Nepean and Nepean and Blue Mountains Sexual Health and HIV Service, Nepean and Blue Mountains Local Health District.
Nepean and Blue Mountains Public Health Unit, Nepean and Blue Mountains Local Health District.
Commun Dis Intell (2018). 2023 Mar 23;47. doi: 10.33321/cdi.2023.47.17.
Syphilis is a nationally notifiable sexually transmitted infection (STI). Rates of syphilis notifications have been on the increase in Australia. Given these increases, we wanted to study the epidemiological trends of syphilis notifications in the Nepean Blue Mountain Local Health District (NBMLHD) over a ten-year period across different healthcare settings.
All syphilis notifications in residents in the NBMLHD in the ten-year period between 1 October 2009 and 30 September 2019 were included in the study. Separate analyses were performed for all syphilis notifications, as well as for infectious syphilis and for syphilis acquired > 2 years ago or of unknown duration. We described age distribution and demographic profile and risk factors of all syphilis notifications. Notification trends were studied and crude incidence rates were calculated. Notifications were stratified by stage of syphilis, sex, and geographical location.
In the study duration, a total of 342 notifications of syphilis were received. Of these, 187 were infectious syphilis and 155 were related to infections acquired > 2 years ago and/or of unknown duration. The majority of notifications were in men: 281 (82%). Overall, syphilis notifications increased over the ten-year study period. The crude incidence rates for infectious syphilis were significantly higher in the second five-year period overall (7.78/100,000 population per year compared to 5.28/100,000 population per year; incidence rate ratio (IRR): 1.47; 95% confidence interval (95% CI): 1.10-1.97; p < 0.01), as well as for males (14.44/100,000 population per year compared to 9.7/100,000 population per year; IRR: 1.49; 95% CI: 1.09-2.03; p < 0.01). There were significant increases in syphilis notifications in males < 35 years of age, from 39 such notifications in the first five-year period (27.5% of all syphilis notifications in this period) to 83 notifications in the second five-year period (42.1% of all notifications in this period), p < 0.05.
In keeping with national trends, notifications in our study increased. Significant increases were noted in notifications among males under 35 years of age. This supports the continued investment in sexual health promotion activities aimed at young sexually active men. Expansion of screening activities to include women and older people would help detect any increase in cases in these groups. Increase in engagement with general practitioners will support them to provide opportunistic STI screens to sexually-active attendees. National screening recommendations remain applicable to this population.
梅毒是一种全国性须报告的性传播感染（STI）。在澳大利亚，梅毒的报告发病率一直在上升。鉴于这些增加，我们希望在十年期间研究不同医疗保健环境中 Nepean Blue Mountain 地方卫生区（NBMLHD）梅毒报告发病率的流行病学趋势。
在 2009 年 10 月 1 日至 2019 年 9 月 30 日期间，NBMLHD 中所有梅毒报告居民均纳入本研究。分别对所有梅毒报告、传染性梅毒和梅毒发病 > 2 年或发病时间不明进行了分析。我们描述了所有梅毒报告的年龄分布和人口统计学特征以及危险因素。研究了报告趋势并计算了粗发病率。按梅毒分期、性别和地理位置对报告进行分层。
在研究期间，共收到 342 例梅毒报告。其中，187 例为传染性梅毒，155 例与发病 > 2 年或发病时间不明的感染有关。大多数报告是男性：281 例（82%）。总体而言，在十年研究期间，梅毒报告发病率呈上升趋势。总体而言，第二个五年期间传染性梅毒的粗发病率明显更高（每年每 100,000 人 7.78 例，而每年每 100,000 人 5.28 例；发病率比（IRR）：1.47；95%置信区间（95%CI）：1.10-1.97；p < 0.01），男性也更高（每年每 100,000 人 14.44 例，而每年每 100,000 人 9.7 例；IRR：1.49；95%CI：1.09-2.03；p < 0.01）。<35 岁男性的梅毒报告发病率显著增加，从第一个五年期间的 39 例报告（该期间所有梅毒报告的 27.5%）增加到第二个五年期间的 83 例报告（该期间所有报告的 42.1%），p < 0.05。
与全国趋势一致，我们的研究中的报告发病率增加。<35 岁男性的报告发病率显著增加。这支持继续投资于针对年轻活跃男性的性健康促进活动。扩大筛查活动范围以包括女性和老年人将有助于发现这些人群中病例的任何增加。增加与全科医生的接触将支持他们为有性行为的患者提供机会性性传播感染筛查。国家筛查建议仍然适用于这一人群。
