Prevalence of Treponema pallidum infection in individuals treated in a specialized medical center in Medellín, Colombia
DOI:
https://doi.org/10.17533/udea.rfnsp.e343212Keywords:
Syphilis; Treponema pallidum; Prevalence; Risk factors; ColombiaAbstract
Objective: To describe the prevalence of Treponema pallidum infection in individuals treated in a specialized medical center in Medellín, Colombia in 2019.
Methodology: A cross-sectional study was conducted, including 776 subjects of the general population (apparently healthy-asymptomatic and without risk factors for syphilis), 126 men who have sex with men (msm) and 190 vulnerable young people (low socioeconomic strata, unemployed and low educational level) which were identified within and beyond spaces of concentration of msm and non-governmental organizations. A survey and a detection test for IgG, IgM and IgA for T. pallidum specific antibodies were used as the primary information source.
Results: Prevalence of T. pallidum infection was 0.53 % in vulnerable young participants, 2.19% in the general population and 16.67 % in msm. The odds ratio of infection in subjects aged between 51 and 60 years was 13.8 (95% CI = 3.5-51.5) compared to that found in young people aged between 21 and 30 years; 12.0 (95% CI = 1.8-79.2) comparing those with low educational level to university students; 3.3 (95% CI = 1.1-9.9) for people without health insurance compared to those belonging to the contributory health insurance regime; and 8.1 (CI 95 % = 2.8-23.0) in those who have sex with key groups versus those who do not report these practices.
Conclusion: A low prevalence of T. pallidum infection was found in young participants, followed by subjects belonging to the general population and was higher in msm. Groups with the highest risk were identified (among the three subgroups studied), including subjects excluded from prevention programs, with a confluence of sexual risk factors and socioeconomic deprivation.
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References
Organización Mundial de la Salud. Cada día, más de 1 millón de personas contraen una infección de transmisión sexual curable [internet]. 2019 [citado 2020 mar. 20 ]. Disponible en: https://www.who.int/es/news-room/detail/06-06-2019-more-than-1-million-new-curable-sexually-transmitted-infections-every-day
Organización Panamericana de la Salud. Nuevas directrices terapéuticas para la clamidiasis, la gonorrea y la sífilis [internet]. 2016 [citado 2020 mar. 20 ]. Disponible en: https://www3.paho.org/hq/index.php?option=com_content&view=article&id=12446:new-guidelines-chlamydia-gonorrhoea-syphilis&Itemid=135&lang=es
Cerrada Bravo T. Sífilis: actualidad, diagnóstico y tratamiento. Rev Fac Med unam. 2003;46(6):236-42.
Contreras E, Zuluaga S, Ocampo V. Sífilis: la gran simuladora. Infectio. 2008;12(2):340-7.
World Health Organization (who). who guidelines for the treatment of Treponema pallidum (syphilis). Geneva: who; 2016.
Organización Mundial de la Salud (oms). Estrategia mundial del sector de la salud contra las infecciones de transmisión sexual, 2016-2021. Ginebra: oms [internet]. 2016[citado 2020 mar. 20 ]. Disponible en: http://apps.who.int/iris/bitstream/handle/10665/250253/WHO-RHR-16.09-spa.pdf;jsessionid=B5164CC9ECA13B116AAEAC2A2907B9EB?sequence=1
Colombia, Ministerio de Salud de Colombia, Fondo de Población de las Naciones Unidas (unfpa). Guía de práctica clínica (gpc) basada en la evidencia para la atención integral de la sífilis gestacional y congénita [internet]; 2014 [citado 2020 mar. 20 ]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/INEC/IETS/gpc%20%E2%80%93guia-completa-sifilis.pdf
Colombia, Instituto Nacional de Salud. Protocolo de vigilancia en salud pública de la sífilis gestacional y congénita [internet]; 2017 [citado 2020 mar. 20 ]. Disponible en: https://www.ins.gov.co/buscador-eventos/Lineamientos/PRO%20Sifilis_.pdf
Organización Panamericana de la Salud (OPS). Estrategia y plan de acción para la eliminación de la transmisión materno infantil del vih y de la sífilis congénita: estrategia de monitoreo regional. Washington DC: OPS; 2014.
Martínez-Garcés J, Macías-Vidal M, Maestre-Serrano R, et al. Serorreacción y prevalencia de sífilis en donantes de un banco de sangre de Barranquilla, Colombia. Biomédica. 2019;39(Supl. 1): 63-171. DOI: https://doi.org/10.7705/biomedica.v39i1.4245
Patiño Bedoya JA, Cortés Márquez MM, Cardona Arias JA. Seroprevalencia de marcadores de infecciones transmisibles por vía transfusional en banco de sangre de Colombia. Rev. Saúde Pública. 2012;46(6):950-9. DOI: https://doi.org/10.1590/S0034-89102012000600004
Villegas-Castaño A, Tamayo-Acevedo L. Prevalencia de infecciones de transmisión sexual y factores de riesgo para la salud sexual de adolescentes escolarizados, Medellín, Colombia, 2013. Iatreia. 2016;29(1):5-17. DOI: https://doi.org/10.17533/udea.iatreia.v29n1a01
Abbott. sd Bioline hiv/Syphilis Duo [internet]. 2018. [citado 2020 abr. 20]. Disponible en: https://www.globalpointofcare.abbott/es/product-details/sd-bioline-hiv-syphilis-duo.html
Colombia, Ministerio de Salud. Resolución 8430, por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud (1993 oct. 4).
Bouniot-Escobar SV, Muñoz-Vigueras CA, Norambuena-Vergara NR, et al. Prevalencia de conductas sexuales de riesgo en estudiantes de primer año de pregrado de la Universidad San Sebastián, Concepción, Chile, 2016: estudio descriptivo. Rev Colomb Obstet Ginecol. 2017;68(3):176-85. DOI: https://doi.org/10.18597/rcog.2799
Uribe Rodríguez, Ana Fernanda, Orcasita Pineda, Linda Teresa. Conductas sexuales de riesgo en estudiantes universitarios de la ciudad de Cali-Colombia. Rev. Virtual. Univ. Catol. Norte [internet]. 2009 [citado 2020 mar. 20].;(27):1-31. Disponible en: https://www.redalyc.org/articulo.oa?id=194215432004
Fustà-Novell X, Morgado-Carrasco D, Barreiro-Capurro A, et al. Syphilis maligna: A presentation to bear in mind. Actas Dermosifiliogr. 2019;110(3):232-7. doi: https://doi.org/10.1016/j.ad.2018.02.024
Bórquez C, Lobato I, Gazmuri P, et al. Prevalencia del virus de la inmunodeficiencia humana, virus de la hepatitis B y Treponema pallidum en reclusos del Centro de Detención Preventiva de Arica, Chile. Rev Chilena Infectol. 2017;34(5):453-7. doi: https://doi.org/10.4067/S0716-10182017000500453
Nayyar C, Chander R, et al. Evaluation of risk factors in patients attending sti clinic in a tertiary care hospital in North India. Indian J Sex Transm Dis AIDS. 2015;36(1):48-52. doi: https://doi.org/10.4103/0253-7184.156715
Cowley G, Milne G, Silva E, et al. Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau. Sex Transm Infect. 2021;97(1):51-55. doi: https://doi.org/10.1136/sextrans-2019-054351
Suehiro TT, Gimenes F, Souza RP, et al. High molecular prevalence of hpv and other sexually transmitted infections in a population of asymptomatic women who work or study at a Brazilian university. Rev Inst Med Trop Sao Paulo. 2021;(63):e1. DOI: https://doi.org/10.1590/S1678-9946202163001
Shi Y, Yang Y, Wang Y, et al. Prevalence and associated factors of Treponema pallidum infection in a rural area of southwestern China. bmc Public Health. 2020;20(1):824. DOI: https://doi.org/10.1186/s12889-020-08952-7
Köksal MO, Beka H, Evlice O, et al. Syphilis seroprevalence among hiv-infected males in Istanbul, Turkey. Rev Argent Microbiol. 2020;52(4):266-71. DOI: https://doi.org/10.1016/j.ram.2020.01.002
Arando M, Caballero E, Curran A, et al. The epidemiological and clinical characteristics of the epidemic of syphilis in Barcelona. Actas Dermosifiliogr. 2019;110(10):841-9. DOI: https://doi.org/10.1016/j.ad.2019.03.014
Fustà X, Fuertes I, Lugo-Colón R, et al. Syphilis epidemics: A descriptive study of patients diagnosed in a tertiary hospital between 2011 and 2015. Med Clin (Barc). 2017;149(12):536-539. DOI: https://doi.org/10.1016/j.medcli.2017.04.024
Gállego-Lezáun C, Arrizabalaga Asenjo M, González-Moreno J, et al. Syphilis in men who have sex with men: A warning sign for hiv infection. Actas Dermosifiliogr. 2015;106(9):740-5. DOI: https://doi.org/10.1016/j.ad.2015.05.010
González-Domenech CM, Antequera Martín-Portugués I, Clavijo-Frutos E, et al. Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men. Enferm Infecc Microbiol Clin. 2015;33(1):32-6. DOI: https://doi.org/10.1016/j.eimc.2014.07.013
Muntaner C, Rocha KB, Borrell C, et al. Clase social y salud en América Latina. Rev Panam Salud Publica. 2012;31(2):166-75.
Organización Mundial de la Salud. Nota informativa de la oms sobre el uso de la prueba doble de diagnóstico rápido del VIH y la sífilis [internet]. 2017 [citado 2020 mar. 20 ]. Disponible en: https://www.paho.org/es/documentos/nota-informativa-oms-sobre-uso-prueba-doble-diagnostico-rapido-vih-sifilis-2017
Bristow CC, Klausner JD, Tran A. Clinical test performance of a rapid point-of-care syphilis treponemal antibody test: A systematic review and meta-analysis. Clin Infect Dis. 2020;71(Supplement_1):S52-S57. DOI: https://doi.org/10.1093/cid/ciaa350
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