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Syphilis infection: incidence, prevalence and associated risk factors in an occupational cohort in Guinea-Bissau

Lopatko Lindman, Jacob LU (2012) LÄKM01 20121
MD Programme
Abstract
ABSTRACT
Background
Prevalence rates of syphilis vary extensively between the different countries in Africa but are in general high. Recent research indicates a declining prevalence trend of syphilis infection in the general population in West Africa. As syphilis is a cause of reproductive morbidity, poor pregnancy outcome and may be an important contributor to the HIV epidemic, trends in syphilis infection are important of many reasons. The aims of this study were to examine changes in TPHA/TPPA seroprevalence and syphilis incidence between 1990 and 2010 as well as to identify risk factors and sexual risk behaviour related to syphilis infection toward which preventive measures might be targeted.

Materials/methods
Since 1990 all... (More)
ABSTRACT
Background
Prevalence rates of syphilis vary extensively between the different countries in Africa but are in general high. Recent research indicates a declining prevalence trend of syphilis infection in the general population in West Africa. As syphilis is a cause of reproductive morbidity, poor pregnancy outcome and may be an important contributor to the HIV epidemic, trends in syphilis infection are important of many reasons. The aims of this study were to examine changes in TPHA/TPPA seroprevalence and syphilis incidence between 1990 and 2010 as well as to identify risk factors and sexual risk behaviour related to syphilis infection toward which preventive measures might be targeted.

Materials/methods
Since 1990 all police officers in Guinea-Bissau have been invited to participate in an open prospective cohort. 4792 police officers have been included, of them 4788 had a recorded syphilis serology result at inclusion. Syphilis incidence and prevalence were analysed in 2-3 years time strata. Risk factors for TPHA/TPPA seroprevalence were analysed by multivariate analysis.

Result
In 1990-2010 prevalence of TPHA/TPPA reactivity ranged between 7.8 % and 20.3 %. No significant declining trend was found (P=.73), although TPHA/TPPA seroprevalence was significantly lower in the last time period 2008-2010 compared to the other time periods (P=.0019). Syphilis incidence ranged between 0.56-2.25/100 person years. A sharp decrease was observed from 1.80/100 person years in 1996-6 June 1998 to 1.11/100 person years in 7 June1998-2000. The decrease in syphilis incidence continued in 2001-2002 to 0.56/100 person years. Older age, Fula ethnicity and HIV infection was found to be associated with TPHA/TPPA seroprevalence. Some of the TPHA/TPPA reactive police officers in the study became non-reactive in TPHA/TPPA over time.
Conclusion
No declining trend in syphilis incidence and prevalence was found in the cohort contrary to what has been reported from general population in West Africa. It is important to continue monitor the trends of syphilis and HIV as well as other sexually transmitted diseases in Guinea-Bissau toward which preventive measures might be targeted. (Less)
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author
Lopatko Lindman, Jacob LU
supervisor
organization
course
LÄKM01 20121
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Syphilis, STI, Africa, Guinea-Bissau
language
English
id
2701557
date added to LUP
2012-08-24 11:12:13
date last changed
2012-08-24 11:12:13
@misc{2701557,
  abstract     = {ABSTRACT
Background
Prevalence rates of syphilis vary extensively between the different countries in Africa but are in general high. Recent research indicates a declining prevalence trend of syphilis infection in the general population in West Africa. As syphilis is a cause of reproductive morbidity, poor pregnancy outcome and may be an important contributor to the HIV epidemic, trends in syphilis infection are important of many reasons. The aims of this study were to examine changes in TPHA/TPPA seroprevalence and syphilis incidence between 1990 and 2010 as well as to identify risk factors and sexual risk behaviour related to syphilis infection toward which preventive measures might be targeted.

Materials/methods
Since 1990 all police officers in Guinea-Bissau have been invited to participate in an open prospective cohort. 4792 police officers have been included, of them 4788 had a recorded syphilis serology result at inclusion. Syphilis incidence and prevalence were analysed in 2-3 years time strata. Risk factors for TPHA/TPPA seroprevalence were analysed by multivariate analysis.

Result
In 1990-2010 prevalence of TPHA/TPPA reactivity ranged between 7.8 % and 20.3 %. No significant declining trend was found (P=.73), although TPHA/TPPA seroprevalence was significantly lower in the last time period 2008-2010 compared to the other time periods (P=.0019). Syphilis incidence ranged between 0.56-2.25/100 person years. A sharp decrease was observed from 1.80/100 person years in 1996-6 June 1998 to 1.11/100 person years in 7 June1998-2000. The decrease in syphilis incidence continued in 2001-2002 to 0.56/100 person years. Older age, Fula ethnicity and HIV infection was found to be associated with TPHA/TPPA seroprevalence. Some of the TPHA/TPPA reactive police officers in the study became non-reactive in TPHA/TPPA over time.
Conclusion
No declining trend in syphilis incidence and prevalence was found in the cohort contrary to what has been reported from general population in West Africa. It is important to continue monitor the trends of syphilis and HIV as well as other sexually transmitted diseases in Guinea-Bissau toward which preventive measures might be targeted.},
  author       = {Lopatko Lindman, Jacob},
  keyword      = {Syphilis,STI,Africa,Guinea-Bissau},
  language     = {eng},
  note         = {Student Paper},
  title        = {Syphilis infection: incidence, prevalence and associated risk factors in an occupational cohort in Guinea-Bissau},
  year         = {2012},
}