pregnancy can prevent infection of the newborn. Therefore, preventive examinations should be considered as a priority for early detection of asymptomatic chlamydial infection in the conduct of antenatal care.
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Affiliation(s)
- Mariya Angelova
- Department of Obstetrics and Gynecology, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria
| | - Emil Kovachev
- Department of Obstetrics and Gynecology, Paraskev Stoyanov Medical University, Varna, Bulgaria
| | - Veselina Tsankova
- Department of Obstetrics and Gynecology, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria
| | - Iliana Koleva
- Department of Obstetrics and Gynecology, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria
| | - Silvia Mangarova
- Department of Obstetrics and Gynecology, Trakia University, Faculty of Medicine, Stara Zagora, Bulgaria
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30
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Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015. PLoS One 2016; 11:e0159309. [PMID: 27447943 PMCID: PMC4957774 DOI: 10.1371/journal.pone.0159309] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/30/2016] [Indexed: 01/09/2023] Open
Abstract
Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US.
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Affiliation(s)
- Winston E. Abara
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristen L. Hess
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robyn Neblett Fanfair
- Division of STD Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kyle T. Bernstein
- Division of STD Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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31
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Kararizou E, Mitsonis C, Dimopoulos N, Gkiatas K, Markou I, Kalfakis N. Psychosis or Simply a New Manifestation of Neurosyphilis? J Int Med Res 2016; 34:335-7. [PMID: 16866029 DOI: 10.1177/147323000603400314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The widespread use of antibiotics in recent years has caused a significant reduction in the incidence of neurosyphilis and changes in its clinical features. We present a case that initially presented as persistent headache and untreatable psychosis. Neurosyphilis was diagnosed during the clinical evaluation. Blood serum analyses for syphilis were positive for rapid plasma reagin titres, the Venereal Disease Research Laboratories test and fluorescent treponemal antibody absorption. A lumbar puncture was performed and cerebrospinal fluid analysis resulted in the diagnosis of neurosyphilis. The patient completed a 2-week course of treatment with aqueous crystalline penicillin G and his symptoms subsequently improved. We suggest that neurosyphilis should always be included in the differential diagnosis of untreatable psychosis.
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Affiliation(s)
- E Kararizou
- Department of Neurology, Eginition Hospital, Athens National University, Athens, Greece.
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32
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Rey-Ladino J, Ross AGP, Cripps AW. Immunity, immunopathology, and human vaccine development against sexually transmitted Chlamydia trachomatis. Hum Vaccin Immunother 2016; 10:2664-73. [PMID: 25483666 PMCID: PMC4977452 DOI: 10.4161/hv.29683] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This review examines the immunity, immunopathology, and contemporary problems of vaccine development against sexually transmitted Chlamydia trachomatis. Despite improved surveillance and treatment initiatives, the incidence of C. trachomatis infection has increased dramatically over the past 30 years in both the developed and developing world. Studies in animal models have shown that protective immunity to C. trachomatis is largely mediated by Th1 T cells producing IFN-γ which is needed to prevent dissemination of infection. Similar protection appears to develop in humans but in contrast to mice, immunity in humans may take years to develop. Animal studies and evidence from human infection indicate that immunity to C. trachomatis is accompanied by significant pathology in the upper genital tract. Although no credible evidence is currently available to indicate that autoimmunity plays a role, nevertheless, this underscores the necessity to design vaccines strictly based on chlamydial-specific antigens and to avoid those displaying even minimal sequence homologies with host molecules. Current advances in C. trachomatis vaccine development as well as alternatives for designing new vaccines for this disease are discussed. A novel approach for chlamydia vaccine development, based on targeting endogenous dendritic cells, is described.
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Affiliation(s)
- Jose Rey-Ladino
- a Department of Microbiology and Immunology; School of Medicine ; Alfaisal University ; Riyadh , Saudi Arabia
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33
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Giuliani M, Vescio MF, Donà MG, Latini A, Frasca M, Colafigli M, Farinella M, Rezza G, Cristaudo A. Perceptions of Human Papillomavirus (HPV) infection and acceptability of HPV vaccine among men attending a sexual health clinic differ according to sexual orientation. Hum Vaccin Immunother 2016; 12:1542-50. [PMID: 26752151 DOI: 10.1080/21645515.2015.1115935] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Our aim was to gain a better understanding of the knowledge about Human Papillomavirus (HPV) infection and attitudes toward the HPV vaccine among men at risk for sexually transmitted infections (STI). A self-administered questionnaire was completed by attendees of the largest STI Center in Rome, Italy, from April to June 2013. Determinants of vaccine acceptability were investigated using a Structured Equation Model. A total of 423 males participated in the survey: 296 (70.0%) men who have sex with men (MSM) and 127 (30.0%) men who have sex with women (MSW). Only one half of the participants knew that HPV is the cause of genital warts (56.9% of MSM vs. 49.5% of MSW, p=0.28). Even less were aware that HPV causes cancer in men (37.2% vs. 27.3%, p=0.08). MSW were more likely to indicate HPV as a cause of cervical cancer (80.8% vs. 69.3%, p=0.03) and to have heard about the vaccine (58.3 vs. 43.6%, p=0.01). Moreover, 72.1% of MSM and 70.3% of MSW were willing to be vaccinated. A rise of one-unit in the HPV awareness score increased the OR of vaccine acceptability among MSM by 25% (OR 1.25, 95%CI: 1.05-1.49; p=0.013). Differently, only attitudes had a relevant effect on willingness to be vaccinated among MSW (OR 3.32, 95%CI: 1.53-7.17; p=0.002). Efforts should be made to maximize awareness of HPV, especially as a causative agent of genital warts and male cancers, and to reinforce positive attitudes toward vaccination among men visiting STI centers.
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Affiliation(s)
- Massimo Giuliani
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
| | - Maria Fenicia Vescio
- b Infectious, Parasitic and Immunomediated Diseases Department , Istituto Superiore di Sanità , Rome , Italy
| | - Maria Gabriella Donà
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
| | - Alessandra Latini
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
| | - Mirko Frasca
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
| | - Manuela Colafigli
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
| | | | - Giovanni Rezza
- b Infectious, Parasitic and Immunomediated Diseases Department , Istituto Superiore di Sanità , Rome , Italy
| | - Antonio Cristaudo
- a STI/HIV Unit, UOC Dermatologia Infettiva e Allergologica, San Gallicano Dermatological Institute (IRCCS) , Rome , Italy
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High Prevalence and High Incidence of Coinfection with Hepatitis B, Hepatitis C, and Syphilis and Low Rate of Effective Vaccination against Hepatitis B in HIV-Positive Men Who Have Sex with Men with Known Date of HIV Seroconversion in Germany. PLoS One 2015; 10:e0142515. [PMID: 26555244 PMCID: PMC4640863 DOI: 10.1371/journal.pone.0142515] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/22/2015] [Indexed: 12/14/2022] Open
Abstract
Objectives Men who have sex with men (MSM) are at higher risk for coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis than the general population. HIV infection and these coinfections accelerate disease progression reciprocally. This study evaluated the prevalence and incidence of these coinfections in HIV1-positive MSM in Germany. Materials and Methods As part of a nationwide, multicenter, prospective cohort study of HIV-infected MSM, plasma samples collected yearly were screened for HBsAg and antibodies to HBc, HBs, HCV, and syphilis. Samples with indications of active HBV or HCV infection were confirmed by polymerase chain reaction. Prevalence and incidence of each infection and incidence rates per study participant were calculated, and incidences over 4-year time intervals compared. Results This study screened 5,445 samples from 1,843 MSM. Median age at HIV seroconversion was 33 years. Prevalences of active, cleared, and occult HBV, and of active/cleared HCV were 1.7%, 27.1%, 0.2%, and 8.2%, respectively, and 47.5% had been effectively vaccinated against HBV. Prevalence of antibodies to Treponema pallidum and of triple or quadruple sexually transmitted infections (STIs) were 39.6% and 18.9%, respectively. Prevalence of STI, cleared HBV, HBV vaccination, and history of syphilis differed significantly among age groups. Incidences of HBV, HCV, and syphilis were 2.51, 1.54, and 4.06 per 100 person-years, respectively. Incidences of HCV and syphilis increased over time. HCV incidence was significantly higher in MSM coinfected with syphilis and living in Berlin, and syphilis incidence was significantly higher for MSM living in Berlin. Discussion Despite extensive HBV vaccination campaigns, fewer than 50% of screened MSM were effectively vaccinated, with a high proportion of HIV-positive MSM coinfected with HBV. High rates of STI coinfections in HIV-positive MSM and increasing incidences emphasize the need for better tailored campaigns for HBV vaccination and STI prevention.
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[Epidemiological developments of selected sexually transmitted infections in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 56:1600-8. [PMID: 24337121 DOI: 10.1007/s00103-013-1866-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The number of people living with HIV infection has been increasing since the mid 1990s and is expected to rise further in the coming years. The HIV epidemic in Germany is still most affected by developments in the group of men who have sex with men (MSM). In this group, the number of newly diagnosed HIV infections has increased in recent years especially in large cities. Despite increased efforts to motivate HIV-infected people, who were not previously diagnosed, to be tested as early as possible and to seek medical treatment, the number of undiagnosed HIV-infected persons has increased. There are more people infected with HIV than those who have been tested positive for HIV and subsequently receive antiretroviral treatment. However, early testing and treatment alone are not sufficient to effectively contain the infection. Increased efforts are required to more effectively prevent new HIV infections by combining all the available options. In Germany as in all other developed countries, a stronger increase in the number of syphilis infections among MSM is reported, which is primarily due to a higher willingness to risk unprotected contacts, whereby the risk of HIV infection is also increased. The public prevention messages available for HIV are only partially effective against syphilis. More frequent examinations and optimized therapy management are necessary in addition to the use of condoms to prevent the spread of syphilis, gonorrhea, and Chlamydia trachomatis. Sustainable containment of new HIV infections must, therefore, be accompanied by both containment of sexually transmitted infections (STI) and use of public prevention messages for HIV/STI.
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Mathematical analysis of a Chlamydia epidemic model with pulse vaccination strategy. Acta Biotheor 2015; 63:1-21. [PMID: 25077807 DOI: 10.1007/s10441-014-9234-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/09/2014] [Indexed: 10/25/2022]
Abstract
In this paper, we have considered a dynamical model of Chlamydia disease with varying total population size, bilinear incidence rate and pulse vaccination strategy. We have defined two positive numbers R₀ and (R₁≤ R₀). It is proved that there exists an infection-free periodic solution which is globally attractive if R₀ < 1 and the disease is permanent if R₁> 1 The important mathematical findings for the dynamical behaviour of the Chlamydia disease model are also numerically verified using MATLAB. Finally epidemiological implications of our analytical findings are addressed critically.
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Potekaev NN, Frigo NV, Almazova AA, Lebedeva GA. Syphilis epidemiology under modern conditions. ACTA ACUST UNITED AC 2015. [DOI: 10.17116/klinderma2015122-34] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Giuliani M, Vescio MF, Latini A, Palamara G, Pimpinelli F, Dona MG, Stivali F, Carduccelli F, Ensoli F, Di Carlo A, Rezza G. Continuous increase in HIV-1 incidence after the year 2000 among men who have sex with men in Rome: insights from a 25-year retrospective cohort study. ACTA ACUST UNITED AC 2014; 19:20969. [PMID: 25443035 DOI: 10.2807/1560-7917.es2014.19.47.20969] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To assess trends in HIV-1 incidence and risk factors for seroconversion among men who have sex with men (MSM) resident in Rome, Italy, a retrospective longitudinal cohort study was conducted over 25 years. Incidence rates and trends were modelled using Poisson regression and risk factors were assessed by multivariate Cox models. Of 1,862 HIV-1-negative individuals, 347 seroconverted during follow-up. HIV-1 incidence rates increased from 5.2/100 persons/year (p/y) in 1986 (95% confidence interval (CI): 2.3–11.5) to 9.2/00 p/y in 1992 (95% CI: 6.4–13.0), decreased to 1.3/100 p/y in 2001 and increased until 2009 (11.7/100 p/y; 95% CI: 7.4–18.6). The risk of HIV-1 seroconversion increased during the study period in younger MSM (incidence rate ratio (IRR) = 17.18; 95% CI: 9.74–30.32 in 16–32 year-olds and IRR = 5.09; 95% CI: 2.92–8.87 in 33–41 year-olds) and in those who acquired syphilis (IRR = 7.71; 95% CI: 5.00–11.88). In contrast, the risk of seroconversion decreased among highly educated MSM (IRR = 0.54; 95% CI: 0.35–0.82) and those without Italian citizenship (IRR = 0.45; 95% CI: 0.28–0.71). The HIV epidemic in MSM living in Rome continues to expand. Targeted prevention programmes against sexually transmitted infections to enhance knowledge transfer and behavioural skills are urgently required.
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Affiliation(s)
- M Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute, Rome, Italy
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Abstract
In this paper, we have developed a five-compartmental epidemic model with Chlamydia infection. We have divided the total population into five classes, namely susceptible, exposed, infective in asymptomatic phase, infective in symptomatic phase and recovered class. The basic reproduction number (R0) is calculated using the next-generation matrix method. The stability analysis of the model shows that the system is locally asymptotically stable at the disease-free equilibrium (DFE) E0when R0< 1. When R0> 1, an endemic equilibrium E1exists and the system becomes locally asymptotically stable at E1under some conditions. We have also discussed the Chlamydia epidemic model with two treatment controls. An objective functional is considered which is based on a combination of minimizing the number of exposed and infective individuals and the cost of treatment. Then an optimal control pair is obtained which minimizes the objective functional. Our numerical findings are illustrated through computer simulations using MATLAB, which show the reliability of our model from the practical point of view. Epidemiological implications of our analytical findings are addressed critically.
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Affiliation(s)
- SWARNALI SHARMA
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah-711103, India
| | - G. P. SAMANTA
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah-711103, India
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Meyer T, Püschel K, Seifert D. Diagnostik sexuell übertragbarer Infektionen. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/s00194-014-0992-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Performance evaluation of the Elecsys syphilis assay for the detection of total antibodies to Treponema pallidum. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 22:17-26. [PMID: 25355799 DOI: 10.1128/cvi.00505-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Syphilis is a health problem of increasing incidence in recent years that may have severe complications if not diagnosed and treated at an early stage. There are many diagnostic tests available for syphilis, but there is no gold standard, and diagnosis therefore usually relies upon a combination of tests. In this multicenter study, we evaluated the treponemal Elecsys syphilis assay for use in the diagnosis of syphilis in routine samples, i.e., when syphilis is suspected or during antenatal or blood donation screening. The sensitivity and specificity of the Elecsys syphilis assay were compared head to head with those of other treponemal assays used in routine clinical practice and were assessed in potentially cross-reactive samples from patients with Epstein-Barr virus, HIV, and Lyme disease. In a total of 8,063 syphilis-negative samples collected from routine diagnostic requests and blood donations, the Elecsys syphilis assay had a specificity of 99.88%. In 928 samples previously identified as syphilis positive, the sensitivity was 99.57 to 100% (the result is presented as a range depending on whether four initially indeterminate samples are included in the assessment). The specificity of the Elecsys syphilis assay in patients with other infections was 100%; no false-positive samples were identified.
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Yang CJ, Lee NY, Chen TC, Lin YH, Liang SH, Lu PL, Huang WC, Tang HJ, Lee CH, Lin HH, Chen YH, Ko WC, Hung CC. One dose versus three weekly doses of benzathine penicillin G for patients co-infected with HIV and early syphilis: a multicenter, prospective observational study. PLoS One 2014; 9:e109667. [PMID: 25286091 PMCID: PMC4186862 DOI: 10.1371/journal.pone.0109667] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND One dose of benzathine penicillin G (BPG) has been recommended for HIV-infected patients with early syphilis (primary, secondary, and early latent syphilis) in the sexually transmitted diseases treatment guidelines, but clinical data to support such a recommendation are limited. METHODS We prospectively observed the serological response to 1 or 3 weekly doses of BPG in HIV-infected adults who sought treatment of early syphilis at 8 hospitals around Taiwan. Rapid plasma reagin (RPR) titers were followed every 3-6 months after treatment. The serological response was defined as a 4-fold or greater decline in RPR titers at 12 months of treatment. The missing values were treated by following the last-observed-carried-forward principle. We hypothesized that 1 dose was non-inferior to 3 weekly doses of BPG with the non-inferiority margin for the difference of serological response set to 10%. RESULTS Between 2007 and 2012, 573 patients completed at least 12 months of follow-up: 295 (51.5%) receiving 1 dose of BPG (1-dose group) and 278 (48.5%) 3 doses (3-dose group). Overall, 198 patients (67.1%; 95% confidence interval [CI], 61.4-72.5%) in the 1-dose group achieved serological response at 12 months, as did 208 patients (74.8%; 95% CI, 69.3-79.8%) in the 3-dose group (one-sided 95% CI of the difference, 15.1%). In the multivariate analysis, secondary syphilis (adjusted odds ratio [AOR], 1.90; 95% CI 1.17-3.09), RPR titer ≥32 (AOR, 1.93; 95% CI, 1.38-2.69), and 3 doses of BPG (AOR, 1.68; 95% CI, 1.20-2.36) were independently associated with a serological response. The time to the first episode of treatment failure was 1184 (standard deviation [SD], 70.5) and 1436 (SD, 80.0) days for 1- and 3-dose group, respectively. CONCLUSIONS Single-dose BPG resulted in a higher serological failure rate and shorter time to treatment failure than 3 weekly doses of BPG in the treatment of early syphilis in HIV-infected patients.
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Affiliation(s)
- Chia-Jui Yang
- Department of Internal Medicine, Far East Memorial Hospital, New Taipei City, Taiwan
| | - Nan-Yao Lee
- Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Tun-Chieh Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Hui Lin
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shiou-Haur Liang
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chi Huang
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Chen-Hsiang Lee
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsi-Hsun Lin
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- China Medical University, Taichung, Taiwan
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Saraçoğlu GV, Erdem İ, Doğan S, Tokuç B. Youth Sexual Health: Sexual Knowledge, Attitudes, and Behavior Among Students at a University in Turkey. Noro Psikiyatr Ars 2014; 51:222-228. [PMID: 28360630 DOI: 10.4274/npa.y6768] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 12/12/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION To determine sexual attitudes, behavior, and knowledge of Namik Kemal University (NKU) students about sexual health and sexually transmitted infections (STIs). METHOD A sample representing 10% of the undergraduate population of NKU in 2009-2010, was studied. Of 1,500 questionnaires distributed, 1,314 (87.6%) were filled out. RESULTS The mean age of the respondents (52.9% male) was 20.07±1.75 years. The rate of students who had received sexual health education was 32.0%, and 15.3% had previously used a sexual health service. Eleven percent of the female students and 50.3% of the male students had had sexual intercourse. The average age of initial sexual intercourse was 16.83±2.07 years. Of the students who had had sexual intercourse, 46.6% reported that they did not use any contraception method. The most preferred method was condoms (37.6%). The rate of contraceptive use was 58.7% in sexually educated students and 43.9% in those not educated (p=.004). The most well-known STI was AIDS (96.5%), with sexually educated students giving higher rates of correct answers about STIs (p<.05). CONCLUSION The students who had received sexual health education were more knowledgeable about vital consequences of STI's, even though it is not sufficient, than sexually active students. Awareness of safe sexual practices and changes in behavior, in particular, promoting condom use should be established in higher risk youths. Deficiencies in knowledge could be addressed by adding a sexual healthtraining component to the university curriculum, and unmet requirements could be met by reorganizing medico-social centers in universities.
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Affiliation(s)
- Gamze Varol Saraçoğlu
- Namık Kemal University Faculty of Medicine, Department of Public Health, Tekirdağ, Turkey
| | - İlknur Erdem
- Namık Kemal University Faculty of Medicine, Department of Infectious Diseases, Tekirdağ, Turkey
| | - Sultan Doğan
- Namık Kemal University Faculty of Medicine, Department of Psychiatry, Tekirdağ, Turkey
| | - Burcu Tokuç
- Trakya University Faculty of Medicine, Department of Public Health, Edirne, Turkey
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Pedrosa AF, Azevedo F, Lisboa C. Screening for Chlamydia infection in a sexually transmitted infection clinic: a missed opportunity? Int J Dermatol 2014; 54:405-9. [PMID: 25069382 DOI: 10.1111/ijd.12338] [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] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Chlamydia trachomatis (CT) infection is the most common sexually transmitted infection (STI) reported in Europe. We aim to evaluate the overall prevalence of CT infection and the rate of asymptomatic infection in an STI clinic over a 5-year period. We will also discuss screening strategies with reference to attendees diagnosed with an STI and their sexual partners, and attendees with a non-infectious genital dermatosis. METHODS Clinical and laboratory data for all attendees at a university hospital STI clinic over a 5-year period were reviewed. Diagnosis of CT infection was made upon polymerase chain reaction (PCR) performed in first-void urine. RESULTS The overall prevalence of CT infection was 4.0% (53/1310); the rate of asymptomatic infection was 84.9% (45/53). The prevalence of CT infection among attendees with an STI diagnosis and their sexual partners was 5.2% (50/963), whereas that among attendees with a non-infectious genital dermatosis was 0.9% (3/347; P < 0.001). Infected attendees were younger than attendees without CT infection (median age: 31 years vs. 40 years; P < 0.001). In 39.5% (17/43) of CT-infected attendees, it was possible to notify a sexual partner; CT infection was subsequently diagnosed in 58.8% (10/17) of partners. CONCLUSIONS Asymptomatic CT infection had a representative frequency, which was more pronounced among young attendees with an STI diagnosis and their sexual partners, to whom screening should be offered. Issues of age limits for screening and whether screening should be directed to males in non-STI clinic settings should be carefully assessed.
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Affiliation(s)
- Ana Filipa Pedrosa
- Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal
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Haug SJ, Takakura A, Jumper JM, Heiden D, McDonald HR, Johnson RN, Fu AD, Lujan BJ, Cunningham ET. Rhegmatogenous Retinal Detachment in Patients with Acute Syphilitic Panuveitis. Ocul Immunol Inflamm 2014; 24:69-76. [PMID: 24960278 DOI: 10.3109/09273948.2014.925122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the clinical characteristics and surgical management of rhegmatogenous retinal detachment (RD) in patients with acute syphilitic panuveitis. METHODS Retrospective case series and comprehensive literature review. RESULTS Including present and previously reported cases, we identified 11 eyes in 8 patients with acute syphilitic panuveitis that developed a rhegmatogenous RD. Seven of 11 eyes (63.6%) were repaired with a combined scleral buckling, vitrectomy, and endolaser photocoagulation surgery; 1 eye (9.1%) was repaired with scleral buckling only; and 2 eyes (18.2%) with vitrectomy only. Cryotherapy was used to treat a giant retinal tear in 1 eye (9.1%). Four eyes (36.4%) redetached and 3 underwent a second vitrectomy surgery. CONCLUSIONS Although uncommon, rhegmatogenous RD can occur in patients with moderate to severe acute syphilitic panuveitis. We believe scleral buckling, vitrectomy, endolaser photocoagulation, and silicone oil tamponade give the best chance for successful retinal reattachment.
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Affiliation(s)
- Sara J Haug
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA
| | - Ako Takakura
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA
| | - J Michael Jumper
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA
| | - David Heiden
- b West Coast Retina Medical Group , San Francisco , California , USA
| | - H Richard McDonald
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA
| | - Robert N Johnson
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA
| | - Arthur D Fu
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA
| | - Brandon J Lujan
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA .,c Department of Vision Science , School of Optometry, University of California , Berkeley , California , USA
| | - Emmett T Cunningham
- a Department of Ophthalmology , California Pacific Medical Center , San Francisco , California , USA .,b West Coast Retina Medical Group , San Francisco , California , USA .,d Department of Ophthalmology , Stanford University School of Medicine , Stanford , California , USA , and.,e The Francis I. Proctor Foundation, UCSF School of Medicine , San Francisco , California , USA
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Abstract
OBJECTIVE Neurosyphilis is caused by dissemination into the central nervous system of Treponema pallidum. Although the incidence of syphilis in the Netherlands has declined since the mid-1980s, syphilis has re-emerged, mainly in the urban centres. It is not known whether this also holds true for neurosyphilis. METHODS The epidemiology of neurosyphilis in Dutch general hospitals in the period 1999-2010 was studied in a retrospective cohort study. Data from the Dutch sexually transmitted infection (STI) clinics were used to analyse the number of patients diagnosed with syphilis in this period. RESULTS An incidence of neurosyphilis of 0.47 per 100 000 adults was calculated, corresponding with about 60 new cases per year. This incidence was higher in the western (urbanised) part of the Netherlands, as compared with the more rural areas (0.6 and 0.4, respectively). The number of patients diagnosed with syphilis in STI clinics increased from 150 to 700 cases in 2004 and decreased to 500 new cases in 2010. The sex ratio was in favour of men, yielding a percentage of 90% of the syphilis cases and of 75% of the neurosyphilitic cases. The incidence of neurosyphilis was highest in men aged 35-65 years, and in women aged 75 years and above. The most frequently reported clinical manifestation of neurosyphilis was tabes dorsalis. In this study, 15% of the patients were HIV seropositive. CONCLUSION The incidence of neurosyphilis in a mixed urban-rural community such as the Netherlands is comparable to that in other European countries. Most patients are young, urban and men, and given the frequent atypical manifestations of the disease reintroduction of screening for neurosyphilis has to be considered.
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High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in the Netherlands. Sex Transm Dis 2014; 39:8-15. [PMID: 22183837 DOI: 10.1097/olq.0b013e3182354e81] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the Netherlands, no guidelines exist for routine sexually transmitted infection (STI) screening of human immunodeficiency virus (HIV)-infected men having sex with men (MSM). We assessed prevalence and factors associated with asymptomatic STI. METHODS MSM visiting HIV outpatient clinics of academic hospitals were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis, and hepatitis B and C infection. Prevalence and risk factors were studied using logistic regression. RESULTS In total, 659 MSM were included between 2007 and 2008. STI were found in 16.0% of patients, mostly anal CT and syphilis. One new hepatitis B and 3 new hepatitis C infections were identified. In multivariate analyses, any STI (syphilis, CT, or NG) was associated with patient's age below 40 years (odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.3-5.0), having had sex with 2 or more sexual partners (OR 2.1, 95% CI: 1.2-3.5), the use of the same sexual toys with a sexual partner (OR 2.2, 95% CI: 1.0-4.9), and enema use before sex (OR: 2.3, 95% 1.2-4.2). Syphilis was independently associated with fisting with gloves versus no fisting (OR: 4.9, 95% CI: 1.7-13.7) and with rimming (OR: 5.0, 95% CI: 1.7-15.0). CT or NG were associated with age below 45 years (age 40-44 years: OR: 2.4, 95% CI: 1.1-5.3; age <40 years: OR: 2.4, 95% CI: 1.1-5.4), enema use before sex (OR: 2.4, 95% CI: 1.3-4.4) and drug use during sex (OR: 2.4, 95% CI: 1.4-4.0). CONCLUSIONS High-risk sexual behavior was very common, and 16% of HIV-infected MSM in HIV care had an asymptomatic STI, mostly anal CT and syphilis. Development of STI screening guidelines is recommended.
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Odesanmi TY, Wasti SP, Odesanmi OS, Adegbola O, Oguntuase OO, Mahmood S. Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14-50 years: a systematic review and meta-analysis. Sex Health 2014; 10:559-69. [PMID: 24160747 DOI: 10.1071/sh13029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/09/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Home-based sampling is a strategy to enhance uptake of sexually transmissible infection (STI) screening. This review aimed to compare the screening uptake levels of home-based self-sampling and clinic-based specimen collection for STIs (chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and trichomoniasis) in females aged 14-50 years. Acceptability and effect on specimen quality were determined. METHODS Sixteen electronic databases were searched from inception to September 2012. Randomised controlled trials (RCTs) comparing the uptake levels of home-based self-sampling and clinic-based sampling for chlamydia, gonorrhoea and trichomoniasis in females aged 14-50 years were eligible for inclusion. The risk of bias in the trials was assessed. Risk ratios (RRs) for dichotomous outcomes were meta-analysed. RESULTS Of 3065 papers, six studies with seven RCTs contributed to the final review. Compared with clinic-based methods, home-based screening increased uptake significantly (P=0.001-0.05) in five trials and was substantiated in a meta-analysis (RR: 1.55; 95% confidence interval: 1.30-1.85; P=0.00001) of two trials. In three trials, a significant preference for home-based testing (P=0.001-0.05) was expressed. No significant difference was observed in specimen quality. Sampling was rated as easy by a significantly higher number of women (P=0.01) in the clinic group in one trial. CONCLUSIONS The review provides evidence that home-based testing results in greater uptake of STI screening in females (14-50 years) than clinic-based testing without compromising quality in the developed world. Home collection strategies should be added to clinic-based screening programs to enhance uptake.
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Affiliation(s)
- Tolulope Y Odesanmi
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
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SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN PATIENTS WITH ACUTE SYPHILITIC POSTERIOR PLACOID CHORIORETINOPATHY. Retina 2014; 34:373-84. [DOI: 10.1097/iae.0b013e3182993f11] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Changing the landscape of the HIV epidemic among MSM in China: results from three consecutive respondent-driven sampling surveys from 2009 to 2011. BIOMED RESEARCH INTERNATIONAL 2014; 2014:563517. [PMID: 24575408 PMCID: PMC3918367 DOI: 10.1155/2014/563517] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/27/2013] [Indexed: 11/17/2022]
Abstract
This study assessed the changes of HIV incidence and its predictors among Beijing's men who have sex with men (MSM). Three consecutive cross-sectional surveys were carried out using a consistent respondent-driven sampling (RDS) approach in 2009, 2010, and 2011, respectively. Structured-questionnaire based interviews were completed with computer-assisted self-administration. Incident infection was examined with BED capture enzyme immunoassay (BED-CEIA). The overall rate of HIV prevalence was 8.0% in the three years (95% confidence interval [CI]: 4.9%-11.2%). The overall rate of BED-CEIA incidence was 7.8/100 person years (PY) (95% CI: 5.5-10.1) with 6.8/100PY (95% CI: 3.4-10.2) in 2009, 11.2/100PY (95% CI: 6.2-16.3) in 2010, and 5.8/100PY (95% CI: 2.4-9.3) in 2011, respectively. Multivariable logistic regression analysis revealed that, compared with HIV-negative MSM, recently infected MSM were more likely to be bisexual (adjusted odds ratio [AOR] = 2.1, 95% CI: 1.1-4.1), live in Beijing ≤3 years (AOR = 2.1, 95% CI: 1.2-4.0), and have a negative attitude towards safe sex (AOR = 1.1 per scale point, 95% CI: 1.0-1.1). This study demonstrated a disturbing rise of HIV infections among Beijing's MSM. These findings underscored the urgency of scaling up effective and better-targeted intervention services to stop the rapid spread of the virus.
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