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Dofitas BL, Kalim SP, Toledo CB, Richardus JH. Stigma, psychosocial and economic effects of yaws in the Philippines: an exploratory, qualitative study. Trop Med Health 2022; 50:43. [PMID: 35794656 PMCID: PMC9258159 DOI: 10.1186/s41182-022-00433-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Yaws is a chronic, non-venereal, highly contagious skin and bone infection affecting children living in impoverished, remote communities and caused by Treponema pallidum subspecie pertenue. Social stigma and economic losses due to yaws have been reported anecdotally in the Southern Philippines but have not been well-documented. Objective To describe and compare the psychological, social, and economic effects of yaws from the perspective of patients, contacts, and key informants in two areas of the Philippines. Materials and methods Yaws and contacts were identified through clinicoseroprevalence surveys conducted in the Liguasan Marsh area, Mindanao, Southern Philippines in 2017 and among the Aetas, an indigenous people community in Quezon province, Luzon region in 2020. Skin examinations and serologic tests confirmed the diagnosis of active, latent, or past yaws among the children and adults. Trained health personnel conducted in-depth interviews of those affected by yaws and their guardians, household contacts, and key informants, such as health workers regarding their perceptions, feelings, health-seeking behaviors, and effects of yaws on their lives. Results A total of 26 participants were interviewed: 17 from Mindanao and 9 from Luzon. Aside from the physical discomforts and embarrassment, yaws was considered stigmatizing in Mindanao, because positive non-treponemal tests or treponemal antibody tests were associated with syphilis and promiscuity. These have led to loss of employment and income opportunities for adults with latent or past yaws. In contrast, the Aetas of Luzon did not perceive yaws as stigmatizing, because it was a common skin problem. Plantar yaws interfered with the Aeta’s gold panning livelihood due to the pain of wounds. Conclusions Yaws is not merely a chronic skin and bone disease. It can lead to significant psychosocial and economic problems as well. Yaws is a generally forgotten disease in the Philippines. There is no yaws surveillance and control program. Treatments are not readily available for the populations affected, thus perpetuating the infection and negative effects. Significance of study This is the first study to document the psychosocial and economic effects of yaws among Filipinos. Information campaigns about yaws and a yaws control program are needed to reduce stigma and discrimination.
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Affiliation(s)
- Belen Lardizabal Dofitas
- Department of Dermatology, College of Medicine, University of the Philippines Manila, Metro Manila, Philippines. .,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Sherjan P Kalim
- Department of Pathology, Cotabato Regional and Medical Center, Sinsuat Ave., Cotabato City, Philippines
| | - Camille B Toledo
- Institute of Psychiatry and Behavioral Medicine, Southern Philippines Medical Center, Davao City, Philippines
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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2
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Vidal-Villegas B, Arcos-Villegas G, Fernández-Vigo JI, Díaz-Valle D. Atypical Syphilitic Outer Retinitis and Severe Retinal Vasculitis as Onset Manifestations in a Patient with Concurrent HIV and Syphilis Infection. Ocul Immunol Inflamm 2022; 30:16-20. [DOI: 10.1080/09273948.2020.1787464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Beatriz Vidal-Villegas
- Ophthalmology Service, Hospital Clínico San Carlos, and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (Idissc), Madrid, Spain
- Red Temática de Investigación Cooperativa Oftared, Instituto de Salud Carlos III, Madrid, Spain
| | | | - José Ignacio Fernández-Vigo
- Ophthalmology Service, Hospital Clínico San Carlos, and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (Idissc), Madrid, Spain
| | - David Díaz-Valle
- Ophthalmology Service, Hospital Clínico San Carlos, and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (Idissc), Madrid, Spain
- Red Temática de Investigación Cooperativa Oftared, Instituto de Salud Carlos III, Madrid, Spain
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3
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Dalvi M, Babatola O. Meningovascular neurosyphilis: cognitive and neuropsychiatric impact. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2021. [DOI: 10.1002/pnp.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Madhusudan Dalvi
- Dr Dalvi is Honorary Senior Lecturer, Kings College London and Consultant Old Age Psychiatrist, Kent and Medway NHS and Social Care Partnership Trust
| | - O Babatola
- Dr Babatola is Speciality Doctor in Old Age Psychiatry, Kent and Medway NHS and Social Care Partnership Trust
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4
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Yun K, Xu J, Leuba S, Zhu Y, Zhang J, Chu Z, Geng W, Jiang Y, Shang H. Development and Validation of a Personalized Social Media Platform-Based HIV Incidence Risk Assessment Tool for Men Who Have Sex With Men in China. J Med Internet Res 2019; 21:e13475. [PMID: 31215509 PMCID: PMC6604506 DOI: 10.2196/13475] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Personalized risk assessments can help medical providers determine targeted populations for counseling and risk reduction interventions. OBJECTIVE The objective of this study was to develop a social media platform-based HIV risk prediction tool for men who have sex with men (MSM) in China based on an independent MSM cohort to help medical providers determine target populations for counseling and risk reduction treatments. METHODS A prospective cohort of MSM from Shenyang, China, followed from 2009 to 2016, was used to develop and validate the prediction model. The eligible MSM were randomly assigned to the training and validation dataset, and Cox proportional hazards regression modeling was conducted using predictors for HIV seroconversion selected by the training dataset. Discrimination and calibration were performed, and the related nomogram and social media platform-based HIV risk assessment tool were constructed. RESULTS The characteristics of the sample between the training dataset and the validation dataset were similar. The risk prediction model identified the following predictors for HIV seroconversion: the main venue used to find male sexual partners, had condomless receptive or insertive anal intercourse, and used rush poppers. The model was well calibrated. The bootstrap C-index was 0.75 (95% CI 0.65-0.85) in the training dataset, and 0.60 (95% CI 0.45-0.74) in the validation dataset. The calibration plots showed good agreement between predicted risk and the actual proportion of no HIV infection in both the training and validation datasets. Nomogram and WeChat-based HIV incidence risk assessment tools for MSM were developed. CONCLUSIONS This social media platform-based HIV infection risk prediction tool can be distributed easily, improve awareness of personal HIV infection risk, and stratify the MSM population based on HIV risk, thus informing targeted interventions for MSM at greatest risk for HIV infection.
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Affiliation(s)
- Ke Yun
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Junjie Xu
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Sequoia Leuba
- Department of Epidemiology, University of North Carolina, Chapel Hill, American Samoa
| | - Yunyu Zhu
- Hebei Yuanqiao Information Technology Co, Ltd, Shijiazhuang, China
| | - Jing Zhang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zhenxing Chu
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wenqing Geng
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Yongjun Jiang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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5
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Tiwari L, Alsarraf A, Yeoh SC, Balasubramaniam R. Systemic considerations for orofacial neuropathy. AUST ENDOD J 2018. [DOI: 10.1111/aej.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lalima Tiwari
- Oral Medicine; Dental School; University of Western Australia; Perth Western Australia Australia
| | - Abdulhameed Alsarraf
- Oral Medicine; Dental School; University of Western Australia; Perth Western Australia Australia
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6
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Brennan DJ, Souleymanov R, Lachowsky N, Betancourt G, Pugh D, McEwen O. Providing Online-Based Sexual Health Outreach to Gay, Bisexual, and Queer Men in Ontario, Canada: Qualitative Interviews with Multisectoral Frontline Service Providers and Managers. AIDS Patient Care STDS 2018; 32:282-287. [PMID: 29897787 DOI: 10.1089/apc.2018.0027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The Internet is a common tool for gay, bisexual, and other men who have sex with men (MSM) to find sexual partners and sexual health information. Given persistently high human immunodeficiency virus (HIV) infection rates among MSM, it is important to examine the role of online outreach for MSM as part of HIV prevention and care. We provide an overview of the unique perspectives of online sexual health outreach, delivered through AIDS Service Organizations (ASOs) through sociosexual Internet sites and mobile applications. Data were drawn from the qualitative arm of the community-based Cruising Counts study conducted across Ontario from December 2013 to January 2014. ASO online outreach providers and managers (n = 22) were recruited to complete a 1-h in-person/telephone interview to explore in-depth their experiences with, and perspectives on, delivering online outreach services for MSM in Ontario. Thematic analyses were conducted inductively using NVivo 10. Service providers suggested a high demand for online outreach services for MSM. Strengths and advantages of online outreach over face-to-face outreach included anonymity, instant access to services, peer model, and accessing hard-to-reach populations of MSM. Barriers included consistent quality of service, collaborations between companies that own online technologies and outreach service agencies, budgetary and staff capacity issues, and uncertainty of best practices and evaluation parameters for online outreach. Findings from these interviews can inform service providers, policy makers, and researchers on how online sexual health outreach can play a greater role in HIV prevention by better acknowledging and addressing the opportunities and barriers experienced by service providers working with MSM communities online.
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Affiliation(s)
- David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Ontario HIV Treatment Network, Toronto, Canada
| | - Rusty Souleymanov
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Nathan Lachowsky
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Gerardo Betancourt
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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7
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Outeiriño BP, del Fresno García M, Urada L. Online transgender Sex Work and Public Health. A Netnographic Study in Tenerife. COMUNITANIA 2018; 15:243-262. [PMID: 35178332 PMCID: PMC8849580 DOI: 10.5944/comunitania.15.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The purpose of this study is to understand and describe the nature of internet advertisements of transgender sex workers, and how demand drives the configuration of their services. An analysis of the offer-demand contents (n = 257) was carried out on a sexual contact website. Five categories were identified: sociodemographic characteristics, supply management, sexual services, health and clients. The results include risk factors associated with public health and social exclusion within this group. The results may inform strategies for developing socio-health interventions targeted towards transgender women in the situation of prostitution.
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8
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Thomas S, Wiselka M, Dhar J, Bibby K. Syphilis Presenting as Acute Multifocal Retino-Choroiditis. J R Soc Med 2017; 99:371-2. [PMID: 16816270 PMCID: PMC1484550 DOI: 10.1177/014107680609900723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Shery Thomas
- Department of Ophthalmology, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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9
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Ocular syphilis: the re-establishment of an old disease. Eye (Lond) 2017; 32:99-103. [PMID: 28776596 DOI: 10.1038/eye.2017.155] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/30/2017] [Indexed: 11/09/2022] Open
Abstract
PurposeTo present the patient profiles, clinical presentations and visual outcomes in those diagnosed with ocular syphilis, attending a subspecialist uveitis service in northern England over a 15-year period.Patients and methodsRetrospective observational case series of patients presenting between January 2002 and December 2016.ResultsA total of 50 eyes of 34 patients had intraocular inflammation due to syphilis. Of these, 94% were male, and 75% were men who had sex with men. Ten (29%), all male, were HIV-positive. Presentations included isolated anterior non-granulomatous uveitis, intermediate uveitis, panuveitis, retinitis, placoid chorioretinitis and papillitis. Concurrent skin rash and/or headache were seen in 41%. Compliance with antibiotic treatment was complete, but there was a high rate of default from ophthalmological follow-up (38%). Visual improvement was seen in 92% of eyes, and at final assessment 71% had acuity of 6/9 or better.ConclusionsOcular syphilis is continuing to increase in incidence, in tandem with the continuing epidemic of early syphilis in the UK (the risk of ocular involvement being about 1%). Almost all are male, and most are men who have sex with men. Clinical presentation is variable; a high index of suspicion and a low threshold for serological testing is important; early treatment can reverse retinal changes and restore visual acuity.
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10
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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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11
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Chadwick JA, MacNab A, Sarma J, Ray S, Kadir I, Muldoon EG. Secondary syphilis presenting with aortitis and coronary ostial occlusion. Sex Transm Infect 2015; 92:108-9. [PMID: 26670911 DOI: 10.1136/sextrans-2015-052247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/07/2015] [Indexed: 11/03/2022] Open
Abstract
Aortitis is an established manifestation of tertiary syphilis. We report a rare case of aortitis with ostial occlusion and left ventricular failure in secondary syphilis. Her management required a true multidisciplinary approach from multiple specialities due to complications of concomitant psychosis and a history of anaphylaxis to penicillin. This case illustrates the complexities of diagnosing and managing a rare presentation of this increasingly prevalent infection.
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Affiliation(s)
- John A Chadwick
- Department of Cardiology, University Hospital of South Manchester, UK
| | - Anita MacNab
- Department of Cardiology, University Hospital of South Manchester, UK
| | - Jaydeep Sarma
- Department of Cardiology, University Hospital of South Manchester, UK
| | - Simon Ray
- Department of Cardiology, University Hospital of South Manchester, UK
| | - Isaac Kadir
- Department of Cardiothoracic Surgery, University Hospital of South Manchester, UK
| | - Eavan G Muldoon
- Department of Infectious Diseases, University Hospital of South Manchester, UK The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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12
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Siqueira CS, Saturno JL, de Sousa SCOM, da Silveira FRX. Diagnostic approaches in unsuspected oral lesions of syphilis. Int J Oral Maxillofac Surg 2014; 43:1436-40. [PMID: 25305698 DOI: 10.1016/j.ijom.2014.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/07/2014] [Accepted: 09/17/2014] [Indexed: 11/17/2022]
Abstract
Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis.
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Affiliation(s)
- C S Siqueira
- Department of Oral Pathology, School of Dentistry, Universidade Federal de Uberlândia, Minas Gerais, Brazil; Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil.
| | - J L Saturno
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - S C O M de Sousa
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - F R X da Silveira
- Department of Stomatology, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
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13
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He H, Wang M, Zaller N, Wang J, Song D, Qu Y, Sui X, Dong Z, Operario D, Zhang H. Prevalence of syphilis infection and associations with sexual risk behaviours among HIV-positive men who have sex with men in Shanghai, China. Int J STD AIDS 2013; 25:410-9. [DOI: 10.1177/0956462413512804] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The aims of this study were to understand the prevalence and correlates of syphilis infection among HIV-positive men who have sex with men (MSM) in Shanghai, China. A total of 200 HIV-positive MSM participants were recruited using “snowball” sampling. Participants were tested for syphilis and completed a one-time questionnaire which included demographic characteristics, sexual behaviours with male and female sexual partners, substance use, and use of antiretroviral medications. Prevalence of syphilis infection was 16.5%. Among HIV/syphilis co-infected participants, 63.6% reported having anal sex with male partners and 24.2% did not use condoms consistently during the past six months; 66.7% reported having oral sex with male partners and 51.5% reported unprotected oral sex during the past six months. Factors associated with testing seropositive for syphilis infection included receptive anal sex with a male partner in the past six months (AOR = 12.61, 90% CI = 2.38–66.89), illicit drug use in the past six months (AOR = 11.47, 90% CI = 2.47–53.45), and use of antiretroviral medication (AOR = 4.48, 90% CI = 1.43–14.05). These data indicate a need for “positive prevention” interventions targeting HIV-positive MSM in China.
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Affiliation(s)
- Huan He
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Min Wang
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Nickolas Zaller
- Department of Infectious Diseases, Alpert Medical School, Brown University, Providence, RI, USA
| | - Jun Wang
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Dandan Song
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Yuhuang Qu
- Beautiful Life Health Promotion Center, Shanghai, PR China
| | - Xin Sui
- Beautiful Life Health Promotion Center, Shanghai, PR China
| | - Zhengxin Dong
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Don Operario
- Program in Public Health, Brown University, Providence, USA
| | - Hongbo Zhang
- Department of Epidemiology and Health statistics, School of Public Health, Anhui Medical University, Hefei, PR China
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Minicucci EM, Vieira RA, Oliveira DT, Marques SA. Oral manifestations of secondary syphilis in the elderly - a timely reminder for dentists. Aust Dent J 2013; 58:368-70. [DOI: 10.1111/adj.12085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 11/12/2012] [Accepted: 11/13/2012] [Indexed: 12/14/2022]
Affiliation(s)
- EM Minicucci
- Department of Dermatology and Radiotherapy; Botucatu School of Medicine; São Paulo State University; UNESP; Brazil
| | - RA Vieira
- Department of Dermatology and Radiotherapy; Botucatu School of Medicine; São Paulo State University; UNESP; Brazil
| | - DT Oliveira
- Department of Pathology; Bauru School of Dentistry of São Paulo University; USP; Brazil
| | - SA Marques
- Department of Dermatology and Radiotherapy; Botucatu School of Medicine; São Paulo State University; UNESP; Brazil
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15
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Evaluation of the BioPlex 2200 syphilis system as a first-line method of reverse-sequence screening for syphilis diagnosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1084-8. [PMID: 23697575 DOI: 10.1128/cvi.00316-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite recent technological advances, the diagnosis of syphilis remains a challenging enterprise. Actually, most high-volume laboratories have adopted the "reverse algorithm" due several factors, including the potential to automate testing. Recently, immunoassays processed on random-access systems have been proposed as screening tests. The purpose of this study was to evaluate diagnostic performances of BioPlex 2200 Syphilis IgG and BioPlex 2200 Syphilis IgM, tests based on Multiplex Flow technology, in comparison with the performance of Architect Syphilis TP, a chemiluminescent immunoassay for the detection of IgG and/or IgM anti-Treponema pallidum antibodies. A retrospective study was performed with a panel of 100 blood donor sera, a panel of 350 clinical and laboratory-characterized syphilitic sera, and 170 samples obtained from subjects with potentially interfering conditions. Moreover, 200 unselected samples submitted to the Microbiology Laboratory of St. Orsola Hospital in Bologna for routine screening for syphilis were evaluated. As confirmatory tests, T. pallidum hemagglutination and Western blot assays were used. Considering the IgG Western blot (WB) assay to be the gold standard method, BioPlex 2200 Syphilis IgG specificity was far higher than Architect Syphilis TP specificity (89.7% versus 78.4%, respectively), whereas the sensitivity was 100% for both automated methods. Compared to the IgM WB assay, BioPlex 2200 Syphilis IgM performed with a specificity of 94.9%, whereas the sensitivity was 84.8%. Considering the excellent ease of use and automation, the high sample throughput and its valuable analytical performances, BioPlex Syphilis 2200 IgG could represent a suitable choice for high-volume laboratories. BioPlex Syphilis 2200 IgM could be considered a good addition to IgG testing for uncovering active infections.
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Leuci S, Martina S, Adamo D, Ruoppo E, Santarelli A, Sorrentino R, Favia G, Mignogna M. Oral Syphilis: a retrospective analysis of 12 cases and a review of the literature. Oral Dis 2013; 19:738-46. [PMID: 23294141 DOI: 10.1111/odi.12058] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 11/28/2012] [Accepted: 12/01/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To present a retrospective analysis of multicentre case series of oral syphilis and a review of relevant literature. SUBJECTS AND METHODS A PUBMED search was carried out from 1950 to 2011. Clinical records of patients with exclusive/prevalent oral manifestations of syphilis were collected and examined in three independent hospitals. RESULTS Of 23 reports describing 34 patients were detected through the review (35% primary, 56% secondary, and 9% tertiary disease), describing unspecific ulcers (59%), mucosal patches (23%), keratosis (6%), pseudomembranes (3%), and gumma (9%). Multicentre case series revealed 12 patients with oral syphilis, of which 17%, 58%, and 25% with, respectively, primary, secondary, and tertiary lesions. Clinically, patients showed white patches (17%), blistering mucositis (8%), chronic unspecific ulcers with/without skin lesions (50%), gumma (17%), and necrosis of the dorsum of the tongue (8%). Oral bullae and tongue necrosis are never described in the current review. CONCLUSIONS Diagnosis of syphilis remains a challenge because of the multiform and polymorphous clinical pattern at onset and its ability to imitate different diseases. It is mandatory to include syphilis in the differential diagnosis of unusual oral lesions. Diagnosis of oral lesions of syphilis is often difficult, and biopsy is required in controversial cases.
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Affiliation(s)
- S Leuci
- Department of Odontostomatological and Maxillo Facial Sciences, Oral Medicine Unit, Federico II University of Naples, Naples, Italy
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Onoe T, Honda M, Matsuo K, Sasaki H, Sawamura M, Onoe Y, Iwamoto A, Onodera S, Kawana T, Tada Y, Nimura M, Nakagawa H. Examination of the correlation between the manual and automated serological testing methods for syphilis. J Dermatol 2011; 39:355-61. [PMID: 21933262 DOI: 10.1111/j.1346-8138.2011.01341.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We evaluated the correlation between the conventional manual serological testing method for syphilis and a novel automated serological testing method and between six different reagents used in the automated method. Twenty-six serum samples, which were positive on non-treponemal manual serological testing, were obtained from 19 patients with early syphilis. The samples were manually analyzed using the non-treponemal serological test for syphilis kit and automatically analyzed using six different reagents approved by the Ministry of Health, Labor and Welfare in Japan. Statistically significant correlations were observed between most of the reagents used in the automated testing (r = 0.652-0.996, P < 0.001), except for one combination of the reagents. In the simple regression analysis, the slope of the simple regression line (range, 0.014-3.040) and some of the regression coefficients were not equal to 1.0. Therefore, it is recommended that when the automated serological testing method is used to test for syphilis, the same reagent should be consistently selected to evaluate the changes in antibody titers. Statistically significant correlations were also observed between the manual method and all the reagents used in the automated method (r = 0.682-0.811, P < 0.001). In this case, the regression coefficients ranged 0.375-6.270, and the simple regression line intercept ranged -71.926 to 4.184. The regression coefficient and the intercept between the manual method and some of the reagents used in the automated method were not similar to the values described in the documentation attached to the reagents used in this study.
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Affiliation(s)
- Tomohiko Onoe
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.
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Thomas DR, Cann KF, Evans MR, Roderick J, Browning M, Birley HDL, Curley W, Clark P, Northey G, Caple S, Lyons M. The public health response to the re-emergence of syphilis in Wales, UK. Int J STD AIDS 2011; 22:488-92. [DOI: 10.1258/ijsa.2011.011048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures. It is likely that early intensive control efforts dampened the epidemic curve. However, since 2006 the number of cases has increased steadily to a peak of four cases per 100,000 population in 2008. The majority of cases continue to occur in MSM (81% in 2009) and in those attending genitourinary (GU) medicine clinics in south east Wales (76%). Traditional sexual networks such as saunas, bars/clubs and cruising grounds remain frequently reported, but Internet-based networks are assuming increasing importance. Public health interventions have been sustained, using traditional partner notification, health promotion initiatives, and more innovative Internet network tracing methods.
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Affiliation(s)
- D Rh Thomas
- Public Health Wales Communicable Disease Surveillance Centre, Cardiff
| | - K F Cann
- Public Health Wales Communicable Disease Surveillance Centre, Cardiff
| | - M R Evans
- Public Health Wales Communicable Disease Surveillance Centre, Cardiff
| | - J Roderick
- Department of Genitourinary Medicine, Cardiff and Vale Local Health Board, Cardiff
| | - M Browning
- Department of Genitourinary Medicine, Cardiff and Vale Local Health Board, Cardiff
| | - H D L Birley
- Department of Genitourinary Medicine, Cardiff and Vale Local Health Board, Cardiff
| | - W Curley
- Terrence Higgins Trust Cymru, Cardiff
| | - P Clark
- Terrence Higgins Trust Cymru, Cardiff
| | - G Northey
- Public Health Wales Communicable Disease Surveillance Centre, Cardiff
| | - S Caple
- Public Health Wales Health Protection Services, Cardiff, UK
| | - M Lyons
- Public Health Wales Health Protection Services, Cardiff, UK
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Welfare W, Lacey H, Lighton L, Simms I. An outbreak of infectious syphilis among young heterosexuals in an English town. Int J STD AIDS 2011; 22:519-20. [DOI: 10.1258/ijsa.2011.011031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a recent outbreak of syphilis in young heterosexuals in the north west of England. A cluster of 12 cases of syphilis (7 primary and 5 early latent) was identified in Rochdale in heterosexuals aged 20 or under. Nine were women. Five were asymptomatic at presentation. This outbreak occurred in a group not usually associated with syphilis transmission in the north west. Not all the identified cases could be linked, and so potentially this outbreak is a sentinel of a larger problem.
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Affiliation(s)
- W Welfare
- Greater Manchester Health Protection Unit
| | - H Lacey
- Department of Genitourinary Medicine, Rochdale, Pennine Acute Hospitals NHS Trust, Manchester
| | - L Lighton
- Greater Manchester Health Protection Unit
| | - I Simms
- Centre for Infections, Health Protection Agency, London, UK
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Adolf R, Bercht F, Aronis ML, Lunardi LW, Schechter M, Sprinz E. Prevalence and risk factors associated with syphilis in a cohort of HIV positive individuals in Brazil. AIDS Care 2011; 24:252-8. [PMID: 21780954 DOI: 10.1080/09540121.2011.597706] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Individuals with syphilis have higher chance of having HIV, and syphilis' genital ulcers increases HIV transmission rate. Nevertheless, there are few well-documented studies about HIV and syphilis co-infection and its risk factors. The study was based on 2262 HIV infected individuals from South Brazilian HIV cohort, which began in 1991, and this analysis included individuals who were included in the cohort until November 2008. Inclusion criteria were having CD4 + T cell count and viral load at baseline, and syphilis serology tests (venereal disease research laboratory [VDRL] > 1:64 or a positive VDRL plus a positive treponemal test). A total of 1012 patients were included; 580 were men (57%); mean age at HIV diagnosis was 33 years; 591 (58%) had previous diagnosis of AIDS; most of the individuals acquired HIV from sexual contact (47.9% heterosexual and 31.7% men who had sex with men [MSM]); and 759 (75%) were on antiretroviral therapy. The prevalence of syphilis was 20.5% (208). After multivariate analysis, being male (2.01; 95% CI, 1.23-3.27; p = 0.005) and MSM (1.91; 95% CI, 1.25-2.90; p = 0.002) were significantly associated to HIV and syphilis co-infection. Males and MSM were associated with higher risk of this co-infection. Our findings may reflect that this particular population is still engaging in unprotected sexual intercourse, and efforts should be made to better target this specific group as they might perpetuate these infections.
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Affiliation(s)
- Rafael Adolf
- School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Chemoprophylaxis Is Likely to Be Acceptable and Could Mitigate Syphilis Epidemics Among Populations of Gay Men. Sex Transm Dis 2011; 38:573-9. [DOI: 10.1097/olq.0b013e31820e64fd] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Bull SS, McFarlane M, Lloyd L, Rietmeijer C. The process of seeking sex partners online and implications for STD/HIV prevention. AIDS Care 2010; 16:1012-20. [PMID: 15511733 DOI: 10.1080/09540120412331292426] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research has shown that online sex-seeking among men who have sex with men (MSM) is related to elevated risk for sexually transmitted diseases (STDs), including HIV infection; however, the process of seeking sex online is not well understood. It is important to understand the process of seeking sex partners in order to determine the best method for reaching MSM at high risk for infection. We report on baseline data from the Smart Sex Quest, an Internet-based STD prevention intervention targeting MSM (n = 1,776, 79% white, mean age = 33 years). Results indicate that older, white, college-educated men solicited sex partners on AOL, whereas Gay.com was a more frequent choice among younger men. Yahoo was named as a solicitation site more frequently by those with no college education, as were 'bareback' websites devoted to facilitating anal sex without the use of condoms. Following online solicitation, men tended to meet in public restrooms (86%), partners' homes (74%) and their own home (57%). Though results are limited by the self-selected nature of the sample, the data have important implications for online outreach, study recruitment and intervention.
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Affiliation(s)
- S Salyers Bull
- Colorado Health Outcomes Program, University of Colorado Health Sciences Center, Aurora, CO 80045-0508, USA.
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Klausner JD, Levine DK, Kent CK. Internet-based site-specific interventions for syphilis prevention among gay and bisexual men. AIDS Care 2010; 16:964-70. [PMID: 15511728 DOI: 10.1080/09540120412331292471] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Recent increases in syphilis in gay men in urban areas in the US and Europe have been associated with men meeting new sex partners on the Internet in chat-rooms and at websites that facilitate partner meeting. In response to the syphilis epidemic in San Francisco, the San Francisco Department of Public Health partnered with a community-based organization, Internet Sexuality Information Services, Inc., to develop, implement and evaluate a broad range of innovative Internet-based prevention interventions including the creation of a website, individual online outreach, banner advertisements, chats, an educational site, message boards, warnings and an online syphilis testing program. This paper documents the varied success of these interventions with process measures and calls for greater emphasis on impact measures in the evaluation of these types of intervention.
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Affiliation(s)
- J D Klausner
- STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA 94103, USA.
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Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. AIDS 2010; 24:1907-16. [PMID: 20616699 DOI: 10.1097/qad.0b013e32833bfe21] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Annual syphilis testing was reintroduced in the Swiss HIV Cohort Study (SHCS) in 2004. We prospectively studied occurrence, risk factors, clinical manifestations, diagnostic approaches and treatment of syphilis. METHODS Over a period of 33 months, participants with positive test results for Treponema pallidum hemagglutination assay were studied using the SHCS database and an additional structured case report form. RESULTS Of 7244 cohort participants, 909 (12.5%) had positive syphilis serology. Among these, 633 had previously been treated and had no current signs or symptoms of syphilis at time of testing. Of 218 patients with newly detected untreated syphilis, 20% reported genitooral contacts as only risk behavior and 60% were asymptomatic. Newly detected syphilis was more frequent among men who have sex with men (MSM) [adjusted odds ratio (OR) 2.8, P < 0.001], in persons reporting casual sexual partners (adjusted OR 2.8, P < 0.001) and in MSM of younger age (P = 0.05). Only 35% of recommended cerebrospinal fluid (CFS) examinations were performed. Neurosyphilis was diagnosed in four neurologically asymptomatic patients; all of them had a Venereal Disease Research Laboratory (VDRL) titer of 1:>or=32. Ninety-one percent of the patients responded to treatment with at least a four-fold decline in VDRL titer. CONCLUSION Syphilis remains an important coinfection in the SHCS justifying reintroduction of routine screening. Genitooral contact is a significant way of transmission and young MSM are at high risk for syphilis. Current guidelines to rule out neurosyphilis by CSF analysis are inconsistently followed in clinical practice. Serologic treatment response is above 90% in the era of combination antiretroviral therapy.
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Abstract
BACKGROUND To develop less costly methods to virologically monitor patients receiving antiretroviral therapy, we evaluated methods that use pooled blood samples and quantitative information available from viral load assays to monitor a cohort of patients on first-line antiretroviral therapy for virologic failure. METHODS We evaluated 150 blood samples collected after 6 months of therapy from participants enrolled in a San Diego primary infection program between January 1998 and January 2007. Samples were screened for virologic failure with individual viral load testing, 10 x 10 matrix pools and minipools of five samples. For the pooled platforms (matrix and minipools), we used a search and retest algorithm based on the quantitative viral load data to resolve samples that remained ambiguous for virologic failure. Viral load thresholds were more than 500 and more than 1500 copies/ml for the matrix and more than 250 and more than 500 copies/ml for the minipool. Efficiency, accuracy and result turnaround times were evaluated. RESULTS Twenty-three percent of cohort samples were detectable at more than 50 HIV RNA copies/ml. At an algorithm threshold of more than 500 HIV RNA copies/ml, both minipool and matrix methods used less than half the number of viral load assays to screen the cohort, compared with testing samples individually. Both pooling platforms had negative predictive values of 100% for viral loads of more than 500 HIV RNA copies/ml and at least 94% for viral loads of more than 250 HIV RNA copies/ml. CONCLUSION In this cohort, both pooling methods improved the efficiency of virologic monitoring over individual testing with a minimal decrease in accuracy. These methods may allow for the induction and sustainability of the virologic monitoring of patients receiving antiretroviral therapy in resource-limited settings.
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Hurtado I, Alastrue I, García de Olalla P, Albiach D, Martín M, Pérez-Hoyos S. [Preventive intervention in venues for interaction used by men who have sex with men]. GACETA SANITARIA 2009; 24:78-80. [PMID: 19748162 DOI: 10.1016/j.gaceta.2009.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 04/02/2009] [Accepted: 06/02/2009] [Indexed: 10/20/2022]
Abstract
An intervention in venues for interaction used by men who have sex with men in Valencia (Spain) was performed to prevent human immunodeficiency virus (HIV) infection or avoid delay in diagnosis and to facilitate contact with the health circuit. Information was provided on prevention and a rapid test for HIV and syphilis was performed. We contacted 500 men and the intervention was performed in 171; 37% of the subjects in saunas and one in four of those in prostitution apartments had never been tested. The prevalence of HIV was 1.6% (n=2) in the saunas, and 11% (n=5) in the apartments (n=5). For syphilis, these percentages were 5% and 2.3% respectively. The intervention revealed the existence of highly exposed population groups with low compliance and facilitated access to the health system in these groups.
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Affiliation(s)
- Isabel Hurtado
- Ciber de Epidemiología y Salud Pública (CIBERESP), España.
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Marangoni A, Moroni A, Accardo S, Cevenini R. Laboratory diagnosis of syphilis with automated immunoassays. J Clin Lab Anal 2009; 23:1-6. [PMID: 19140205 DOI: 10.1002/jcla.20268] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The serological detection of specific antibodies to Treponema pallidum is of particular importance in the diagnosis of syphilis. The purpose of this study was to evaluate diagnostic performances of automated immunoassays in comparison with T. pallidum hemagglutination test (TPHA) and Western Blot (WB). The retrospective study was performed with different panels of sera: 244 clinical and serological characterized syphilitic sera and 203 potentially interfering samples. All the sera were tested by Enzygnost Syphilis, ARCHITECT Syphilis TP, TPHA, and homemade WB. The diagnostic performances of the two assays were very similar: both Enzygnost Syphilis and ARCHITECT Syphilis TP performed with a sensitivity of 99.2%, whereas the specificity was 98.5 and 98.4%, respectively. Considering the suitability for automation, both immunoassays may represent a good choice as a screening test. However, the use of a confirmatory test, such as TPHA or WB, remains a must in order to avoid false-positive results.
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Affiliation(s)
- Antonella Marangoni
- Dipartimento di Ematologia e Sc. Oncologiche, Section of Microbiology, St. Orsola Hospital, University of Bologna, Bologna, Italy.
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Abstract
BACKGROUND Little data exist on Internet and email use among STD clinic patients for research and clinical care communication. METHODS An anonymous cross-sectional survey of STD clinic patients aged >/=18 years in Seattle, WA, March 13 to 22, 2006. RESULTS Of 489 study period patients, 251 (51%) completed the questionnaire. Participants had a median age of 30 (range 18-66) years and were 69% male, 56% white, 19% black, 9% Hispanic, and 7% Asian/Pacific Islander. Of all participants, 75% had some postsecondary education but half reported an annual income of <US$15,000. Of 251 participants, 200 (80%) reported using the Internet from a private location at least once a week, 190 (76%) had their own email that they check at least 3 times a week, and 144 (57%) were willing to receive an email reminding them to come back for a follow-up appointment if diagnosed with an STD. Men who have sex with men were more likely than women and heterosexual men to be regular Internet and email users (92% vs. 70%, P = 0.001) and to have met a sex partner over the Internet during the past year (69% vs. 11%, P <0.001). Higher educational level and income, but not age or gender, were also associated with Internet and email use, as was racial/ethnic background (86% of whites, 48% of blacks, 73% of Hispanics, 100% of Asians/Pacific Islanders, and 57% of others, P <0.001). CONCLUSIONS Internet and email use are common and acceptable to many STD clinic patients for research and clinical purposes.
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Syphilis, psychiatry and offending behaviour: clinical cases from nineteenth-century Ireland. Ir J Med Sci 2008; 178:73-7. [PMID: 19052842 DOI: 10.1007/s11845-008-0259-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2008] [Accepted: 10/31/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Syphilis presented substantial challenges to nineteenth-century medical and psychiatric services. AIMS To illustrate the clinical course and diagnostic challenges associated with neurosyphilis in nineteenth-century Ireland. METHOD This paper uses original archival material from the Central Criminal Lunatic Asylum, Dublin to present clinical cases and inform a discussion of related issues. RESULTS Mr A, a 34-year-old banker convicted of "felonious entry", demonstrated many psychiatric and neurological features of neurosyphilis ("general paralysis of the insane"); he soon became "feeble", "paralytic" and "demented", and died within 2 years. The case of Mr B, a 38-year-old game-keeper convicted of "attempting to upset trains", illustrates diagnostic dilemmas associated with neurosyphilis, especially when complicated by evidence of tuberculosis ("scrofulous diathesis"). CONCLUSIONS The clinical and diagnostic challenges presented by syphilis have changed over the past century, but these cases, combined with recent evidence of syphilis outbreaks, highlight ongoing needs for clinical and epidemiological vigilance.
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Levine D, Woodruff AJ, Mocello AR, Lebrija J, Klausner JD. inSPOT: the first online STD partner notification system using electronic postcards. PLoS Med 2008; 5:e213. [PMID: 18942887 PMCID: PMC2570420 DOI: 10.1371/journal.pmed.0050213] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Deb Levine and colleagues describe an innovative online e-card service for partner notification, initial evaluation results, and future research needs.
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Abstract
Cases of syphilis have been increasing in the UK and it remains an important public health problem. Here, we provide an overview of syphilis, its presentation, diagnosis and management.
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Affiliation(s)
- Kathryn Eccleston
- Department of Genito-Urinary Medicine, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester, UK.
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Abstract
PurposeThis paper aims to examine whether greater consideration should be given to the timing of sexual health interventions within the calendar year.Design/methodology/approachThe paper uses a review of the literature.FindingsThe evidence points to seasonality in a number of areas of sexual health among young people, including: the timing of first intercourse and conceptions, both of which peak in the summer and over Christmas; abortions which peak approximately two months later in February and late summer and sexually transmitted infections, which peak over the summer and autumn. In the case of conceptions there is evidence that the seasonal pattern among young people is different from that of adults. Potential explanations fall into four main categories: biological; behavioural; social, and service‐related.Research limitations/implicationsMany of the studies included in this review are from the USA, and some are based on either small samples or specific risk groups, which raises questions of representativeness and generalisability. Further, it is notable how little research there has been regarding seasonal variations in other aspects of sexual behaviour, such as risk reduction practice and other potential explanatory factors such as health‐seeking behaviour and availability of services.Practical implicationsThe findings consistently point to periods of heightened sexual activity among young people in the summer and over Christmas, and suggest that greater consideration should indeed be given to the timing of sexual health interventions within the calendar year.Originality/valueTo the best of the authors' knowledge, no other review of this kind has yet been found.
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Abstract
After a marked decline in the number of syphilis cases in the context of AIDS prevention campaigns, a significant increase has been observed in states of the former Soviet Union since 1994. In recent years, outbreaks have also been reported in the US, Canada, and several European countries. The current epidemic in the US and in different parts of Europe has largely involved men who have sex with men, many of whom are infected with HIV. Since a misdiagnosis of syphilis can have serious consequences for the patient and also for pregnancies and newborns, clinicians should be aware of the many manifestations of syphilis and difficulties in the diagnosis and management of the disease. Younger clinicians in particular are no longer familiar with the diverse clinical symptoms and the complex diagnostics of syphilis. Patients co-infected with HIV may present with atypical clinical manifestations and laboratory test results. Furthermore, through its association with an increased risk of HIV infection, syphilis has acquired a new potential for morbidity and mortality, and the diagnosis of syphilis should be routinely considered in patients with uveitis, sudden deafness, aortic thoracic aneurysm, or pregnancy. Only a minority of syphilis infections are detected in the primary stage. This may be because of atypical locations and, occasionally, atypical morphology of the lesions; however, it may also be because of the difficulty of detecting the pathogen. In the secondary stage, which is clinically extremely diverse, the diagnosis is confirmed serologically. There is a need for increased awareness of the symptoms and signs of acute infections, together with a willingness to consider the diagnosis of syphilis in patients with vague symptoms. An increasing number of diagnostic tests (both specific and nonspecific) are now available. However, in the absence of clinical symptoms or in cases with a low titer or inconsistent test results, diagnosis of syphilis can be difficult or even impossible. Treatment and follow-up should follow current guidelines designed for the involved area. In this article, the cutaneous manifestations of syphilis and their diagnostic and therapeutic management are described in detail.
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Postigo C. Sexually Transmitted Diseases and Immigration in Spain. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s1578-2190(07)70505-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Walter T, Lebouche B, Miailhes P, Cotte L, Roure C, Schlienger I, Trepo C. Symptomatic Relapse of Neurologic Syphilis after Benzathine Penicillin G Therapy for Primary or Secondary Syphilis in HIV-Infected Patients. Clin Infect Dis 2006; 43:787-90. [PMID: 16912958 DOI: 10.1086/507099] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Accepted: 06/08/2006] [Indexed: 11/03/2022] Open
Abstract
We describe 3 symptomatic cases of neurologic syphilis that occurred after the administration of the usual therapy for primary or secondary syphilis in human immunodeficiency virus (HIV)-infected patients. We discuss the difficulty of diagnosing neurosyphilis, the need for lumbar puncture, and risk factors of relapse. Because HIV infection may alter the natural history and response of neurologic syphilis to treatment, scrupulous follow-up and repeated cycles of therapy are warranted.
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Affiliation(s)
- T Walter
- Department of Hepatogastroenterology, Hospices Civils de Lyon, Hôtel-Dieu Hospital, Lyon,France
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Campo J, Perea MA, del Romero J, Cano J, Hernando V, Bascones A. Oral transmission of HIV, reality or fiction? An update. Oral Dis 2006; 12:219-28. [PMID: 16700731 DOI: 10.1111/j.1601-0825.2005.01187.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human immunodeficiency virus (HIV) and many other viruses can be isolated in blood and body fluids, including saliva, and can be transmitted by genital-genital and especially anal-genital sexual activity. The risk of transmission of HIV via oral sexual practices is very low. Unlike other mucosal areas of the body, the oral cavity appears to be an extremely uncommon transmission route for HIV. We present a review of available evidence on the oral-genital transmission of HIV and analyse the factors that act to protect oral tissues from infection, thereby reducing the risk of HIV transmission by oral sex. Among these factors we highlight the levels of HIV RNA in saliva, presence of fewer CD4+ target cells, presence of IgA antibodies in saliva, presence of other infections in the oral cavity and the endogenous salivary antiviral factors lysozyme, defensins, thrombospondin and secretory leucocyte protease inhibitor (SLPI).
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Affiliation(s)
- J Campo
- Department of Buccofacial Medicine and Surgery, School of Dentistry, Complutense University of Madrid, Spain.
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Thomas S, Wiselka M, Dhar J, Bibby K. Syphilis presenting as acute multifocal retino-choroiditis. J R Soc Med 2006. [PMID: 16816270 DOI: 10.1258/jrsm.99.7.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Shery Thomas
- Department of Ophthalmology, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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Quesada A, Campos L, Rubio C, Martín MA, Herranz P, Arribas JR, Pastor B, Zarallo J. Tres casos de neurosífilis precoz en pacientes infectados por VIH. ACTAS DERMO-SIFILIOGRAFICAS 2006; 97:395-9. [PMID: 16956520 DOI: 10.1016/s0001-7310(06)73427-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In spite of the relative control of the disease in the late 20th century, syphilis, like other sexually transmitted diseases, has undergone a strong resurgence in recent years in the large urban centers of Europe and the US. Many patients with syphilis are also HIV+. The association between the two diseases may modify the clinical evolution of syphilis and increase the incidence of neurological disorders. We discuss the cases of three patients diagnosed with both diseases last year, with neurological presentation of syphilis occurring early and ophthalmic or cochlear vestibular involvement. This recent outbreak of syphilis seems to lead to an increase in the number of atypical cases presenting in our daily practice, where we must be prepared for early diagnosis and treatment.
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Affiliation(s)
- A Quesada
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.
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Barrera MV, Bosch RJ, Mendiola M, Frieyro M, Castillo R, Fernández A, Herrera E. Reactivación de la sífilis en Málaga. ACTAS DERMO-SIFILIOGRAFICAS 2006; 97:323-6. [PMID: 16956564 DOI: 10.1016/s0001-7310(06)73410-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION In our milieu, syphilis has been truly rare in recent years, although it has never ceased to be present. However, we would like to draw attention to its recent revival, presenting with certain peculiarities. PATIENTS ADN METHODS: The characteristics of 12 cases of syphilis diagnosed in our dermatology department between June and December 2004 were studied. RESULTS Only one of the 12 patients, whose ages ranged from 20 to 48, was female, and six were homosexual. Five of the latter and one heterosexual were also infected with the human immunodeficiency virus. Three patients were diagnosed in the primary stage, while the other nine showed alterations characteristic of the second stage, although five of them were not aware of having had chancres or adenopathies. Serology tests were key to the diagnosis, because of the great variety of clinical manifestations. All of the patients responded well to penicillin treatment. CONCLUSION Luetic serology should be performed in patients with symptoms that suggest secondary syphilis, especially in homosexuals and those who are HIV positive.
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Affiliation(s)
- María V Barrera
- Servicio y Cátedra de Dermatología, Hospital Clínico Universitario Virgen de la Victoria, Facultad de Medicina, Málaga, España
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Abstract
The past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in Eastern Europe, particularly the UK, and in the US. Although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. Significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carcinoma are associated with tertiary disease. Since the prevalence of infective syphilis in heterosexuals has been increasing, there has now been a gradual rise in the number of children born with congenital syphilis. Consequently, the congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face. The aim of this report is to review syphilis-related oral lesions, as well as to summarize the relations between human immunodeficiency virus (HIV) and syphilis.
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Affiliation(s)
- Jair Carneiro Leão
- Department of Clinic and Preventive Dentistry, Federal University of Pernambuco, Recife/PE, Brazil.
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McFarlane M, Kachur R, Klausner JD, Roland E, Cohen M. Internet-based health promotion and disease control in the 8 cities: successes, barriers, and future plans. Sex Transm Dis 2006; 32:S60-4. [PMID: 16205295 DOI: 10.1097/01.olq.0000180464.77968.e2] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this paper is to provide a detailed description of Internet-based sexually transmitted disease/human immunodeficiency virus prevention in the 8 US cities most affected by syphilis in men who have sex with men. GOAL By reviewing the efforts under way in these 8 cities, we will understand the barriers and facilitators associated with Internet-based prevention efforts. STUDY This is a review of Internet activities taking place in 8 major US cities. RESULTS Efforts in the 8 cities vary, with some cities reporting little or no Internet-based prevention activities. Other cities have attempted banner advertising, online outreach, online partner notification, online laboratory slips for syphilis testing, and auditorium-style chat sessions. CONCLUSION Though a number of policy-related barriers prevent some cities from engaging in Internet-based prevention, these activities are clearly important to the overall prevention effort. In order to surmount local policy barriers, it is essential to obtain evaluation data from the programs initiated.
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Affiliation(s)
- Mary McFarlane
- Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Abraham S, Toutous-Trellu L, Pechère M, Hugonnet S, Liassine N, Yerly S, Rohner P, Ninet B, Hirschel B, Piguet V. Increased Incidence of Sexually Transmitted Infections in Geneva, Switzerland. Dermatology 2006; 212:41-6. [PMID: 16319473 DOI: 10.1159/000089021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2005] [Accepted: 05/23/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Focal outbreaks of sexually transmitted infections (STIs) such as syphilis and gonorrhoea have been reported in the large cities of Western Europe over the past few years. The aim of our study was to determine whether a similar trend is observed in Geneva and the situation with regard to HIV infection. METHODS We review the incidence of syphilis, gonorrhoea, Chlamydia trachomatis and HIV in Geneva from 1999 to 2004. RESULTS Figures indicate a steady and sustained increase in the incidence of syphilis, gonorrhoea and Chlamydia trachomatis in Geneva since 1999 that is maintained into 2004. As for HIV, the number of positive testings in Switzerland has stabilised and primary infection figures do not indicate an increase in newly acquired infections in Geneva. CONCLUSION The situation in Geneva is similar to that observed elsewhere in Western Europe and indicates the need of public health interventions.
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Affiliation(s)
- Shahnaz Abraham
- Department of Dermatology and Venereology, University Hospital of Geneva, Geneva, Switzerland
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Abstract
Internet access has caused a global revolution in the way people of all ages and genders interact. Many have turned to the Internet to seek love, companionship, and sex, prompting researchers to move behavioral studies online. The sexual behavior of men who have sex with men (MSM) has been more closely studied than that of any other group online given the abundance of gay-oriented websites and concerns about increasing transmission of HIV and other sexually transmitted infections. Not only does the Internet provide a new medium for the conduct of behavioral research and for participant recruitment into an array of research studies, it has the as yet unrealized potential to reach huge numbers of MSM with innovative harm reduction and prevention messages tailored to individualized needs, interests, and risk behavior. Internet-based research on sexual behavior has many advantages in rapidity of recruitment of diverse samples which include individuals unreachable through conventional methods (i.e., non-gay identified and geographically and socially isolated MSM, etc.). Internet-based research also presents some new methodologic challenges in study design, participant recruitment, survey implementation, and interpretation of results. In addition, there are ethical issues unique to online research including difficulties in verifying informed consent, obstacles to surveying minors, and the ability to assure anonymity. This paper presents a review of Internet-based research on sexual behavior in MSM, a general discussion of the methodologic and ethical challenges of Internet-based research, and recommendations for future interdisciplinary research.
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Affiliation(s)
- Mary Ann Chiasson
- Medical and Health Research Association of New York City, Inc., 40 Worth Street, Suite 720, New York, NY 10013, USA.
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Guy RJ, Leslie DE, Simpson K, Hatch B, Leydon J, Hellard ME, Kelly HA. Sustained increase in infectious syphilis notifications in Victoria. Med J Aust 2005; 183:218. [PMID: 16097926 DOI: 10.5694/j.1326-5377.2005.tb07004.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Accepted: 05/19/2005] [Indexed: 11/17/2022]
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Vall M. [New goals for control of sexually transmitted diseases: role of centers of sexually transmitted diseases]. Med Clin (Barc) 2005; 125:61-4. [PMID: 15970186 DOI: 10.1157/13076481] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- M Vall
- Unidad de ITS, CAP Drassanes, Barcelona, Spain.
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Marangoni A, Sambri V, Accardo S, Cavrini F, D'Antuono A, Moroni A, Storni E, Cevenini R. Evaluation of LIAISON Treponema Screen, a novel recombinant antigen-based chemiluminescence immunoassay for laboratory diagnosis of syphilis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 12:1231-4. [PMID: 16210488 PMCID: PMC1247834 DOI: 10.1128/cdli.12.10.1231-1234.2005] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Revised: 06/22/2005] [Accepted: 07/29/2005] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to evaluate the diagnostic performance of LIAISON Treponema Screen (DiaSorin, Saluggia, Italy), a new automated chemiluminescence immunoassay (CLIA), in comparison with that of rapid plasma reagin (RPR) and the following currently used treponemal tests: hemagglutination test (TPHA), immunoenzymatic assay (EIA), and Western blot (WB). First, a retrospective study was performed with a panel of 2,494 blood donor sera, a panel of 131 clinical and serologically characterized syphilitic sera, and 96 samples obtained from subjects with potentially interfering diseases or conditions. A prospective study was also performed by testing 1,800 unselected samples submitted to the Microbiology Laboratory of the St. Orsola Hospital in Bologna, Italy, for routine screening for syphilis. As expected, RPR was the least specific method, especially when potentially cross-reacting sera were tested. On the contrary, all of the treponemal tests proved to be very specific (99.9%) and they performed with the following sensitivities: 100% (WB), 99.2% (CLIA), 95.4% (EIA), and 94.7% (TPHA).
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Wong W, Chaw JK, Kent CK, Klausner JD. Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003. Sex Transm Dis 2005; 32:458-63. [PMID: 15976605 DOI: 10.1097/01.olq.0000168280.34424.58] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Substantial increases in syphilis among gay and bisexual men have been reported in San Francisco. GOAL To identify risk factors for early syphilis infection among gay and bisexual men attending the San Francisco municipal STD clinic (City Clinic). STUDY Cross-sectional, self-administered, behavioral survey of gay and bisexual men attending City Clinic between November 2002 and March 2003 linked with electronic medical record data. RESULTS Among 1318 gay and bisexual men surveyed, 53 (4.0%) were diagnosed with early syphilis. The final multivariate model included nonwhite race (OR = 2.1 [1.1-4.4]), HIV-infection (OR = 3.9 [2.0-7.7]), using both methamphetamine and sildenafil (Viagra(R)) (OR = 6.2 [2.6-14.9]), using methamphetamine without sildenafil (OR = 3.2 [1.3-7.6]), using sildenafil without methamphetamines (OR = 0.9 [0.3-2.9]), stronger gay community affiliation (OR = 2.3 [1.2-4.6]), and having recent Internet partners (OR = 2.1 [1.0-4.3]). CONCLUSIONS Syphilis prevention efforts should address methamphetamine and sildenafil use among gay and bisexual men and require strong and substantive involvement with the gay community to address syphilis in San Francisco.
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Affiliation(s)
- William Wong
- STD/HIV Prevention and Care Programs, Chicago Department of Public Health, IL 60616, USA.
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Hospers HJ, Kok G, Harterink P, de Zwart O. A new meeting place: chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men. AIDS 2005; 19:1097-101. [PMID: 15958842 DOI: 10.1097/01.aids.0000174457.08992.62] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the process of Internet chatting, and subsequent dating and sexual (risk) behaviour among Dutch men who have sex with men (MSM), and to compare the demographic profile of the Internet sample with a traditional Dutch MSM sample. DESIGN A self-selected anonymous Internet sample. METHODS Enrolment via a prominent gay chat room. Potential respondents were asked to complete an online questionnaire about chatting and dating, and sexual (risk) behaviour with their last date via chatting (e-date). In 26 days, 5302 questionnaires were returned. Of these, 4984 were evaluated as reliable and were used in the analyses. RESULTS Eighty-two per cent chatted at least once a week, 88% had ever dated through chatting, and of these 89% had had sex with one or more e-dates. With respect to the last e-date, almost 50% had had anal sex with their last e-date, and 15% reported unprotected anal sex. Especially among HIV-positive men, a high percentage of unprotected anal sex was reported (39%). After correcting for the disclosure of HIV status, this percentage remained twice as high compared with HIV-negative and never-tested men (28 versus 14%). Compared with a traditional MSM sample, the Internet sample was significantly younger, and comprised more non-Dutch and bisexual men, whereas the level of sexual risk behaviour with casual partners was comparable. CONCLUSION The Internet is a popular new meeting place for MSM, and attracts men with a different demographic profile. The level of risk behaviour warrants that opportunities for interventions on the Internet are explored, with special attention to HIV-positive chatters.
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Affiliation(s)
- Harm J Hospers
- Maastricht University, Faculty of Psychology, Department of Experimental Psychology, Maastricht, The Netherlands.
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Simms I, Fenton KA, Ashton M, Turner KME, Crawley-Boevey EE, Gorton R, Thomas DR, Lynch A, Winter A, Fisher MJ, Lighton L, Maguire HC, Solomou M. The re-emergence of syphilis in the United Kingdom: the new epidemic phases. Sex Transm Dis 2005; 32:220-6. [PMID: 15788919 DOI: 10.1097/01.olq.0000149848.03733.c1] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to characterize the resurgence of infectious syphilis in the United Kingdom between 1997 and 2003. STUDY The authors conducted a retrospective analysis of routine surveillance data from genitourinary medicine clinics and data collected through enhanced surveillance. RESULTS Between 1997 and 2002, diagnoses of primary, secondary, and early latent syphilis made at genitourinary medicine clinics increased by 213% in heterosexual males, 1412% in men who have sex with men (MSM), and 22% in females. These increases have been driven by a series of outbreaks, the largest of which were seen in Manchester (528) and London (1222) up to the end of October 2003. All the outbreaks have been geographically localized and the majority of cases occurred in MSM. A high percentage of concurrent HIV infection was reported, and oral sex was often reported as a route of transmission. CONCLUSIONS Syphilis has re-emerged in response to behavior change, probably driven by changes in the HIV epidemic. The future course of the epidemic is difficult to predict and control remains elusive.
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Affiliation(s)
- Ian Simms
- Health Protection Agency Communicable Disease Surveillance Centre, London, UK.
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