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Gilmour LS, Best EJ, Duncanson MJ, Wheeler BJ, Sherwood J, Thirkell CE, Walls T. High Incidence of Congenital Syphilis in New Zealand: A New Zealand Pediatric Surveillance Unit Study. Pediatr Infect Dis J 2022; 41:66-71. [PMID: 34889872 DOI: 10.1097/inf.0000000000003233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Syphilis, a disease once in decline, has made a resurgence worldwide. New Zealand has had increasing syphilis rates since enhanced syphilis surveillance was initiated in 2013. This study reports epidemiologic, descriptive and treatment data on management of infants prenatally exposed or vertically infected with syphilis across New Zealand as reported by pediatricians. METHODS Over a 26-month period from April 2018 to May 2020 (inclusive), pediatricians throughout New Zealand notified potential, probable and confirmed cases of congenital syphilis to the New Zealand Pediatric Surveillance Unit. National reporting numbers were concurrently ascertained to demonstrate reporting accuracy. RESULTS Thirty-two cases were notified, comprised of 25 infants born to women with positive antenatal syphilis serology (5 whom developed congenital syphilis), and 7 infants diagnosed with congenital syphilis after birth where syphilis was not diagnosed in pregnancy. There were 12 cases of congenital syphilis; an incidence rate of 9.4 cases per 100,000 live births. Nine of the 12 infants had clinical features of congenital syphilis. One-third of maternal infections were early syphilis, and the women who gave birth to infected infants were less likely to have received antenatal care, adequate treatment and follow-up monitoring of treatment for syphilis during pregnancy. CONCLUSIONS This study quantifies an important burden of disease from congenital syphilis in our population. Case finding and treatment of syphilis in pregnancy are critical to prevent this. Our findings support the urgent need for measures such as repeat maternal syphilis screening in early third trimester; whether by affected region or instituted for all, in the context of rising cases.
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Affiliation(s)
| | - Emma Joanne Best
- Department of Paediatric Infectious Diseases, Starship Children's Health, Auckland
- Department of Paediatrics: Child and Youth Health
- National Immunisation Advisory Centre, University of Auckland
| | - Mavis Joy Duncanson
- New Zealand Paediatric Surveillance Unit, Women's and Children's Health, Otago Medical School Dunedin Campus, University of Otago
| | - Benjamin John Wheeler
- New Zealand Paediatric Surveillance Unit, Women's and Children's Health, Otago Medical School Dunedin Campus, University of Otago
| | - Jill Sherwood
- New Zealand Institute of Environmental Science and Research Limited (ESR)
| | | | - Tony Walls
- From the Department of Paediatrics, Christchurch Public Hospital
- Department of Paediatrics, University of Otago, Christchurch
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Valdes A, Cazanave C, Dabis F, Neau D, Lacoste D, Gaborieau V, Farbos S, Dworkin MS. Knowledge, behaviors, and attitudes of HIV-infected men about syphilis. Med Mal Infect 2017; 47:470-476. [PMID: 28943166 DOI: 10.1016/j.medmal.2017.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/30/2016] [Accepted: 07/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore knowledge on syphilis, sexual behaviors, and attitudes in men living with HIV in southwestern France. PATIENTS AND METHODS In the ANRS CO3 Aquitaine Cohort of people living with HIV (PLHIV), a self-administered questionnaire was proposed to all male PLHIV attending one of the seven participating clinics between September 22 and October 24, 2014. The 15 questions explored patient knowledge about syphilis disease, attitudes, and behaviors during sexual intercourse. RESULTS Among 302 patients surveyed, 101 reported at least one episode of syphilis. A history of syphilis was associated with awareness that syphilis was on the rise in men who have sex with men (MSM) in the Aquitaine region (46% vs. 22%, P<0.0001). Knowledge that syphilis could be transmitted by oral sex was low in both patients with (37%) and without (20%) a history of syphilis (P=0.0045). Patients with a history of syphilis more often used recreational drugs (RR 1.6; P=0.0028). Among 160 patients who had sexual intercourse with a man in the past 12 months, 23% reported using condoms for oral intercourse and 80% reported using condoms for anal intercourse. Sixty-two per cent of MSM declared being ready to change their practice if informed about the rise in syphilis. CONCLUSIONS This survey revealed important information gaps in PLHIV about syphilis and related behavior. The reported receptiveness of this population to behavioral change may help inform educational interventions.
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Affiliation(s)
- A Valdes
- Université de Bordeaux, Inserm U1219, ISPED, 33076 Bordeaux, France; Université de Bordeaux, ISPED, 33076 Bordeaux, France; COREVIH Aquitaine, 33076 Bordeaux, France
| | - C Cazanave
- COREVIH Aquitaine, 33076 Bordeaux, France; Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France; Université de Bordeaux, USC EA 3671, infections humaines à mycoplasmes et à chlamydiae, 33076 Bordeaux, France; Inra, USC EA3671, infections humaines à mycoplasmes et à chlamydiae, 33076 Bordeaux, France.
| | - F Dabis
- Université de Bordeaux, Inserm U1219, ISPED, 33076 Bordeaux, France; Université de Bordeaux, ISPED, 33076 Bordeaux, France; COREVIH Aquitaine, 33076 Bordeaux, France
| | - D Neau
- COREVIH Aquitaine, 33076 Bordeaux, France; Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France
| | - D Lacoste
- COREVIH Aquitaine, 33076 Bordeaux, France; Service de médecine interne, hôpital Saint-André, CHU de Bordeaux, 33075 Bordeaux, France
| | - V Gaborieau
- Service de médecine, centre hospitalier de Pau, 64000 Pau, France
| | - S Farbos
- Service de maladies infectieuses, centre hospitalier de la Côte-Basque, 64100 Bayonne, France
| | - M S Dworkin
- Université de Bordeaux, Inserm U1219, ISPED, 33076 Bordeaux, France; Université de Bordeaux, ISPED, 33076 Bordeaux, France; School of Public Health, University of Illinois, Chicago, United States
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Coughlan E, Young H, Parkes C, Coshall M, Dickson N, Psutka R, Saxton P, Pink R, Adams K. A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand. Sex Health 2015; 12:170-3. [PMID: 25493444 DOI: 10.1071/sh14140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/02/2014] [Indexed: 11/23/2022]
Abstract
During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.
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Affiliation(s)
- Edward Coughlan
- Christchurch Sexual Health Centre, Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand
| | - Heather Young
- Christchurch Sexual Health Centre, Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand
| | - Catherine Parkes
- Christchurch Sexual Health Centre, Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand
| | - Maureen Coshall
- Christchurch Sexual Health Centre, Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand
| | - Nigel Dickson
- Department of Preventive and Social Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Rebecca Psutka
- Department of Preventive and Social Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Peter Saxton
- Gay Men's Sexual Health Research Group, Department of Social and Community Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Ramon Pink
- Medical Officer of Health, Canterbury, Community and Public Health, Division of the Canterbury District Health Board, P. O. Box 1475, Christchurch 8140, New Zealand
| | - Katharine Adams
- Canterbury District Health Board, Private Bag 4710, Christchurch 8140, New Zealand
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Vijeratnam D, Mani R. Letter response to R Psutka et al. – Enhanced surveillance of infectious syphilis in New Zealand sexual health clinics ( Int J STD AIDS 2013; 24: 791–798). Int J STD AIDS 2014; 25:535-6. [DOI: 10.1177/0956462414527582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Dayan Vijeratnam
- Specialist Registrar in Genitourinary Medicine, St Mary’s Community Health Campus, Portsmouth, UK
- Consultant in Genitourinary & HIV Medicine, St Mary’s Community Health Campus, Portsmouth, UK
| | - Reena Mani
- Specialist Registrar in Genitourinary Medicine, St Mary’s Community Health Campus, Portsmouth, UK
- Consultant in Genitourinary & HIV Medicine, St Mary’s Community Health Campus, Portsmouth, UK
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