Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), BP 943, Franceville, Gabon.
Centre National de Transfusion sanguine (CNTS), BP 13895, Libreville, Gabon.
BMC Public Health. 2019 Feb 8;19(1):167. doi: 10.1186/s12889-019-6489-7.
Very few studies have been conducted on the seroprevalence of syphilis in Gabon. According to the World Health Organization, the average seroprevalence of syphilis has declined from 5.5 to 1.1% in Central Africa. The aim of this study was to test the hypothesis that syphilis decreased in Gabon between 2004 and 2016 and to identify factors involved in this pattern by testing a large sample of first-time blood donors in the capital Libreville.
The detection of Treponema pallidum was done using a Rapid Plasma Reagin test (RPR) and confirmed by an ELISA test using the Biorad Syphilis Total Antibody EIA II kit or BioMerieux Trepanostika TP recombinant. Assays were performed by dedicated technicians according to manufacturers' recommendations and following the laboratory standard operating procedures. Test results were manually transferred into the laboratory Excel files and hand-written in the laboratory logbook for syphilis testing. Logistic regression was used to assess the impact of sociodemographic characteristics on syphilis marker seroprevalence in both univariate and multivariable analysis. Odds ratios (OR) and 95% confidence intervals were calculated.
The seroprevalence of syphilis markers was 8.4% (95% CI = 7.9-8.9) in 2004 and 2.4% (95% CI = 2.1-2.7) in 2016. The difference was significant [OR = 3.78; 95% CI (3.26-4.38); P < 0.001]. The decrease in syphilis seroprevalence was significant in both women and men and in each age group in univariate analysis. In multivariable analysis, controlling for all sociodemographic factors, the decrease in syphilis seroprevalence from 2004 to 2016 remained significant (OR = 3.29; 95% CI = 2.88-3.88, P < 0.001). The seroprevalence of syphilis decreased significantly in men compared to women and young donors compared to donors aged ≥36 years.
This study shows a significant decline in syphilis seroprevalence in first-time blood donors in Libreville, Gabon. Government actions, including multiple HIV prevention activities, are a likely part of this decline.
加蓬对梅毒血清流行率的研究很少。根据世界卫生组织的数据，中非洲梅毒的平均血清流行率已从 5.5%降至 1.1%。本研究旨在检验以下假设，即在 2004 年至 2016 年间，加蓬的梅毒发病率下降，并通过对首都利伯维尔的大量首次献血者进行检测，确定导致这种模式的因素。
采用快速血浆反应素试验（RPR）检测梅毒螺旋体，并用 Biorad 梅毒总抗体 ELISA II 试剂盒或 BioMerieux Trepanostika TP 重组试剂盒进行酶联免疫吸附试验（ELISA）确认。检测由专业技术人员根据制造商的建议进行，并按照实验室标准操作程序进行。检测结果由专人手动输入实验室 Excel 文件，并手写记录在梅毒检测实验室日志中。采用逻辑回归分析在单变量和多变量分析中评估社会人口特征对梅毒标志物血清流行率的影响。计算比值比（OR）和 95%置信区间。
2004 年梅毒标志物血清流行率为 8.4%（95%CI=7.9-8.9），2016 年为 2.4%（95%CI=2.1-2.7）。差异有统计学意义[OR=3.78；95%CI（3.26-4.38）；P<0.001]。在单变量分析中，女性、男性和每个年龄组的梅毒血清流行率均显著下降。在多变量分析中，控制所有社会人口因素后，2004 年至 2016 年梅毒血清流行率的下降仍有统计学意义[OR=3.29；95%CI=2.88-3.88，P<0.001]。与女性相比，男性和年轻献血者的梅毒血清流行率显著下降，与年龄≥36 岁的献血者相比。
本研究显示，加蓬利伯维尔首次献血者的梅毒血清流行率显著下降。政府的行动，包括多种艾滋病毒预防活动，可能是导致这种下降的部分原因。
