Hospital Tengku Ampuan Rahimah Klang, Department of Medicine, Selangor, Malaysia.
University of Malaya, Department of Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia.
Med J Malaysia. 2020 May;75(3):199-203.
There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital.
We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study.
There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21).
Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.
马来西亚梅毒流行病学的研究有限。本研究描述了在一家三级转诊大学医院就诊的梅毒患者的临床特征和治疗结果。
我们回顾性地审查了 2010 年 1 月至 2015 年 12 月期间，在马来亚大学医学中心（UMMC）血清学检测呈梅毒阳性的患者的病历。血清学阳性定义为快速血浆反应素（RPR）或性病研究实验室（VDRL）阳性，梅毒螺旋体颗粒凝集试验（TPPA）确证阳性。治疗结果分为成功或失败。使用社会科学统计软件包（SPSS）评估与治疗失败预测因素相关的人口统计学和临床特征。本研究还包括一个神经梅毒描述性亚研究。
共发现 637 例梅毒血清学阳性患者，但有 258 例因不符合纳入标准而被排除。然后对 379 例患者进行了人口统计学研究；14 例（3.7%）患者接受了神经梅毒治疗；纳入了 170 例完整数据的患者。所有患者中，42/170（24.7%）治疗失败，12/170（7.1%）再感染，116/170（68.2%）治疗成功。排除 12 例再感染患者后，又有 158 例患者被纳入并分析了治疗失败的预测因素。多变量逻辑回归分析发现，仅低基线 RPR（<1:16）有统计学意义（p 值：0.007，95%CI：1.42，9.21）。
大多数患者为 HIV 阳性，来自男男性接触者（MSM）人群。低基线 RPR 滴度是治疗失败的预测因素。
