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Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
■从2010年开始，中国政府启动了为期10年的梅毒控制计划，称为国家梅毒控制计划（NSCP），来应对梅毒的威胁.我们旨在评估NSCP计划在江苏省梅毒控制中的效果。中国。
■梅毒发病率的时间趋势，安全套的患病率和使用率采用Joinpoint回归分析,包括年平均变化百分比(APC)和年平均百分比(APPC).采用卡方检验分析不同亚组的结局。使用ArcGIS分析梅毒发病率的时空分布。
■地理，在NSCP期间，全省所有地区的早期和先天性梅毒发病率显着下降。早期梅毒发病率从每100,000人21.1降至8.8（APC：-7.5，95CI：-8.6，-6.5，p<0.001），从2010年到2020年，每100,000名新生儿中，先天性梅毒从63.6降至4.1（APC：-14.8，95CI：-20.8，-8.4，p<0.01）。此外，在男男性行为者中，梅毒患病率从13.4降至3.8%(APC:-8.7,95CI:-12.1,-5.0,p=0.001)，从5.3％到1.7％（APC：-7.9，95CI：-11.7，-3.8，p=0.002）在女性性工作者中保持在1.0％以下，在孕妇中略有差异（APC：0.3，95CI：-4.3，5.1，p=0.877）。0.2%(2436)在怀孕期间接受免费梅毒检测的孕妇被诊断患有目前的梅毒感染,该省97.0％（2555）的新生儿被送往诊断为梅毒的妇女。91.8%(2,346)的活婴儿和约90%的确诊患者接受了完整的标准梅毒诊断和治疗服务。
■实施NSCP后，早期梅毒发病率和梅毒患病率的趋势在几乎所有关键人群中都显示出相当大的下降趋势。先天性梅毒也显著减少，应持续和加强NSCP计划，以进一步控制中国的梅毒流行。
■梅毒发病率的时间趋势，安全套的患病率和使用率采用Joinpoint回归分析,包括年平均变化百分比(APC)和年平均百分比(APPC).采用卡方检验分析不同亚组的结局。使用ArcGIS分析梅毒发病率的时空分布。
■地理，在NSCP期间，全省所有地区的早期和先天性梅毒发病率显着下降。早期梅毒发病率从每100,000人21.1降至8.8（APC：-7.5，95CI：-8.6，-6.5，p<0.001），从2010年到2020年，每100,000名新生儿中，先天性梅毒从63.6降至4.1（APC：-14.8，95CI：-20.8，-8.4，p<0.01）。此外，在男男性行为者中，梅毒患病率从13.4降至3.8%(APC:-8.7,95CI:-12.1,-5.0,p=0.001)，从5.3％到1.7％（APC：-7.9，95CI：-11.7，-3.8，p=0.002）在女性性工作者中保持在1.0％以下，在孕妇中略有差异（APC：0.3，95CI：-4.3，5.1，p=0.877）。0.2%(2436)在怀孕期间接受免费梅毒检测的孕妇被诊断患有目前的梅毒感染,该省97.0％（2555）的新生儿被送往诊断为梅毒的妇女。91.8%(2,346)的活婴儿和约90%的确诊患者接受了完整的标准梅毒诊断和治疗服务。
■实施NSCP后，早期梅毒发病率和梅毒患病率的趋势在几乎所有关键人群中都显示出相当大的下降趋势。先天性梅毒也显著减少，应持续和加强NSCP计划，以进一步控制中国的梅毒流行。
