2012 至 2016 年日本报告的与男男性行为者和女女性行为者相关梅毒病例迅速增加。
Rapid Increase in Reports of Syphilis Associated With Men Who Have Sex With Women and Women Who Have Sex With Men, Japan, 2012 to 2016.
出版信息
Sex Transm Dis. 2018 Mar;45(3):139-143. doi: 10.1097/OLQ.0000000000000768.
BACKGROUND
In Japan, syphilis reports have recently increased rapidly. However, unlike other developed countries where men who have sex with men (MSM) were associated with the rise, the increase in Japan has been attributed more to men who have sex with women (MSW) and women who have sex with men (WSM). We report on this increase based on surveillance data.
METHODS
Syphilis is a notifiable disease requiring all laboratory-confirmed cases to be reported; stage and sex of the sex partner(s) suspected as the infection source are also reported. Focusing on primary and secondary (P&S) cases, we describe the temporal, demographic, and geographic distributions of reported cases in 2012 through 2016.
RESULTS
A total of 7040 (64.0%) of 10,997 cases were P&S; the annual rate of increase was greatest for P&S and the proportion of P&S increased over time. Among P&S cases (1609 MSM, 2768 MSW, and 1323 WSM), MSW and WSM each surpassed MSM cases in 2016. Men were older with a wider age distribution (median, 37 years; interquartile range, 28-46 years) relative to women (median, 26 years; interquartile range, 21-34 years). Among women, 20- to 24-year-olds consistently had the highest reporting rate, reaching 9.0 per 100,000 in 2016. Congenital syphilis reports increased from 0.4 in 2012 to 1.4 per 100,000 live births in 2016. Although Tokyo prefecture had the highest reporting rate (3.98 per 100,000 person-years), the proportionate contribution from Tokyo decreased in 2016.
CONCLUSIONS
Reports on P&S syphilis increased yearly among MSW and WSM. Young women seem to be at particular risk, and with increased reports of congenital syphilis, syphilis prevention and control is currently a public health priority in Japan.
背景
在日本，梅毒报告最近迅速增加。然而，与其他发达国家不同，这些病例主要与男男性行为者（MSM）有关，日本梅毒病例的增加更多归因于与女性发生性关系的男性（MSW）和与男性发生性关系的女性（WSM）。我们根据监测数据报告了这一增长。
方法
梅毒是一种需要报告所有实验室确诊病例的法定传染病；还报告了疑似感染源的性伴侣的性别和阶段。我们重点关注原发性和继发性（P&S）病例，描述了 2012 年至 2016 年报告病例的时间、人口统计学和地理分布。
结果
在 10997 例病例中，共有 7040 例（64.0%）为 P&S；P&S 的年增长率最高，且 P&S 的比例随时间推移而增加。在 P&S 病例中（1609 例 MSM、2768 例 MSW 和 1323 例 WSM），MSW 和 WSM 在 2016 年分别超过了 MSM 病例。男性年龄较大，年龄分布范围较广（中位数 37 岁；四分位距 28-46 岁），而女性年龄较小（中位数 26 岁；四分位距 21-34 岁）。在女性中，20-24 岁年龄段的报告率一直最高，2016 年达到每 10 万人 9.0 例。先天性梅毒报告从 2012 年的 0.4 例/每 10 万活产儿增加到 2016 年的 1.4 例/每 10 万活产儿。尽管东京都的报告率最高（每 100000 人年 3.98 例），但 2016 年来自东京的比例贡献有所下降。
结论
MSW 和 WSM 的 P&S 梅毒报告逐年增加。年轻女性似乎面临特别高的风险，并且随着先天性梅毒报告的增加，梅毒预防和控制目前是日本的公共卫生重点。
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