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Title: | The rise of infectious syphilis in Victoria and the impact of enhanced clinical testing. | Authors: | Lewis J.;Hellard M.;Roth N.;Medland N.;Goller J.;Leslie D.;Guy R.;Allen K. | Institution: | (Allen, Guy, Goller, Lewis, Hellard) Centre for Epidemiology, Population Health Research, Macfarlane Burnet Institute for Medical Research and Public Health, Australia (Allen, Goller) Victorian Public Health Training Scheme, Department of Human Services, Australia (Guy) Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia (Leslie) Victorian Infectious Diseases Reference Laboratory, Australia (Medland) The Centre Clinic, Australia (Roth) Prahran Market Clinic, Australia (Allen) Centre for Clinical Effectiveness, Southern Health, Monash Institute of Health Services Research, Locked Bag 29, Clayton, VIC 3168, Australia | Issue Date: | 16-Oct-2012 | Copyright year: | 2008 | Publisher: | Public Health Association of Australia Inc. (PO Box 319, Curtin ACT 2605, Australia) | Place of publication: | Australia | Publication information: | Australian and New Zealand Journal of Public Health. 32 (1) (pp 38-42), 2008. Date of Publication: February 2008. | Abstract: | Objective: Passive surveillance indicates a clear increase in infectious syphilis cases in Victoria, but trends are likely to be influenced by changes in testing. We therefore used testing data from two Melbourne clinics with a high caseload of men who have sex with men to examine infectious syphilis prevalence, time trends and risk factors for infection. Method(s): We extracted laboratory testing data on all males tested for syphilis at the clinics between 2000 and 2004, including demographic information, syphilis test results and laboratory information used to assign HIV status (a HIV positive diagnosis or HIV positive clinical monitoring data). Result(s): Of 7,906 syphilis tests conducted at the two clinics, overall 1.4% resulted in a diagnosis of infectious syphilis, significantly increasing from 0.5% in 2000 to 2.5% in 2004, p<0.01, and among HIV positive males significantly increasing from 0.0% in 2000 to 6.1% in 2004, p<0.01. The frequency of annual syphilis testing among HIV positive males attending for any STI testing significantly increased from 47.3% in 2000 to 81.4% in 2004, p<0.01. Between 2002 and 2003, the syphilis testing rate per 1,000 consultations increased by 44% (from 65.3 to 94.3 tests per 1,000 consultations) compared with a 500% increase in the infectious syphilis diagnosis rate (from 0.2 to 1.2 positive tests per 1,000 consultations). Conclusions and Implications: The increase in infectious syphilis notifications appears unrelated to the observed increased in testing and is more likely to be attributed to increased transmission, highlighting the need for urgent prevention interventions. © 2008 The Authors. Journal Compilation © 2008 Public Health Association of Australia. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/j.1753-6405.2008.00164.x | PubMed URL: | 18290912 [http://www.ncbi.nlm.nih.gov/pubmed/?term=18290912] | ISSN: | 1326-0200 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/31666 | Type: | Article | Subjects: | male sexually transmitted disease/di [Diagnosis] sexually transmitted disease/et [Etiology] sexually transmitted disease/pc [Prevention] *syphilis/di [Diagnosis] *syphilis/et [Etiology] *syphilis/pc [Prevention] syphilis serology Treponema pallidum Human immunodeficiency virus adolescent adult article Australia clinical practice consultation controlled study demography diagnostic test enzyme immunoassay health care facility health survey hemagglutination test homosexuality human Human immunodeficiency virus infected patient Human immunodeficiency virus infection/et [Etiology] incidence infection control major clinical study health survey hemagglutination test homosexuality human Human immunodeficiency virus Human immunodeficiency virus infected patient Human immunodeficiency virus infection / etiology incidence infection control major clinical study male article *syphilis / *diagnosis / *etiology / *prevention syphilis serology Treponema pallidum adult adolescent sexually transmitted disease / diagnosis / etiology / prevention Australia clinical practice consultation controlled study demography diagnostic test enzyme immunoassay health care facility |
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