Tetteh Ashorkor, Abdi Nadifa, Moore Victoria, Gravel Geneviève
Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
Front Public Health. 2025 Jan 17;12:1522671. doi: 10.3389/fpubh.2024.1522671. eCollection 2024.
The number of cases of confirmed early congenital syphilis has risen steeply in Canada in recent years, particularly since 2018, to the highest number ever recorded since national reporting began in 1993. We analyzed national data on confirmed early congenital syphilis from 1993 to 2022 to describe epidemiologic trends in Canada during this period.
Data from 1993 to 2017 were obtained from routine surveillance conducted through the Canadian Notifiable Disease Surveillance System, and data from 2018 to 2022 were obtained from enhanced surveillance conducted through a federal-provincial-territorial working group. Case counts and rates were computed nationally and by province and territory. Infectious syphilis data from the same time period for females of reproductive age were also analyzed.
The national rate of confirmed early congenital syphilis was 127-fold higher in 2022 than in 1993, increasing from 0.3 to 32.7 cases per 100,000 live births. Case counts began increasing rapidly in 2018, with the highest case count observed to date ( = 115) occurring in 2022. The highest rates in the country in recent years have been observed in Saskatchewan, Manitoba, Alberta, and Ontario. Infectious syphilis rates among females of reproductive age have also been rapidly increasing in these provinces. Between 2018 and 2022, the national rate of confirmed early congenital syphilis increased approximately seven-fold and the national rate of infectious syphilis increased approximately two-fold, including an approximately three-and-a-half-fold rate increase among females of reproductive age.
These numbers represent huge shifts in the epidemiological landscape of syphilis in Canada. The increase in vertical transmission appears to be driven by not only the increasing rate of infectious syphilis among females of reproductive age but also by multiple structural and social determinants of health impacting pregnant individuals.
近年来，加拿大确诊的早期先天性梅毒病例数急剧上升，特别是自2018年以来，达到了自1993年开始全国报告以来的最高纪录。我们分析了1993年至2022年确诊的早期先天性梅毒的全国数据，以描述这一时期加拿大的流行病学趋势。
1993年至2017年的数据来自通过加拿大法定疾病监测系统进行的常规监测，2018年至2022年的数据来自通过联邦-省-地区工作组进行的强化监测。计算全国以及各省和地区的病例数和发病率。还分析了同一时期育龄女性的感染性梅毒数据。
2022年全国确诊的早期先天性梅毒发病率比1993年高127倍，从每10万例活产0.3例增至32.7例。病例数在2018年开始迅速增加，迄今观察到的最高病例数（n = 115）出现在2022年。近年来该国发病率最高的是萨斯喀彻温省、马尼托巴省、艾伯塔省和安大略省。这些省份育龄女性的感染性梅毒发病率也在迅速上升。2018年至2022年期间，全国确诊的早期先天性梅毒发病率增加了约7倍，全国感染性梅毒发病率增加了约2倍，其中育龄女性发病率增加了约3.5倍。
这些数字代表了加拿大梅毒流行病学格局的巨大变化。垂直传播的增加似乎不仅是由育龄女性感染性梅毒发病率的上升驱动的，还受到影响孕妇的多种健康结构和社会决定因素的驱动。
