HIV/AIDS, STDs and STIs

Biography

Biography: Xingdong Ye

Abstract

Syphilis is a sexually transmitted infection (STI) that causes cutaneous manifestations such as genital ulcers, and a variety of complications including neurologic, renal, gastrointestinal, and hepatic diseases. After being virtually eradicated in the 1960s, syphilis has made a re-emergence in China since the initiation of economic and social reforms, and Chinese government has implemented a battle for syphilis control named syphilis control plan 2010~2020, set the goal of The average annual growth rate of early syphilis is less than 5%,By the end of 2015, the number of congenital syphilis was controlled at 30/100,000 live births, and at the end of 2020, the number of live births was controlled at 15/10. Guangzhou is one of the cities most affected by syphilis within Guangdong province. During the period of 2000 to 2011, syphilis burden in this area was tripled that of the national average. Given its specific position as the capital city of Guangdong Province and the de facto economic center of South China, as well as the large population involved (over 14 million in 2016), syphilis epidemics in Guangzhou are of great concern. We had downloaded the data of syphilis case from China national infectious reporting system and analysed. It showed that number of syphilis cases reported in Guangzhou has increased from 2691 individuals in 2005 to 8546 individuals in 2016, and incidence of syphilis during this time was increase from 47.33/100,000 population in 2005 to 55.28/100,000 population in 2016. And of those syphilis case reported, the incidence of early syphilis including primary syphilis and secondary syphilis had been decreased from 21.84/100,000 population to 7.84/100,000 populations, The composition ratio of different types of syphilis changes, highlighting the realization of early syphilis, congenital syphilis decline otherwise the proportion of latent syphilis has been rising, cases of latent syphilis account for 48% in 2015 increased to 82% in 2016, the incidence of congenital syphilis get to around 30/ 100,000 live births. But, whether the syphilis cases in the national infectious reporting system mentioned above were all really syphilis cases of initiated diagnose and need to be reported? Answer was not. We reviewed more than 2000 syphilis cases data and conclude that the accuracy of syphilis case report ranged from 30.21% to 73.14% in China, it implicated that Syphilis case reported in the infectious disease system was partly incorrect because of over-reporting （rate  of over Reporting ranged from 27% to 70% varied different types of syphilis）. As for syphilis incidence of high risk population such as MSM, FSWs and Drug user population, cross-sectional survey by our colleague during recently year showed that The rate of TPPA positive was 10.1% among MSM; and the prevalence of syphilis was 5.5%; HIV 7.6% and co-infection was 2.7%. For population of FSWs, The positive rate of TPPA was 8.2%, the reactive syphilis prevalence was 1.4%. The positive rate of TPPA in middle and low places was 9.4%, and the rate of the population with both RPR and TPPA positive was 1.6%. We also conducted a syphilis incidence investigation among Drug users in 2014, Guangzhou, It showed that The positive rate of TPPA was 8.9%, the syphilis prevalence was 4%. In short, China has implemented the second battle for control syphilis spreading for seven years, over reporting of syphilis cases were common and ranged from 27% to 70% varied different types of syphilis. Currently, more than 80% reported syphilis cases were latent syphilis. Both early syphilis and congenital syphilis had been controlled through series intervention precaution. Men who has sex with men has the highest incidence of syphilis among the target four populations, However, in Guangzhou, the current epidemiological features of syphilis among MSM has not yet showed that syphilis promoted HIV infection and spread that observed in other country and region.