The Kirby Institute, Sydney, NSW.
University of Notre Dame Australia, Fremantle, WA.
Med J Aust. 2024 Aug 19;221(4):201-208. doi: 10.5694/mja2.52388. Epub 2024 Jul 15.
To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia.
Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data.
SETTING, PARTICIPANTS: Women aged 15-44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011-2021.
Numbers and rates of infectious syphilis notifications, by Indigenous status and age group; numbers and rates of congenital syphilis, by Indigenous status of the infant; antenatal care history for mothers of infants born with congenital syphilis.
During 2011-2021, 5011 cases of infectious syphilis in women aged 15-44 years were notified. The notification rate for Aboriginal and Torres Strait Islander women rose from 56 (95% confidence interval [CI], 45-65) cases per 100 000 in 2011 to 227 (95% CI, 206-248) cases per 100 000 population in 2021; for non-Indigenous women, it rose from 1.1 (95% CI, 0.8-1.4) to 9.2 (95% CI, 8.4-10.1) cases per 100 000 population. The notification rate was higher for Aboriginal and Torres Strait Islander women than for non-Indigenous women (incidence rate ratio [IRR], 23.1; 95% CI, 19.7-27.1), lower for 15-24- (IRR, 0.7; 95% CI, 0.6-0.9) and 35-44-year-old women (IRR, 0.6; 95% CI, 0.5-0.7) than for 25-34-year-old women, and higher in remote regions than in major cities (IRR, 2.7; 95% CI, 2.2-3.8). During 2011-2021, 74 cases of congenital syphilis were notified, the annual number increasing from six in 2011 to a peak of 17 in 2020; the rate was consistently higher among Aboriginal and Torres Strait Islander infants than among non-Indigenous infants (2021: 38.3 v 2.1 per 100 000 live births). The mothers of 32 infants with congenital syphilis (43%) had not received antenatal care.
The number of infectious syphilis notifications for women of reproductive age increased in Australia during 2011-2021, as did the number of cases of congenital syphilis. To avert congenital syphilis, antenatal screening of pregnant women, followed by prompt treatment for infectious syphilis when diagnosed, needs to be improved.
估计澳大利亚育龄妇女感染性梅毒和先天性梅毒的报告率。
回顾性队列研究；对全国感染性梅毒和强化先天性梅毒监测数据进行分析。
地点、参与者：2011-2021 年，澳大利亚诊断为感染性梅毒的 15-44 岁女性和患有先天性梅毒的婴儿。
按土著身份和年龄组划分的感染性梅毒报告数量和报告率；按婴儿土著身份划分的先天性梅毒报告数量和报告率；患有先天性梅毒的婴儿的母亲的产前护理史。
2011-2021 年期间，共报告了 5011 例 15-44 岁女性的感染性梅毒病例。土著和托雷斯海峡岛民妇女的报告率从 2011 年的每 10 万人口 56 例（95%置信区间 [CI]，45-65）上升到 2021 年的每 10 万人口 227 例（95% CI，206-248）；非土著妇女的报告率从每 10 万人口 1.1 例（95% CI，0.8-1.4）上升到每 10 万人口 9.2 例（95% CI，8.4-10.1）。土著和托雷斯海峡岛民妇女的报告率高于非土著妇女（发病率比 [IRR]，23.1；95% CI，19.7-27.1），15-24 岁（IRR，0.7；95% CI，0.6-0.9）和 35-44 岁（IRR，0.6；95% CI，0.5-0.7）年龄组的报告率低于 25-34 岁年龄组，偏远地区的报告率高于主要城市（IRR，2.7；95% CI，2.2-3.8）。2011-2021 年期间，共报告了 74 例先天性梅毒病例，每年报告数量从 2011 年的 6 例增加到 2020 年的 17 例；土著和托雷斯海峡岛民婴儿的报告率始终高于非土著婴儿（2021 年：每 10 万活产儿 38.3 例比 2.1 例）。先天性梅毒婴儿的母亲中有 32 名（43%）未接受产前护理。
2011-2021 年期间，澳大利亚育龄妇女感染性梅毒的报告数量增加，先天性梅毒的病例数量也有所增加。为了避免先天性梅毒，需要改进孕妇的产前筛查，并在诊断出感染性梅毒后及时进行治疗。
