Enhanced Surveillance of Infectious Syphilis in New Zealand Sexual Health Clinics - 2013

Tuesday 17th September 2019


Executive Summary

Background
There was an increase in the number of infectious syphilis cases reported by Sexual Health Clinics (SHCs) from 2002–2009 as part of New Zealand Sexually Transmitted Infection (STI) surveillance. During this period several separate studies showed clusters of syphilis in different areas of the country amongst men who have sex with men (MSM). A pilot project for national enhanced syphilis surveillance was undertaken by the AIDS Epidemiology Group (AEG) in 2011.
ESR took over reporting enhanced syphilis surveillance in 2013. A steering group of representatives from the Sexual Health Society reviewed the questionnaire previously used by AEG. The questionnaire was updated to include additional questions and remove questions that were considered to be unnecessary.

Methods
This report draws on data collected by AEG for 2011 and 2012 as well as 2013 data collected by ESR. Basic demographic information such as age or place of diagnosis is reported by sex. All other data presented in this report are categorised by sexual behaviour (MSM and heterosexual).

Findings
Eighty-one cases of infectious syphilis were reported by SHCs in 2013, an increase from 2012. Seventy-three (90.1%) cases were male. The highest numbers of cases were reported in Auckland (41 cases) and Christchurch (18 cases). The 45–49 years age group had the highest number of cases (16) and all of these cases were male. Sixty-three (86.3%) male cases were reported as being MSM, including four cases who also had sex with females. The most commonly reported ethnic group in MSM cases was NZ European (62.9%). Most MSM and heterosexual cases were infected in New Zealand (81.0% and 80.0% respectively).
For MSM cases, the initial testing was most likely to have been in a SHC (46 cases). The most commonly reported primary reason for testing in MSM cases was clinical symptoms or suspicion. More MSM cases reported symptoms than heterosexual cases (65.1% and 27.8% respectively). More MSM cases also reported a concurrent STI diagnosis than heterosexual cases (27.0% and 11.1% respectively). Eighteen (29.0%) MSM cases were HIV seropositive. Forty MSM cases (65.6%) had two or more sexual partners in the previous three months. The most commonly reported context leading to infection for MSM cases was internet-dating and sex-on-site venues (10 cases each).

Discussion
This report highlights the usefulness of enhanced surveillance to inform a response to recent increases in case numbers for infectious syphilis in New Zealand, but also notes the limitations of this surveillance. Full reporting by laboratories and follow-up by appropriately skilled sexual health or public health physicians to confirm the case status would give a more complete picture of the epidemiology of this serious disease in New Zealand.

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Enhanced Surveillance of Infectious Syphilis in New Zealand Sexual Health Clinics - 2013

 

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Enhanced Surveillance of Infectious Syphilis in New Zealand Sexual Health Clinics - 2013

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