London School of Hygiene & Tropical Medicine, London, UK; University of Manitoba, Winnipeg, MB, Canada.
London School of Hygiene & Tropical Medicine, London, UK.
Lancet. 2023 Jul 22;402(10398):336-346. doi: 10.1016/S0140-6736(22)02348-0.
Syphilis is a sexually and vertically transmitted bacterial infection caused by the bacterium Treponema pallidum. Its prevalence is high in low-income and middle-income countries, and its incidence has increased in high-income countries in the last few decades among men who have sex with men. Syphilis is a major cause of adverse pregnancy outcomes in low-income and middle-income countries. Clinical features include a primary chancre at the point of inoculation, followed weeks later by the rash of secondary syphilis, a latent period, and in some cases, involvement of the eyes, CNS, and cardiovascular systems. It is diagnosed serologically. A single intramuscular dose of long-acting benzathine penicillin is recommended for people who have had syphilis for less than 1 year and longer courses for people with late latent syphilis. Control strategies include screening and treatment of all pregnant women, and targeted interventions for groups at high risk. Vaccine development, research on antibiotic prophylaxis, and digital messaging as prevention strategies are ongoing.
梅毒是一种由苍白密螺旋体引起的性传播和垂直传播的细菌性感染。在中低收入国家，其流行率较高，而在过去几十年中，高收入国家的男男性行为者中，梅毒的发病率有所增加。梅毒是中低收入国家不良妊娠结局的主要原因。临床特征包括接种部位的原发性下疳，数周后出现二期梅毒疹、潜伏期，在某些情况下还会累及眼睛、中枢神经系统和心血管系统。该病通过血清学诊断。对于感染梅毒不到 1 年的患者，建议单次肌内注射长效苄星青霉素；对于潜伏后期梅毒患者，建议使用更长疗程的药物。控制策略包括对所有孕妇进行筛查和治疗，以及针对高危人群的针对性干预。疫苗开发、抗生素预防研究和数字信息传递作为预防策略正在进行中。
