School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
Sun-Yat Sen University Cancer Center, Guangzhou, 510080, Guangdong, China.
Infection. 2022 Oct;50(5):1179-1190. doi: 10.1007/s15010-022-01791-1. Epub 2022 Mar 17.
To evaluate the effectiveness of preventive and control measures for congenital syphilis (CS) implemented since 2012 in Guangdong Province, China, and assess the epidemic trend in the near future.
The interrupted time series analysis was conducted to compare changes in slope and level of CS notification rate from 2005 to 2020 in Guangdong Province and its three regions with different economic developmental levels. The ARIMA model was established to predict the new CS case number of Guangdong Province in 2021.
A total of 12,687 CS cases were reported from 2005 to 2020. The CS notification rate of the province had been increasing until 2012 (128.55 cases per 100,000 live births) and then been decreasing constantly, hitting the lowest point in 2020 (5.76 cases per 100,000 live births). The severe epidemic cluster shifted from the developed region to underdeveloped ones over time. The effectiveness of the measures was proved by the significant change in the slope of the notification rate which was found in both of the provinces (- 18.18, 95% CI - 25.63 to - 10.75) and two less-developed regions (- 10.49, 95% CI - 13.13 to - 7.86 and - 32.89, 95% CI - 41.67 to - 24.10, respectively). In the developed region where the notification rate had already been decreasing in the pre-implementation period, implementing these measures also aided in hastening the rate of descent. The CS case number in 2021 was predicted to be 48, indicating a low-level epidemic.
The preventive and control measures have assisted Guangdong Province to control CS effectively, of which the supportive ones ensured a successful implementation. For resource-limited countries where CS is still endemic, especially guaranteeing the support in financial subsidy, professional training, supervision and so on might trigger the effectiveness of other measures and eventually make significant and sustainable progress.
评估 2012 年以来中国广东省先天性梅毒（CS）预防和控制措施的效果，并评估近期的流行趋势。
采用中断时间序列分析比较广东省及其三个经济发展水平不同地区 2005 年至 2020 年 CS 报告发病率的斜率和水平变化。建立 ARIMA 模型预测 2021 年广东省新 CS 病例数。
2005 年至 2020 年共报告 12687 例 CS 病例。该省的 CS 报告发病率一直在增加，直到 2012 年（每 10 万活产 128.55 例），然后持续下降，2020 年达到最低点（每 10 万活产 5.76 例）。随着时间的推移，严重的疫情集群从发达地区转移到欠发达地区。通知率斜率的显著变化证明了措施的有效性，在全省（-18.18，95%置信区间-25.63 至-10.75）和两个欠发达地区（-10.49，95%置信区间-13.13 至-7.86 和-32.89，95%置信区间-41.67 至-24.10）都发现了这一变化。在实施这些措施之前，通知率已经在下降的发达地区，实施这些措施也有助于加快下降速度。预测 2021 年 CS 病例数为 48 例，表明疫情处于低水平。
预防和控制措施有效控制了广东省 CS，其中支持措施确保了措施的成功实施。对于 CS 仍流行的资源有限的国家，特别是保证在财政补贴、专业培训、监督等方面的支持，可能会引发其他措施的有效性，并最终取得显著和可持续的进展。
