Evaluating the effect of the plan of national syphilis control in controlling the syphilis epidemic in Jiangsu, China 2010-2020

Lingen Shi; Liping Chen; Xiaoyan Liu; Haiyang Hu; Yuheng Chen; Yunting Chen; Zhi Zhang; Ying Zhou; Jing Lu; Dandan Yang; Wenhui Guan

doi:10.3389/fpubh.2023.1281229

Evaluating the effect of the plan of national syphilis control in controlling the syphilis epidemic in Jiangsu, China 2010-2020

Front Public Health. 2023 Dec 21:11:1281229. doi: 10.3389/fpubh.2023.1281229. eCollection 2023.

Authors

Lingen Shi^{1

2}, Liping Chen¹, Xiaoyan Liu¹, Haiyang Hu¹, Yuheng Chen¹, Yunting Chen¹, Zhi Zhang¹, Ying Zhou¹, Jing Lu¹, Dandan Yang¹, Wenhui Guan¹

Affiliations

¹ Jiangsu Provincial Center for Disease Control and Prevention, Institute for STI and HIV Control and Prevention, Jiangsu, China.
² Medical School, Nanjing University, Jiangsu, China.

Abstract

Background: Starting in 2010, the Chinese government initiated a 10-year syphilis control plan, called the national syphilis control plan (NSCP), to address the emerging threat of syphilis. We aimed to evaluate the effect of the NSCP plan on syphilis control in Jiangsu, China.

Methods: The temporal trends of syphilis incidence, prevalence and rate of condom use were estimated by Joinpoint regression with average annual percent change (APC) and average annual percentage (APPC). A Chi-square test was conducted to analyze the outcomes in different subgroups. ArcGIS was used to analyze the spatiotemporal distribution of syphilis incidence.

Results: Geographically, early and congenital syphilis incidence decreased significantly in all areas of the province during the period of NSCP. Early syphilis incidence decreased from 21.1 to 8.8 (APC: -7.5, 95%CI: -8.6, -6.5, p < 0.001) per 100,000 people, and congenital syphilis decreased from 63.6 to 4.1 (APC: -14.8, 95%CI: -20.8, -8.4, p < 0.01) per 100,000 newborns from 2010 to 2020. Also, syphilis prevalence reduced from 13.4 to 3.8% (APC: -8.7, 95%CI: -12.1, -5.0, p = 0.001) among men who have sex with men, from 5.3 to 1.7% (APC: -7.9, 95%CI: -11.7, -3.8, p = 0.002) among female sex workers and remained under 1.0% with slight variations among pregnant women (APC: 0.3, 95%CI: -4.3, 5.1, p = 0.877) from 2010 to 2020. 0.2% (2,436) of pregnant women who received free syphilis testing during pregnancy were diagnosed with current syphilis infection, and 97.0% (2,555) of newborns in the province were delivered to women diagnosed with syphilis. 91.8% (2,346) of live babies and about 90% of diagnosed patients received complete standard syphilis diagnosis and treatment services.

Conclusion: Trends of early syphilis incidence and syphilis prevalence show a considerable decreasing trend among almost all the key populations after implementing NSCP. Congenital syphilis has significantly decreased as well and hence, the NSCP program should be sustained and strengthened to control the syphilis epidemic in China further.

Keywords: congenital syphilis; early syphilis; epidemic; evaluating; trends.

MeSH terms

China / epidemiology
Female
Homosexuality, Male
Humans
Infant
Infant, Newborn
Male
Pregnancy
Sex Workers*
Sexual and Gender Minorities*
Syphilis* / epidemiology
Syphilis* / prevention & control
Syphilis, Congenital* / epidemiology
Syphilis, Congenital* / prevention & control

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research received funding from Jiangsu Provincial Medical Key Discipline (No. ZDXK202250).