Abstract：
OBJECTIVE: To evaluate the effectiveness of preventive and control measures for congenital syphilis (CS) implemented since 2012 in Guangdong Province, China, and assess the epidemic trend in the near future.
METHODS: The interrupted time series analysis was conducted to compare changes in slope and level of CS notification rate from 2005 to 2020 in Guangdong Province and its three regions with different economic developmental levels. The ARIMA model was established to predict the new CS case number of Guangdong Province in 2021.
RESULTS: A total of 12,687 CS cases were reported from 2005 to 2020. The CS notification rate of the province had been increasing until 2012 (128.55 cases per 100,000 live births) and then been decreasing constantly, hitting the lowest point in 2020 (5.76 cases per 100,000 live births). The severe epidemic cluster shifted from the developed region to underdeveloped ones over time. The effectiveness of the measures was proved by the significant change in the slope of the notification rate which was found in both of the provinces (- 18.18, 95% CI - 25.63 to - 10.75) and two less-developed regions (- 10.49, 95% CI - 13.13 to - 7.86 and - 32.89, 95% CI - 41.67 to - 24.10, respectively). In the developed region where the notification rate had already been decreasing in the pre-implementation period, implementing these measures also aided in hastening the rate of descent. The CS case number in 2021 was predicted to be 48, indicating a low-level epidemic.
CONCLUSIONS: The preventive and control measures have assisted Guangdong Province to control CS effectively, of which the supportive ones ensured a successful implementation. For resource-limited countries where CS is still endemic, especially guaranteeing the support in financial subsidy, professional training, supervision and so on might trigger the effectiveness of other measures and eventually make significant and sustainable progress.
METHODS: The interrupted time series analysis was conducted to compare changes in slope and level of CS notification rate from 2005 to 2020 in Guangdong Province and its three regions with different economic developmental levels. The ARIMA model was established to predict the new CS case number of Guangdong Province in 2021.
RESULTS: A total of 12,687 CS cases were reported from 2005 to 2020. The CS notification rate of the province had been increasing until 2012 (128.55 cases per 100,000 live births) and then been decreasing constantly, hitting the lowest point in 2020 (5.76 cases per 100,000 live births). The severe epidemic cluster shifted from the developed region to underdeveloped ones over time. The effectiveness of the measures was proved by the significant change in the slope of the notification rate which was found in both of the provinces (- 18.18, 95% CI - 25.63 to - 10.75) and two less-developed regions (- 10.49, 95% CI - 13.13 to - 7.86 and - 32.89, 95% CI - 41.67 to - 24.10, respectively). In the developed region where the notification rate had already been decreasing in the pre-implementation period, implementing these measures also aided in hastening the rate of descent. The CS case number in 2021 was predicted to be 48, indicating a low-level epidemic.
CONCLUSIONS: The preventive and control measures have assisted Guangdong Province to control CS effectively, of which the supportive ones ensured a successful implementation. For resource-limited countries where CS is still endemic, especially guaranteeing the support in financial subsidy, professional training, supervision and so on might trigger the effectiveness of other measures and eventually make significant and sustainable progress.
摘要：
目的：评价广东省自2012年以来实施的先天性梅毒防治措施的效果。中国,并评估近期流行趋势。
方法：采用间断时间序列分析方法，比较了广东省及其三个经济发展水平不同的地区2005-2020年CS通知率斜率和水平的变化。建立ARIMA模型,对广东省2021年新增CS病例数进行预测。
结果：2005年至2020年共报告12,687例CS病例。到2012年，该省的CS通报率一直在增加(每10万活产128.55例)，然后一直在下降，达到2020年的最低点（每10万活产5.76例）。随着时间的推移，严重的流行病集群从发达地区转移到欠发达地区。在两个省（-18.18，95％CI-25.63至-10.75）和两个欠发达地区（-10.49，95％CI-13.13至-7.86和-32.89，95％CI-41.67至-24.10）的通知率斜率发生了显着变化，证明了措施的有效性。在执行前期间通知率已经下降的发达区域，实施这些措施也有助于加快下降速度。2021年的CS病例数预计为48例，表明疫情较低。
结论：预防和控制措施有助于广东省有效控制CS，其中的支持性保证了成功实施。对于CS仍然流行的资源有限的国家，特别是保证财政补贴的支持，专业培训,监督等可能会引发其他措施的有效性，并最终取得重大和可持续的进展。
方法：采用间断时间序列分析方法，比较了广东省及其三个经济发展水平不同的地区2005-2020年CS通知率斜率和水平的变化。建立ARIMA模型,对广东省2021年新增CS病例数进行预测。
结果：2005年至2020年共报告12,687例CS病例。到2012年，该省的CS通报率一直在增加(每10万活产128.55例)，然后一直在下降，达到2020年的最低点（每10万活产5.76例）。随着时间的推移，严重的流行病集群从发达地区转移到欠发达地区。在两个省（-18.18，95％CI-25.63至-10.75）和两个欠发达地区（-10.49，95％CI-13.13至-7.86和-32.89，95％CI-41.67至-24.10）的通知率斜率发生了显着变化，证明了措施的有效性。在执行前期间通知率已经下降的发达区域，实施这些措施也有助于加快下降速度。2021年的CS病例数预计为48例，表明疫情较低。
结论：预防和控制措施有助于广东省有效控制CS，其中的支持性保证了成功实施。对于CS仍然流行的资源有限的国家，特别是保证财政补贴的支持，专业培训,监督等可能会引发其他措施的有效性，并最终取得重大和可持续的进展。
