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  1 / 3774 MEDLINE  
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[PMID]:27773873
[Au] Autor:Rourk AR; Nolte FS; Litwin CM
[Ti] Título:Performance Characteristics of the Reverse Syphilis Screening Algorithm in a Population With a Moderately High Prevalence of Syphilis.
[So] Source:Am J Clin Pathol;146(5):572-577, 2016 Nov 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: With the recent introduction of automated treponemal tests, a new reverse syphilis algorithm has been proposed and now used by many clinical laboratories. We analyzed the impact of instituting the reverse screening syphilis algorithm in a laboratory that serves a geographic area with a moderately high prevalence of syphilis infection. Methods: Serum samples sent for syphilis testing were tested using a treponemal enzyme immunoassay (EIA) as the screening assay. EIA reactive samples were tested by rapid plasma reagin (RPR) and titered to end point if reactive. RPR nonreactive samples were analyzed by the Treponema pallidum particle agglutination test (TP-PA). Pertinent medical records were reviewed for false-reactive screens and samples with evidence of past syphilis infection. Results: Among 10,060 patients tested, 502 (5%) were reactive on the initial EIA screen. The RPR was reactive in 150 (1.5%). TP-PA testing determined that 103 (1.0%) were falsely reactive on initial EIA screen. The reverse screening algorithm, however, identified 242 (2.4%) with evidence of latent, secondary, or past syphilis, 21 of whom had no or unknown prior treatment with antibiotics. Conclusions: Despite a 1.0% false-reactive rate, the reverse syphilis algorithm detected 21 patients with possible latent syphilis that may have gone undetected by traditional syphilis screening.
[Mh] Termos MeSH primário: Algoritmos
Anticorpos Antibacterianos/sangue
Antígenos de Bactérias/imunologia
Sífilis/diagnóstico
Treponema pallidum/imunologia
[Mh] Termos MeSH secundário: Reações Falso-Negativas
Seres Humanos
Técnicas Imunoenzimáticas
Imunoglobulina G/sangue
Prevalência
Sífilis/epidemiologia
Sífilis/microbiologia
Sorodiagnóstico da Sífilis
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Bacterial); 0 (Antigens, Bacterial); 0 (Immunoglobulin G)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqw182


  2 / 3774 MEDLINE  
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[PMID]:28700763
[Au] Autor:Bartels A; Crandall M; Spring L
[Ad] Endereço:Department of General Medicine, Naval Hospital Camp Lejeune, NC, USA. E-mail: Anne.k.bartels.mil@mail.mil.
[Ti] Título:Recalcitrant genital papules.
[So] Source:J Fam Pract;66(7):457-460, 2017 07.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This patient was initially told he had genital warts, but the appearance of the lesions, and the presence of a rash on his trunk and extremities, suggested another diagnosis.
[Mh] Termos MeSH primário: Doenças do Pênis/etiologia
Dermatopatias Papuloescamosas/etiologia
Sorodiagnóstico da Sífilis
Sífilis Cutânea/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Biópsia
Seres Humanos
Masculino
Doenças do Pênis/diagnóstico
Doenças do Pênis/patologia
Dermatopatias Papuloescamosas/diagnóstico
Dermatopatias Papuloescamosas/patologia
Sífilis Cutânea/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE


  3 / 3774 MEDLINE  
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[PMID]:28653418
[Au] Autor:Trinh TT; Kamb ML; Luu M; Ham DC; Perez F
[Ad] Endereço:Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
[Ti] Título:Syphilis testing practices in the Americas.
[So] Source:Trop Med Int Health;22(9):1196-1203, 2017 Sep.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. METHODS: Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations). RESULTS: The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%). CONCLUSIONS: Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing.
[Mh] Termos MeSH primário: Laboratórios
Controle de Qualidade
Sífilis/diagnóstico
Treponema pallidum
[Mh] Termos MeSH secundário: Algoritmos
Américas
Recursos em Saúde
Seres Humanos
Técnicas Imunoenzimáticas
Inquéritos e Questionários
Sífilis/microbiologia
Sorodiagnóstico da Sífilis
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12920


  4 / 3774 MEDLINE  
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[PMID]:28446129
[Au] Autor:Xiao Y; Tong ML; Liu LL; Lin LR; Chen MJ; Zhang HL; Zheng WH; Li SL; Lin HL; Lin ZF; Xing HQ; Niu JJ; Yang TC
[Ad] Endereço:Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China.
[Ti] Título:Novel predictors of neurosyphilis among HIV-negative syphilis patients with neurological symptoms: an observational study.
[So] Source:BMC Infect Dis;17(1):310, 2017 Apr 26.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Known predictors of neurosyphilis were mainly drawn from human immunodeficiency virus (HIV)-infected syphilis patients, which may not be applicable to HIV-negative populations as they have different characteristics, particularly those with neurological symptoms. This study aimed to identify novel predictors of HIV-negative symptomatic neurosyphilis (S-NS). METHODS: From June 2005 to June 2015, 370 HIV-negative syphilis patients with neurological symptoms were recruited, consisting of 191 S-NS patients (including 123 confirmed neurosyphilis and 68 probable neurosyphilis patients) and 179 syphilis/non-neurosyphilis (N-NS) patients. Clinical and laboratory characteristics of S-NS were compared with N-NS to identify factors predictive of S-NS. Serum rapid plasma reagin (RPR), Treponema pallidum particle agglutination (TPPA), and their parallel testing format for screening S-NS were evaluated. RESULTS: The likelihood of S-NS was positively associated with the serum RPR and TPPA titers. The serum TPPA titers performed better than the serum RPR titers in screening S-NS. The optimal cut-off points to recognize S-NS were serum RPR titer ≥1:4 and serum TPPA titer ≥1:2560 respectively. A parallel testing format of a serum RPR titer ≥1:2 and serum TPPA titer ≥1:1280 screened out 95.8% of S-NS and all confirmed cases of neurosyphilis. S-NS was independently associated with male sex, serum RPR titer ≥1:4, serum TPPA titer ≥1:2560, and elevated serum creatine kinase. Concurrence of these factors increased the likelihood of S-NS. CONCLUSIONS: Quantitation of serum TPPA is worthwhile and performs better than serum RPR in screening S-NS. Serum RPR, serum TPPA, male sex, and serum creatine kinase can predict S-NS. Moreover, patients with both a serum RPR titer <1:2 and a serum TPPA titer <1:1280 have a low probability of S-NS, suggesting that it is reasonable to reduce lumbar punctures in such individuals.
[Mh] Termos MeSH primário: Neurossífilis/diagnóstico
Neurossífilis/etiologia
[Mh] Termos MeSH secundário: Testes de Aglutinação/métodos
Feminino
Soropositividade para HIV
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Fatores de Risco
Punção Espinal
Sífilis/complicações
Sorodiagnóstico da Sífilis
Treponema pallidum/patogenicidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2339-3


  5 / 3774 MEDLINE  
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[PMID]:28100187
[Au] Autor:Dai W; Luo Z; Xu R; Zhao G; Tu D; Yang L; Wang F; Cai Y; Lan L; Hong F; Yang T; Feng T
[Ad] Endereço:Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
[Ti] Título:Prevalence of HIV and syphilis co-infection and associated factors among non-commercial men who have sex with men attending a sexually transmitted disease clinic in Shenzhen, China.
[So] Source:BMC Infect Dis;17(1):86, 2017 Jan 18.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although HIV and syphilis co-infection has been frequently observed in men who have sex with men (MSM), only few studies have focused on it. Different subgroups of MSM might exhibit heterogeneous HIV and syphilis risk profiles, indicating that interventions for HIV and HIV-related co-infections may vary with different subgroups of MSM. However, no previous study has investigated HIV and syphilis co-infection among non-commercial MSM (ncMSM) attending a sexually transmitted disease (STD) clinic. Therefore, this study aimed to explore the prevalence of HIV and syphilis co-infection and associated factors among ncMSM attending an STD clinic in Shenzhen, China. METHODS: NcMSM attending the STD clinic of Shenzhen Center for Chronic Disease Control were recruited in this cross-sectional study every Monday between March 2013 and August 2015 using a site based convenience sampling method. An anonymous questionnaire was used to collect data regarding socio-demographic characteristics, risky sexual behaviors and HIV-related knowledge. Blood samples were collected to perform HIV and syphilis tests. RESULTS: Totally 533 participants were enrolled in this study and the prevalence of HIV and syphilis co-infection among them was 13.13%. Multivariable analyses indicated that having lived in Shenzhen for less than one year (aOR = 2.80, 95% CI = 1.30-6.05), having first anal sexual intercourse before the age of 18 (aOR = 2.78, 95% CI = 1.29-5.89), having 3 to 5 anal sexual partners in the past six months (aOR = 2.54, 95% CI = 1.19-5.40), playing exclusively receptive (aOR = 6.87, 95% CI = 3.02-15.61) or both insertive and receptive (aOR = 3.65, 95% CI = 1.64-8.09) roles in anal sexual intercourse and not always using condom in anal sexual intercourse (aOR = 2.13, 95% CI = 1.08-4.19) were associated risk factors for HIV and syphilis co-infection, relative to the non-infected ncMSM. Compared with the mono-infected ncMSM, associated risk factors for the co-infection were being unmarried (aOR = 2.47, 95% CI = 1.03-5.89) and playing exclusively receptive role (aOR = 2.44, 95% CI = 1.04-5.73) in anal sexual intercourse. CONCLUSIONS: HIV and syphilis co-infection is quite prevalent among the study participants in Shenzhen. Integrated and intensified intervention strategies, specifically targeting at the non-infected and mono-infected ncMSM attending the STD clinic, are needed to reduce HIV and syphilis co-infection. Most importantly, non-infected and mono-infected ncMSM attending the STD clinic with the aforementioned associated risk factors should be given special concern.
[Mh] Termos MeSH primário: Coinfecção/epidemiologia
Preservativos/utilização
Infecções por HIV/epidemiologia
Homossexualidade Masculina/estatística & dados numéricos
Comportamento Sexual/estatística & dados numéricos
Sífilis/epidemiologia
[Mh] Termos MeSH secundário: Adulto
China/epidemiologia
Estudos Transversais
Seres Humanos
Masculino
Prevalência
Fatores de Risco
Assunção de Riscos
Parceiros Sexuais
Inquéritos e Questionários
Sorodiagnóstico da Sífilis
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2187-1


  6 / 3774 MEDLINE  
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[PMID]:27763779
[Au] Autor:Rhoads DD; Genzen JR; Bashleben CP; Faix JD; Ansari MQ
[Ti] Título:Prevalence of Traditional and Reverse-Algorithm Syphilis Screening in Laboratory Practice: A Survey of Participants in the College of American Pathologists Syphilis Serology Proficiency Testing Program.
[So] Source:Arch Pathol Lab Med;141(1):93-97, 2017 Jan.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: -Syphilis serology screening in laboratory practice is evolving. Traditionally, the syphilis screening algorithm begins with a nontreponemal immunoassay, which is manually performed by a laboratory technologist. In contrast, the reverse algorithm begins with a treponemal immunoassay, which can be automated. The Centers for Disease Control and Prevention has recognized both approaches, but little is known about the current state of laboratory practice, which could impact test utilization and interpretation. OBJECTIVE: -To assess the current state of laboratory practice for syphilis serologic screening. DESIGN: -In August 2015, a voluntary questionnaire was sent to the 2360 laboratories that subscribe to the College of American Pathologists syphilis serology proficiency survey. RESULTS: -Of the laboratories surveyed, 98% (2316 of 2360) returned the questionnaire, and about 83% (1911 of 2316) responded to at least some questions. Twenty-eight percent (378 of 1364) reported revision of their syphilis screening algorithm within the past 2 years, and 9% (170 of 1905) of laboratories anticipated changing their screening algorithm in the coming year. Sixty-three percent (1205 of 1911) reported using the traditional algorithm, 16% (304 of 1911) reported using the reverse algorithm, and 2.5% (47 of 1911) reported using both algorithms, whereas 9% (169 of 1911) reported not performing a reflex confirmation test. Of those performing the reverse algorithm, 74% (282 of 380) implemented a new testing platform when introducing the new algorithm. CONCLUSION: -The majority of laboratories still perform the traditional algorithm, but a significant minority have implemented the reverse-screening algorithm. Although the nontreponemal immunologic response typically wanes after cure and becomes undetectable, treponemal immunoassays typically remain positive for life, and it is important for laboratorians and clinicians to consider these assay differences when implementing, using, and interpreting serologic syphilis screening algorithms.
[Mh] Termos MeSH primário: Algoritmos
Laboratórios/estatística & dados numéricos
Ensaio de Proficiência Laboratorial/estatística & dados numéricos
Inquéritos e Questionários
Sorodiagnóstico da Sífilis/estatística & dados numéricos
[Mh] Termos MeSH secundário: American Medical Association
Seres Humanos
Laboratórios/normas
Ensaio de Proficiência Laboratorial/normas
Programas de Rastreamento/métodos
Programas de Rastreamento/normas
Programas de Rastreamento/estatística & dados numéricos
Patologistas
Patologia Clínica/organização & administração
Patologia Clínica/normas
Patologia Clínica/estatística & dados numéricos
Prevalência
Sensibilidade e Especificidade
Sífilis/diagnóstico
Sífilis/epidemiologia
Sorodiagnóstico da Sífilis/métodos
Sorodiagnóstico da Sífilis/normas
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE
[do] DOI:10.5858/2016-0110-CP


  7 / 3774 MEDLINE  
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[PMID]:27723157
[Au] Autor:Sarkodie F; Hassall O; Owusu-Dabo E; Owusu-Ofori S; Bates I; Bygbjerg IC; Owusu-Ofori A; Harritshøj LH; Ullum H
[Ad] Endereço:Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
[Ti] Título:Improving the screening of blood donors with syphilis rapid diagnostic test (RDT) and rapid plasma reagin (RPR) in low- and middle-income countries (LMIC).
[So] Source:Transfus Med;27(1):52-59, 2017 Feb.
[Is] ISSN:1365-3148
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Syphilis testing conventionally relies on a combination of non-treponemal and treponemal tests. The primary objective of this study was to describe the positive predictive value (PPV) of a screening algorithm in a combination of a treponemal rapid diagnostic test (RDT) and rapid plasma reagin (RPR) test at Komfo Anokye Teaching Hospital (KATH), Ghana. MATERIALS AND METHODS: From February 2014 to January 2015, 5 mL of venous blood samples were taken from 16 016 blood donors and tested with a treponemal RDT; 5 mL of venous blood was taken from 526 consenting initial syphilis sero-reactive blood donors. These RDT reactive samples were confirmed with an algorithm, applying the Vitros /Abbott-Architect algorithm as gold standard. RESULTS: A total of 478 of 526 RDT reactive donors were confirmed positive for syphilis, making a PPV of 90·9%. Of the 172 (32·7%) donors who were also RPR positive, 167 were confirmed, resulting in a PPV of 97·1%. The PPV of the combined RDT and RPR (suspected active syphilis) testing algorithm was highest among donors at an enhanced risk of syphilis, family/replacement donors (99·9%), and among voluntary donors above 25 years (98·6%). DISCUSSION: Screening of blood donors by combining syphilis RDT and RPR with relatively good PPV may provide a reasonable technology for LMIC that has a limited capacity for testing and can contribute to the improvement of blood safety with a minimal loss of donors.
[Mh] Termos MeSH primário: Algoritmos
Anticorpos Antibacterianos/sangue
Doadores de Sangue
Seleção do Doador/métodos
Sorodiagnóstico da Sífilis/métodos
Sífilis/sangue
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Países em Desenvolvimento
Seleção do Doador/organização & administração
Seleção do Doador/normas
Feminino
Gana
Seres Humanos
Masculino
Meia-Idade
Sorodiagnóstico da Sífilis/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Bacterial)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE
[do] DOI:10.1111/tme.12363


  8 / 3774 MEDLINE  
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[PMID]:27356549
[Au] Autor:Pastuszczak M; Gozdzialska A; Jakiela B; Obtulowicz A; Jaskiewicz J; Wojas-Pelc A
[Ad] Endereço:Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland.
[Ti] Título:Robust pro-inflammatory immune response is associated with serological cure in patients with syphilis: an observational study.
[So] Source:Sex Transm Infect;93(1):11-14, 2017 Feb.
[Is] ISSN:1472-3263
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Approximately 15% of adequately treated patients with early syphilis remain serofast. Pathogenesis and clinical significance of this phenomenon is unclear. The objective of this study was to determine whether there is any association between host immune response and treatment outcome (serofast state or proper serological response). METHODS: Forty-four patients with secondary syphilis were enrolled to this study. Levels of pro-inflammatory cytokines such as interferon-γ, tumour necrosis factor-α and interleukin-6 were measured before treatment and 8 hours after injection of antibiotic. RESULTS: After 1 year, based on the serological response patients were stratified into two groups: (1) proper serological response (n=31) and (2) serofast state (n=9). The serological cure rate was 77.5% at 12 months after treatment. Patients with proper serological response had significantly higher levels of analysed cytokines (at baseline and 8 hours after treatment) compared with the serofast state group (p<0.05). CONCLUSIONS: We showed that robust host pro-inflammatory immune response to infection may be the predictive factor of serological cure. The treatment outcome may be also associated with the magnitude of immune reaction occurring during the treatment.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Penicilina G/uso terapêutico
Sorodiagnóstico da Sífilis
Sífilis/imunologia
Treponema pallidum/imunologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Interleucina-6/metabolismo
Masculino
Meia-Idade
Polônia
Sífilis/tratamento farmacológico
Sífilis/metabolismo
Fator de Necrose Tumoral alfa/metabolismo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (IL6 protein, human); 0 (Interleukin-6); 0 (TNF protein, human); 0 (Tumor Necrosis Factor-alpha); Q42T66VG0C (Penicillin G)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170529
[Lr] Data última revisão:
170529
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160701
[St] Status:MEDLINE
[do] DOI:10.1136/sextrans-2016-052681


  9 / 3774 MEDLINE  
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[PMID]:27992604
[Au] Autor:Nishijima T; Teruya K; Shibata S; Yanagawa Y; Kobayashi T; Mizushima D; Aoki T; Kinai E; Yazaki H; Tsukada K; Genka I; Kikuchi Y; Oka S; Gatanaga H
[Ad] Endereço:AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
[Ti] Título:Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008-2015.
[So] Source:PLoS One;11(12):e0168642, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The epidemiology of incident syphilis infection among HIV-1-infected men who have sex with men (MSM) largely remains unknown. METHODS: The incidence and risk factors for incident syphilis (positive TPHA and RPR> = 1:8) among HIV-1-infected MSM who visited a large HIV clinic in Tokyo for the first time between 2008 and 2013 were determined, using clinical data and stored blood samples taken every three months for screening and determination of the date of incident syphilis. Poisson regression compared the incidence of syphilis at different observation periods. RESULTS: Of 885 HIV-1-infected MSM with baseline data, 34% either presented with active syphilis at baseline (21%) or became infected with syphilis during follow-up (13%). After excluding 214 patients (MSM with syphilis at baseline (n = 190) and no follow-up syphilis test (n = 24)), of 671 men, 112 (17%) developed incident syphilis with an incidence of 43.7/1,000 person-years [95% CI, 36.5-52.3]. The incidence decreased slightly during observation period although the trend was not significant (2008-2009: 48.2/1,000 person-years, 2010-2011: 51.1/1,000 person-years, 2012-2013: 42.6/1,000 person-years, 2014 to 2015: 37.9/1,000 person-years, p = 0.315). Multivariable analysis identified young age (<33 years versus >40, HR 4.0, 95%CI 2.22-7.18, p<0.001), history of syphilis at baseline (HR 3.0, 95%CI 2.03-4.47, p<0.001), positive anti-amoeba antibody (HR 1.8, 95%CI 1.17-2.68, p = 0.006), and high baseline CD4 count (CD4 ≥350 /µL versus CD4 <200, HR 1.6, 95%CI 1.00-2.53, p = 0.050) as risk factors for incident syphilis. Incidence of syphilis was particularly high among young patients (age <33 years: 60.1/1,000 person-years). Interestingly, 37% of patients with incident syphilis were asymptomatic. CONCLUSIONS: Although incidence of syphilis did not increase during the observation period, it was high among HIV-1-infected MSM, especially among young HIV-1-infected MSM and those with history of syphilis, in Tokyo. Regular screening for syphilis needs to be strictly applied to this population.
[Mh] Termos MeSH primário: Infecções por HIV/complicações
HIV-1
Sorodiagnóstico da Sífilis/métodos
Sífilis/diagnóstico
Sífilis/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Instituições de Assistência Ambulatorial
Homossexualidade Masculina
Seres Humanos
Incidência
Masculino
Análise de Regressão
Fatores de Risco
Tóquio/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170703
[Lr] Data última revisão:
170703
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161220
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0168642


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[PMID]:27938337
[Au] Autor:Dassah ET; Adu-Sarkodie Y; Mayaud P
[Ad] Endereço:Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, P. O. Box KS 1934, Kumasi, Ghana. edidassah@yahoo.com.
[Ti] Título:Performance of Syphilis Sentinel Surveillance in the context of endemic Treponematoses: experience from Ghana.
[So] Source:BMC Infect Dis;16(1):745, 2016 Dec 09.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Use of treponemal tests to screen for syphilis (caused by Treponema pallidum pallidum) poses challenges with infection status classification, especially in settings where other treponemal infections are endemic. This study aimed to determine the validity of the syphilis surveillance testing strategy implemented since 2004 using two treponemal tests, and estimate the seroprevalence of active syphilis infection in Ghana where yaws (caused by Treponema pallidum pertenue) is endemic. METHODS: We retested sera from the 2007 HIV sentinel survey (HSS) using a traditional algorithm, quantitative rapid plasma reagin test followed by qualitative Treponema pallidum haemagglutination assay. The adjusted seroprevalence of active syphilis was calculated by applying the proportions of active syphilis within identified categories of HSS samples during the retesting, to the entire population of HSS samples. The 95% confidence intervals (CIs) were calculated for each proportion, and the t-test was used to assess differences in proportions. RESULTS: Of 2,214 samples that were retested, 203 (9.2%) had active syphilis infection, 21 (0.9%) were biological false reactions, 640 (28.9%) were past or treated syphilis infections, and 1,350 (61%) were uninfected. The current syphilis testing strategy overestimated the seroprevalence of active syphilis infection by a third (HSS versus traditional algorithm: 6.0% (95% CI: 5.6-6.3) vs. 4.5% (95% CI: 4.2-4.8); p < 0.001), and had low positive predictive value (16.8%) for detecting active syphilis infection. More than half (51.9%) of HSS syphilis positive cases were actually past/treated treponemal infections, possibly previous exposure to yaws. CONCLUSION: There is an urgent need to review the current syphilis sentinel surveillance testing strategy in Ghana in the context of concurrent endemic treponematoses, to better inform policy.
[Mh] Termos MeSH primário: Sífilis/diagnóstico
Sífilis/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Algoritmos
Feminino
Gana/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Vigilância de Evento Sentinela
Estudos Soroepidemiológicos
Inquéritos e Questionários
Sorodiagnóstico da Sífilis/métodos
Treponema pallidum/patogenicidade
Infecções por Treponema/tratamento farmacológico
Bouba/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE



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