Descriptive Epidemiology of Syphilis

Descriptive Epidemiology measures the frequency of disease in a population, determines the characteristics of diseased individuals, and determines whether the occurrence of disease varies by place and time (Ashengrau & Seage, 2019). Sex is related to disparities in disease existence. Certain diseases are more common among men while other diseases are more prevalent among women (Ashengrau & Seage, 2019). This study was conducted in the country of Sweden resulting in a discussion on descriptive epidemiology for years 2000-2007 on the disease syphilis.

Syphilis a sexually transmitted disease, with different phases. Earlier phases last about three months and are highly infectious. However, the first indication of the first stage is most of the time tiny in shape, and an ulcer which is not painful. (Velicko & Arneborn, 2008). The Ulcer, for the most part, heals, the Bacterial infection grows to the second phase that every so often begins with a rash that can last weeks or months. Spreading can also develop during this stage when it becomes in contact with the mucous membrane of the skin. Syphilis can be controlled early and treated by detection (Velicko & Arneborn, 2008).

Treating adults prevents the abnormality of syphilis, which leads to serious newborn disorders, birth defects, and slower progression of the infant. According to the World Health Organization, there are 12 million newly developed cases that are new yearly and worldwide; in Western Europe, 140,000 new cases occur. (Velicko & Arneborn, 2008). Between the 1980s and 1990s, Syphilis and gonorrhea declined greatly. Increasingly sexual at-risk behavior and population movement have contributed to the rising cases of STDs, since 2000.

Rebirth of syphilis outbreaks occurs amongst men because men partake in sexual encounters with men (MSM) and therefore, increasing the dangers of sexual behavior. This was also learned in Sweden, reporting a decline in syphilis occurrences; in 1982 there were 5.8 cases per 100,000 individuals and in 1999, 0.4 cases per 100,000 individuals and by the year 2000, 1.1 cases per 100,000 individuals, and it has continued to rise. (Velicko & Arneborn, 2008). The age groups affected amongst the Swedish male population were individuals between the ages of 25-44 years old (Velicko & Arneborn, 2008).

  Increased trends of syphilis in a 2 to 3-year period from worldwide of the continent were reported, mainly the progressed outbreaks in low inner-city occurrence areas.  Largely, the (MSM) population outbreaks also was recorded between numerous subclasses: Escorts and their clients, Communities of Immigrants, and Heterosexual adults with various sex partners (Fenton, 2004). Various subpopulation epidemics, in Western Europe, affect sexuality, ethnicity, gender, age group, area of residence, and communication with public health services (Fenton, 2004).

Methods of syphilis cases hold data on age, sex, the county of which is reporting, steady gestation period, and the patient’s history. Also, types of infections were reported: showing symptoms or not showing symptoms, a regular diagnostic, and having sexual contact. Phases of the infection including first, secondary, and early stages of syphilis, late stages, the third stage of syphilis and the unknown (Cates, Rothenburg & Blount, 1996). Evidence on population not reporting the disease late dormant and the third stage of syphilis is used to discover the phases of the infection reported by the physicians (Righarts, Simms & Solomou, 2004). Non-notifiable cases are removed upon medical officials within the county if reported. Notifiable cases remain in the surveillance system and the Route of transmission is retrieved (Cates, Rothenburg & Blount, 1996).  During the collection of the route of transmission, patients are expected to indicate if their contacts are sexual if the contacts are sexual the patient must determine whether the contact is a heterosexual or a homosexual partner (Velicko & Arneborn, 2008).

The prevalence in syphilis among (MSM) in Sweden and the United Kingdom was considered based on evaluating the percentage of men reporting having sex with men, accounts for 2.5% between 16 to 44-year-old male population in the UK (Velicko & Arneborn, 2008). From the year 2000, the occurrence of syphilis began rising, in 2004 2.1 cases per 100,000 individuals to approximately 99 cases. In 2007, occurrences of 2.6 cases were reported, a rise of 136% compared in 2000 of 1.1cases per 100,000 individuals (Velicko & Arneborn, 2008). Syphilis occurrence during 2000-2007, was three to seven times higher amongst males than females. In 2001, male to female proportion raised to 7.5 cases, having the highest the 1990s. 80-88% of syphilis cases were reported as men, between 2000-2007 (Velicko & Arneborn, 2008).

During 2000-2007 the average age for females reported with syphilis had an average of 33 years, men disease-ridden through heterosexual interactions was 38 years, and men infected through homosexual contact had a median age of 39 years (Velicko & Arneborn, 2008). In Sweden, countries Skåne and Stockholm; and cities; Malmö and Stockholm reported the largest cases of syphilis between (MSM) during the years 2000-2007. Stockholm County in 2004 stayed focus on the (MSM) epidemic, with most cases reporting from around Stockholm County (Payne, Berglund & Henriksson, 2005).  Projected syphilis occurrences amongst (MSM) in Sweden was 20-28 times higher than that of the Swedish male populace (Velicko & Arneborn, 2008).

Discussing the descriptive epidemiology on syphilis among (MSM) case in Sweden gives insight into the occurrences during the years of 2000-2007 and identifies the most affected population among heterosexual men. This research has been interesting and has broadened my understanding of why the percentages of syphilis in Sweden were much higher among heterosexual men than women. However, in conclusion, the high risk of the disease is primarily due to the lack of using protective devices during sexual intercourse in addition to participating in high-risk sexual behavior.

References

• Ashengrau, A., & Seage, G. (2019). Descriptive Epidemiology. In essentials of epidemiology ( 4^th ed.). Burlington, MA: Jones & Bartlett Learning.
• Cates, W. J., Rothenburg, R. B., & Blount, J. H. (1996). Syphilis control: The historical context and epidemiologic basis for interrupting sexual transmission of treponema pallidum. Journal of the American Sexually Transmitted Disease Association, 23 (1), 68-75. Retrieved from journals.lwww.com/stdjournal/Fulltext/1996/01000/syphilis_Control_The_Historic_Context_and.13.aspx
• Fenton, K. (2004). A multilevel approach to understanding the resurgence and evolution of infectious syphilis in Western Europe. 9(12), Euro Surveillance. Retrieved from https://doi.org/10.2807/esm.09.12.00491-en
• Payne, L., Berglund, T., Henriksson, L., & Berggren-Palme, I. (2005). Re-emergence of syphilis in Sweden: results from a surveillance study for 2004. 10(45), Euro Surveillance. Retrieved from https://doi.org/10.2807/esw.10.45.02830-en
• Righarts A A., Simms I, L, W., Solomou M, & A, F. K. (2004). Syphilis surveillance and epidemiology in the United Kingdom. Euro Surveillance. 9(12), Retrieved from https://doi.org/10.2807/esm.09.12.00497-en
• Velicko I., Arneborn M, & Blaxhult, A. (2008). Syphilis epidemiology in Sweden: Re-emergence since 2000 primarily due to spread among men who have sex with men. Euro Surveillance. 13(50) Retrieved from https://doi.org/10.2807/ese.13.50.19063-en