|Home | About | Journals | Submit | Contact Us | Français|
China is suffering from a growing syphilis epidemic. National sentinel site data show the incidence has increased from 1.4 cases/100000 persons in 1993, to 32.9 cases/100000 in 1999. Nationwide surveillance data indicate the incidence of active syphilis in 2004 was 8.7/100000. In this issue of Sexually Transmitted Infections two reports highlight the growing problem of syphilis in China and illustrate the need for effective screening and control programmes.
In the first report, Cheng and colleagues report results of a screening and intervention programme carried out in Shenzhen to control mother‐to‐child transmission of syphilis. 477656 pregnant women were screened, with 96.3% coverage by 2005. Of 2019 women who were positive, 1855 (91.5%) were treated. The babies of women who tested positive and who chose to proceed with pregnancy were screened for congenital syphilis; of 1020 infants born to these women 92 (9.0%) had the disease. The congenital syphilis rate was less than half that of the year before the programme. With 22/100000 cases of mother‐to‐child transmission, however, the authors acknowledge that more needs to be done to reach vulnerable young women and encourage earlier antenatal care.
See p 347 and accompanying editorial p 345
In the second report Wong and colleagues describe the prevalence of syphilis among 11473 patients attending 14 sexually transmitted infection (STI) clinics in eight cities in Guangxi. In this study 1297 (11.9%) had syphilis; of these 58% presented with genital ulcers, palmar/plantar erythema or inguinal lymphadenopathy. Of note 532 (40.1%) of cases were commercial sex workers and 133 (1.8%) of all cases were HIV co‐infected. The authors conclude that syphilis infection has reached alarming rates in China's STI clinic population, inferring generalised spread of the disease through commercial sex and other bridging populations.
See p 351
The benefits of early HIV testing still do not seem to be getting through to some groups of men who have sex with men (MSM) and opportunities for testing in genitourinary (GUM) clinics are being missed. Two reports in this issue, from three cities in the UK and from Amsterdam in the Netherlands, show high rates of undiagnosed HIV infection in these countries. Stolte and colleagues found that, although HIV testing is supposed to be offered routinely in the Amsterdam STI clinic, only 37.5% (144/384) of previously untested MSM had an HIV test at a new consultation. Men under 30 years and those reporting unprotected anal intercourse were the least likely to be tested.
See p 387
Dodds and colleagues conducted anonymous unlinked surveys in 90 gay community venues in London, Brighton and Manchester. They found HIV rates of 12.3% in London, 13.7% in Brighton and 8.6% in Manchester. In all three cities at least a third of HIV‐positive men were unaware of their status despite the fact that 69% had visited a GUM clinic in the past year. Time for a shift to opt out HIV‐testing policies perhaps?
See p 392
Jin and colleagues in Sydney, Australia, compared STI rates in HIV‐positive and ‐negative community‐based cohorts. Their findings confirm those of other studies including Stolte et al and Dodds et al, with high rates of STIs in HIV‐positive men.
See p 397