Zika virus (ZIKV) has been detected in blood, urine, semen, cerebral spinal fluid, saliva, amniotic fluid, and breast milk. In most ZIKV infected individuals, the virus is detected in the blood to one week after the onset of symptoms and has been found to persist longer in urine and semen. To better understand virus dynamics, a prospective cohort study was conducted in Brazil to assess the presence and duration of ZIKV and related markers (viral RNA, antibodies, T cell response, and innate immunity) in blood, semen, saliva, urine, vaginal secretions/menstrual blood, rectal swab and sweat. The objective of the current manuscript is to describe the cohort, including an overview of the collected data and a description of the baseline characteristics of the participants. Men and women ≥ 18 years with acute illness and their symptomatic and asymptomatic household contacts with positive reverse transcriptase-polymerase chain reaction test for ZIKV in blood and/or urine were included. All participants were followed up for 12 months. From July 2017 to June 2019, a total of 786 participants (284 men, 502 women) were screened. Of these, 260 (33.1%) were enrolled in the study; index cases: 64 men (24.6%), 162 (62.3%) women; household contacts: 12 men (4.6%), 22 (8.5%) women. There was a statistically significant difference in age and sex between enrolled and not enrolled participants (p<0.005). Baseline sociodemographic and medical data were collected at enrollment from all participants. The median and interquartile range (IQR) age was 35 (IQR; 25.3, 43) for men and 36.5 years (IQR; 28, 47) for women. Following rash, which was one of the inclusion criteria for index cases, the most reported symptoms in the enrollment visit since the onset of the disease were fever, itching, arthralgia with or without edema, non-purulent conjunctivitis, headache, and myalgia. Ten hospitalizations were reported by eight patients (two patients were hospitalized twice) during follow up, after a median of 108 days following symptom onset (range 7 to 266 days) and with a median of 1.5 days (range 1 to 20 days) of hospital stay. A total of 4,137 visits were performed, 223 (85.8%) participants have attended all visits and 37 (14.2%) patients were discontinued.
To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016.For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI.For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases.Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.Produire des estimations de la prévalence et de l'incidence mondiales des infections urogénitales dues à la chlamydiose, à la gonorrhée, à la trichomonase et à la syphilis chez les femmes et les hommes de 15 à 49 ans, en 2016.Pour la chlamydiose, la gonorrhée et la trichomonase, nous avons systématiquement recherché les études menées entre 2009 et 2016 qui s’intéressaient à la prévalence. Nous avons également consulté des experts régionaux. Pour produire des estimations, nous avons eu recours à une méta-analyse bayésienne. Pour la syphilis, nous avons regroupé les estimations nationales obtenues à l'aide de Spectrum-STI.Pour la chlamydiose, la gonorrhée et/ou la trichomonase, 130 études étaient éligibles. Pour la syphilis, la base de données de Spectrum-STI contenait 978 points de données pour la période considérée. Les estimations de la prévalence mondiale en 2016 chez les femmes étaient les suivantes: chlamydiose 3,8% (intervalle d'incertitude de 95%, II: 3,3–4,5); gonorrhée 0,9% (II 95%: 0,7–1,1); trichomonase 5,3% (II 95%: 4,0–7,2); et syphilis 0,5% (II 95%: 0,4–0,6). Chez les hommes, les estimations de la prévalence étaient les suivantes: chlamydiose 2,7% (II 95%: 1,9-3,7); gonorrhée 0,7% (II 95%: 0,5-1,1); trichomonase 0,6% (II 95%: 0,4-0,9); et syphilis 0,5% (II 95%: 0,4–0,6). L'incidence totale estimée était de 376,4 millions de cas: 127,2 millions (II 95%: 95,1–165,9 millions) de cas de chlamydiose; 86,9 millions (II 95%: 58,6-123,4 millions) de cas de gonorrhée; 156,0 millions (II 95%: 103,4-231,2 millions) de cas de trichomonase; et 6,3 millions (II 95%: 5,5–7,1 millions) de cas de syphilis.Les estimations mondiales de la prévalence et de l'incidence de ces quatre infections sexuellement transmissibles guérissables restent élevées. Cette étude souligne la nécessité d'amplifier les efforts de collecte de données au niveau des pays et offre un point de référence pour suivre la progression de la Stratégie mondiale du secteur de la santé contre les IST 2016–2021 de l'Organisation mondiale de la Santé.Generar estimaciones de la prevalencia y la incidencia mundiales de la infección urogenital por clamidia, gonorrea, tricomoniasis y sífilis en mujeres y hombres de 15 a 49 años de edad en 2016.Para la clamidia, la gonorrea y la tricomoniasis, se realizaron búsquedas sistemáticas de estudios realizados entre 2009 y 2016 que registrasen la prevalencia. También se consultó a expertos regionales. Para generar estimaciones, se utilizó el metanálisis bayesiano. Para la sífilis, se añadieron las estimaciones nacionales generadas por el uso de Spectrum-STI.Para la clamidia, la gonorrea y/o la tricomoniasis, hubo 130 estudios que cumplían los criterios. Para la sífilis, la base de datos Spectrum-STI contenía 978 puntos de datos para el mismo periodo. Las estimaciones de prevalencia mundial en mujeres en 2016 fueron: clamidia 3,8 % (intervalo de incertidumbre, II, del 95 %: 3,3-4,5); gonorrea 0,9 % (II del 95 %: 0,7-1,1); tricomoniasis 5,3 % (II del 95 %: 4,0-7,2); y sífilis 0,5 % (II del 95 %: 0,4-0,6). Las estimaciones de prevalencia en hombres fueron: clamidia 2,7 % (intervalo de incertidumbre, II, del 95 %: 1,9-3,7); gonorrea 0,7 % (II del 95 %: 0,5-1,1); tricomoniasis 0,6 % (II del 95 %: 0,4-0,9); y sífilis 0,5 % (II del 95 %: 0,4-0,6). El total estimado de casos incidentes fue de 376,4 millones: 127,2 millones (II del 95 %: 95,1-165,9 millones) de casos de clamidia; 86,9 millones (II del 95 %: 58,6-123,4 millones) de casos de gonorrea; 156,0 millones (II del 95 %: 103,4-231,2 millones) de casos de tricomoniasis; y 6,3 millones (II del 95 %: 5,5-7,1 millones) de casos de sífilis.Las estimaciones mundiales de la prevalencia y la incidencia de estas cuatro enfermedades de transmisión sexual curables siguen siendo elevadas. El estudio destaca la necesidad de ampliar los esfuerzos de recopilación de datos a nivel nacional y proporciona una base inicial para el seguimiento de los progresos de la Estrategia Mundial del Sector de la Salud de la Organización Mundial de la Salud sobre las ETS entre 2016 y 2021.وضع تقديرات للانتشار والإصابة العالمية لعدوى الجهاز البولي التناسلي، وأمراض الكلاميديا، والسيلان، وداء المشعرات، والزهري لدى النساء والرجال، الذين تتراوح أعمارهم بين 15 و49 سنة، في عام 2016.بالنسبة للكلاميديا، والسيلان، وداء المشعرات، فقد قمنا بالبحث بشكل منهجي عن الدراسات التي تمت خلال الفترة من 2009 إلى 2016 والتي توضح مدى الانتشار. كما قمنا باستشارة خبراء إقليميين. ولوضع التقديرات، قمنا باستخدام التحليل التلوي Bayesian. بالنسبة لمرض الزهري، قمنا بتجميع التقديرات الوطنية الناتجة عن استخدام Spectrum-STI.بالنسبة لأمراض الكلاميديا، والسيلان، وداء المشعرات، كانت هناك 130 دراسة مؤهلة. وبالنسبة لمرض الزهري، احتوت قادة بيانات Spectrum-STI على 978 نقطة بيانات لنفس الفترة. كانت تقديرات الانتشار العالمي في عام 2016 في النساء: الكلاميديا 3.8% (فاصل عدم الثقة 95%: 3.3 إلى 4.5)، والسيلان 0.9% (فاصل عدم الثقة 95%: 0.7 إلى 1.1)، وداء المشعرات 5.3% (فاصل عدم الثقة 95%: 4.0 إلى 7.2)؛ والزهري 0.5% (فاصل عدم الثقة 95%: 0.4 إلى 0.6). كانت تقديرات الانتشار في عام 2016 في الرجال: الكلاميديا 2.7% (فاصل عدم الثقة 95%: 1.9 إلى 3.7)، والسيلان 0.7% (فاصل عدم الثقة 95%: 0.5 إلى 1.1)، وداء المشعرات 0.6% (فاصل عدم الثقة 95%: 0.4 إلى 0.9)، والزهري 0.5% (فاصل عدم الثقة 95%: 0.4–0.6). بلغ مجموع حالات الإصابة التقديري 376.4 مليون حالة: 127.2 مليون (فاصل عدم الثقة 95%: 95.1 إلى 165.9 مليون) حالات الكلاميديا؛ 86.9 مليون (فاصل عدم الثقة 95%: 58.6 إلى 123.4 مليون) حالات السيلان؛ 156.0 مليون (فاصل عدم الثقة 95%: 103.4 إلى 231.2 مليون) حالات داء المشعرات؛ 6.3 مليون (فاصل عدم الثقة 95%: 5.5 إلى 7.1 مليون) حالات الزهري.لا تزال التقديرات العالمية عالية لانتشار والإصابة بهذه الأمراض الأربعة المنقولة جنسياً والعلاج منها. تسلط الدراسة الضوء على الحاجة إلى توسيع جهود جمع البيانات على مستوى الدول، وتوفر خط أساس أولي لمراقبة التقدم المحرز في إستراتيجية قطاع الصحة العالمية التابع لمنظمة الصحة العالمية بشأن الأمراض المنقولة جنسياً خلال الفترة من 2016 إلى 2021.旨在估计 2016 年 15-49 岁男女泌尿生殖系统感染衣原体病、淋病、滴虫病和梅毒的全球患病率和发病率。.对于衣原体病、淋病和滴虫病,我们系统搜索了 2009 年至 2016 年间的患病率报告研究。我们还咨询了区域专家。为了生成估计值,我们使用了贝叶斯荟萃分析。对于梅毒,我们汇总分析了使用 Spectrum-STI 生成的全国估计值。.对于衣原体病、淋病和/或滴虫病,符合要求的有 130 项研究。对于梅毒, Spectrum-STI 数据库包含了同一时期的 978 个数据点。2016 年,全球女性患病率估计值为:衣原体病 3.8%(95% 不确定区间,UI:3.3-4.5);淋病 0.9%(95% UI:0.7–1.1);滴虫病 5.3%(95% UI:4.0–7.2)和梅毒 0.5%(95% UI:0.4-0.6)。全球男性患病率估计值为:衣原体病 2.7%(95% UI:1.9-3.7);淋病 0.7%(95% UI:0.5-1.1);滴虫病 0.6%(95% UI:0.4-0.9);梅毒 0.5%(95% UI:0.4-0.6)。预计病例总数为 3.764 亿:1.272 亿(95% UI:9510-16590 万)衣原体病病例;8690 万(95% UI:5860-12340 万)淋病病例;15600 万(95% UI:10340-23120 万)滴虫病病例;630 万(95% UI:550-710 万)梅毒病例。.对这四种可治愈的性传播疾病的患病率和发病率的全球估计值仍然很高。该研究强调了扩大国家级数据收集工作的必要性,并为监测 2016 至 2021 年世卫组织全球卫生部门性传播疾病战略的进展提供了初始基线。.Оценить распространенность в мировом масштабе и частоту урогенитальных инфекций, вызываемых хламидией, а также гонореи, трихомониаза и сифилиса у мужчин и женщин в возрасте от 15 до 49 лет по состоянию на 2016 год.Для хламидиоза, гонореи и трихомониаза авторы провели систематический поиск исследований, выполненных в период с 2009 по 2016 год, в которых приводились данные по распространенности заболеваний. Авторы также консультировались с международными специалистами. Для оценки использовался байесовский метаанализ. Для исследования сифилиса нами были объединены национальные оценки, созданные с использованием методики Spectrum-STI.Было обнаружено 130 исследований на тему хламидийной инфекции, гонореи и (или) трихомониаза. Что касается сифилиса, база данных Spectrum-STI за тот же период содержала 978 источников данных. По состоянию на 2016 год распространенность изучаемых заболеваний в мире среди женщин составляла: хламидиоз 3,8% (95%-й интервал неопределенности, ИН: 3,3–4,5), гонорея 0,9% (95%-й ИН: 0,7–1,1), трихомониаз 5,3% (95%-й ИН: 4,0–7,2) и сифилис 0,5% (95%-й ИН: 0,4–0,6). У мужчин распространенность хламидиоза составила 2,7% (95%-й ИН: 1,9–3,7), гонореи 0,7% (95%-й ИН: 0,5–1,1), трихомониаза 0,6% (95%-й ИН: 0,4–0,9) и сифилиса 0,5% (95%-й ИН: 0,4–0,6). Общее приблизительное количество случаев заболевания составило 376,4 млн человек: 127,2 млн (95 %-й ИН: 95,1–165,9 млн) случаев хламидийной инфекции, 86,9 млн (95%-й ИН: 58,6–123,4 млн) случаев гонореи, 156,0 млн (95%-й ИН: 103,4–231,2 млн) случаев трихомониаза и 6,3 млн (95%-й ИН: 5,5–7,1 млн) случаев сифилиса.Оценки мировой распространенности и частоты этих четырех излечимых инфекций, передаваемых половым путем (ИППП), остаются высокими. Исследование показывает необходимость предпринимать дальнейшие усилия по сбору данных на уровне каждой страны и может служить источником базовых значений для мониторинга прогресса в исполнении глобальных стратегий ВОЗ в секторе здравоохранения относительно ИППП на период 2016–2021 гг.
The Initiative for Global Elimination of Congenital Syphilis was launched in 2007, and the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched in 2010. In 2014, the World Health Organization, jointly with UNAIDS, UNICEF, UNFPA, and other global partners released guidance on the processes and criteria for dual elimination of mother-to-child transmission (MTCT) of HIV and syphilis. Countries all over the world are now striving for dual elimination. This presentation will address recent successes like Cuba and current strategies and new tools that can help to overcome barriers in the dual elimination of MTCT HIV and syphilis with a particular focus on MTCT of syphilis.
Abstract Background Between 2014 and 2016, Brazil experienced a severe shortage in penicillin supply, resulting in a lack of treatment among some pregnant women and newborns with syphilis and the use of non-evidence-based regimens. This study evaluated all live births in Fortaleza reported with CS in 2015 in order to identify the different therapeutic regimens used in newborns during this period of penicillin shortage. Methods A retrospective cross-sectional study design was conducted using manually extracted data from medical chart review of maternal and infant cases delivered in 2015 from all public maternity hospitals in the city of Fortaleza. Data collection occurred from June 2017 to July 2018. Results A total of 575 congenital syphilis cases were reported to the municipality of Fortaleza during 2015 and 469 (81.5%) were analyzed. Of these, only 210 (44.8%) were treated with a nationally-recommended treatment. As alternative therapeutic options, ceftriaxone was used in 65 (13.8%), Cefazolin in 15 (3.2%) and the combination of more than one drug in 179 (38.2%). Newborns with serum VDRL titers ≥1:16 ( p = 0.021), who had some clinical manifestation at birth ( p = 0.003), who were born premature ( p < 0.001), with low birth weight ( p = 0.010), with jaundice indicative of the need for phototherapy ( p = 0.019) and with hepatomegaly ( p = 0.045) were more likely to be treated with penicillin according to national treatment guidelines compared to newborns treated with other regimens. Conclusion During the period of shortage of penicillin in Fortaleza, less than half of the infants reported with CS were treated with a nationally-recommended regimen, the remaining received treatment with medications available in the hospital of birth including drugs that are not part of nationally or internationally-recommended treatment recommendations.
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