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Keywords = congenital syphilis epidemiology

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17 pages, 515 KiB  
Review
The Epidemiology of Syphilis Worldwide in the Last Decade
by Francois Rosset, Valentina Celoria, Sergio Delmonte, Luca Mastorino, Nadia Sciamarrelli, Sara Boskovic, Simone Ribero and Pietro Quaglino
J. Clin. Med. 2025, 14(15), 5308; https://doi.org/10.3390/jcm14155308 - 28 Jul 2025
Viewed by 559
Abstract
Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global [...] Read more.
Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation—including diagnostics and potential vaccine research—are critical to controlling the global syphilis epidemic. Full article
(This article belongs to the Section Epidemiology & Public Health)
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11 pages, 2074 KiB  
Case Report
Syphilis Infection During Pregnancy: The Possible Effect on the Course of Pregnancy and Fetal Outcomes—A Case Report and Literature Review
by Dovile Kielaite, Saule Januskiene and Virginija Paliulyte
Biomedicines 2025, 13(1), 169; https://doi.org/10.3390/biomedicines13010169 - 13 Jan 2025
Cited by 3 | Viewed by 2644
Abstract
Background/Objectives: A wide range of syphilis-related pregnancy complications are encountered in clinical practice. Active surveillance of the epidemiological situation in different countries and a series of retrospective data analyses allow for a comprehensive assessment of the feasible consequences of syphilis infection during pregnancy. [...] Read more.
Background/Objectives: A wide range of syphilis-related pregnancy complications are encountered in clinical practice. Active surveillance of the epidemiological situation in different countries and a series of retrospective data analyses allow for a comprehensive assessment of the feasible consequences of syphilis infection during pregnancy. The negative effects of infection on reproductive health are also described. Risk-increasing factors (inadequate or late treatment, partner coinfection) and protective factors (timely diagnostics and treatment) are distinguished. The importance of adequate and timely management as well as the accessibility of healthcare and socioeconomic status, which influence health outcomes, are stressed. This article presents a rare case of untreated syphilis infection during pregnancy. The infection was diagnosed during the first antenatal visit; how-ever, treatment was not initiated. At the 33rd week of gestation, the patient was admitted to the hospital because of sparse bloody vaginal discharge. Following sudden fetal hypoxia, an urgent cesarean section was performed at 33 weeks of gestation. A preterm newborn was delivered in critical condition, and congenital syphilis was diagnosed. Methods: We searched the PubMed, Cochrane, and MeSH databases using the key search terms “treponema pallidum”, “sexually transmitted infections”, “pregnancy”, “congenital infection”, “syphilis”, and “congenital syphilis”, as well as their combinations. A total of 28 papers published over a ten-year period were included in the literature review. A clinical case was analyzed. Results: The impact of syphilis on pregnancy is quite evident. Our case showcased one of the most common impacts, i.e., premature birth, of congenital infections with associated bacterial meningitis, respiratory distress syndrome, multiple organ damage, and insufficient weight. Such associations with many adverse pregnancy outcomes as well as congenital syphilis and neonatal defects are often avoidable. Conclusions: Considering the potential consequences of infections, the issue of sexually transmitted diseases remains relevant, and improving diagnostic and treatment opportunities becomes of paramount importance as cases increase. Full article
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19 pages, 3010 KiB  
Review
Congenital Syphilis: A Re-Emerging but Preventable Infection
by Serena Salomè, Maria Donata Cambriglia, Giovanna Montesano, Letizia Capasso and Francesco Raimondi
Pathogens 2024, 13(6), 481; https://doi.org/10.3390/pathogens13060481 - 6 Jun 2024
Cited by 10 | Viewed by 4862
Abstract
Congenital syphilis presents a significant global burden, contributing to fetal loss, stillbirth, neonatal mortality, and congenital infection. Despite the target established in 2007 by the World Health Organization (WHO) of fewer than 50 cases per 100,000 live births, the global incidence is on [...] Read more.
Congenital syphilis presents a significant global burden, contributing to fetal loss, stillbirth, neonatal mortality, and congenital infection. Despite the target established in 2007 by the World Health Organization (WHO) of fewer than 50 cases per 100,000 live births, the global incidence is on the rise, particularly in low- and middle-income regions. Recent data indicate a rate of 473 cases per 100,000 live births, resulting in 661,000 total cases of congenital syphilis, including 355,000 adverse birth outcomes such as early fetal deaths, stillbirths, neonatal deaths, preterm or low-birth-weight births, and infants with clinical congenital syphilis. Alarmingly, only 6% of these adverse outcomes occurred in mothers who were enrolled, screened, and treated. Unlike many neonatal infections, congenital syphilis is preventable through effective antenatal screening and treatment of infected pregnant women. However, despite available screening tools, affordable treatment options, and the integration of prevention programs into antenatal care in various countries, congenital syphilis remains a pressing public health concern worldwide. This review aims to summarize the current epidemiology, transmission, and treatment of syphilis in pregnancy, as well as to explore global efforts to reduce vertical transmission and address the reasons for falling short of the WHO elimination target. Full article
(This article belongs to the Special Issue Emerging and Re-emerging Infections in Pediatrics)
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7 pages, 192 KiB  
Review
Reemergence of Congenital Syphilis in the United States: A Narrative Review
by Omar Aboudawoud, Shahrukh Chaudhry, Pallavi Dubey and Ghislain Hardy
Venereology 2024, 3(2), 89-95; https://doi.org/10.3390/venereology3020007 - 18 Apr 2024
Viewed by 1819
Abstract
Congenital syphilis, a preventable and deadly disease, has witnessed an alarming resurgence in the US in recent years, posing a vital public health challenge. Historically, effective prevention and treatment strategies led to a decline in congenital syphilis, and some believed that it could [...] Read more.
Congenital syphilis, a preventable and deadly disease, has witnessed an alarming resurgence in the US in recent years, posing a vital public health challenge. Historically, effective prevention and treatment strategies led to a decline in congenital syphilis, and some believed that it could be eradicated. However, inadequate prenatal care, limited access to healthcare services, and gaps in syphilis screening programs have led to a resurgence of congenital syphilis. In this narrative review, we aim to highlight the key factors contributing to the reemergence of congenital syphilis and its implications on maternal and child health. Full article
15 pages, 2290 KiB  
Article
Sociodemographic and Clinical Factors for Microcephaly Secondary to Teratogenic Infections in Brazil: An Ecological Study
by Arlison Pereira Ferreira, Davi Silva Santana, Eric Renato Lima Figueiredo, Marcelo Coelho Simões, Dionei Freitas de Morais, Victória Brioso Tavares, Juliana Gonçalves de Sousa, Marcos Jessé Abrahão Silva, Fabiana de Campos Gomes and João Simão de Melo Neto
Viruses 2023, 15(8), 1675; https://doi.org/10.3390/v15081675 - 31 Jul 2023
Cited by 1 | Viewed by 1774
Abstract
Microcephaly is a neurological condition characterized by anomalies in the growth of the cranial circumference. This study aims to examine the association between sociodemographic and clinical variables and the occurrence of secondary microcephaly in newborns in Brazil. It also aims to investigate the [...] Read more.
Microcephaly is a neurological condition characterized by anomalies in the growth of the cranial circumference. This study aims to examine the association between sociodemographic and clinical variables and the occurrence of secondary microcephaly in newborns in Brazil. It also aims to investigate the association between this congenital anomaly and teratogenic infections. This research adopts an observational approach with an ecological, descriptive, and analytical design. The sample includes infants aged ≤28 days and registered in the country’s Live Births Information System from January 2015 to December 2021. Newborns were categorized into G1, consisting of newborns with one of the three infections (Zika, toxoplasmosis, or syphilis), and G2, consisting of newborns with two of the three infections. A total of 1513 samples were analyzed and divided into two groups: one infection (syphilis n = 423; toxoplasmosis n = 295; or Zika n = 739) and two infections (n = 56). The northeastern region of Brazil has the highest prevalence of microcephaly. Regarding the population profile, the Zika virus infection is more common among white mothers, while the syphilis infection is more common among black mothers. Among newborns with microcephaly, boys have a lower prevalence of toxoplasmosis infection, while girls have a lower prevalence of Zika virus infection. This study provides pertinent information on each infection and contributes to the epidemiologic understanding of the association between teratogenic infections and microcephaly. Full article
(This article belongs to the Special Issue Long-Term Developmental Outcomes of Congenital Virus Infections)
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17 pages, 4703 KiB  
Article
Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil—A Comparative Analysis
by Talita Brito, Thaísa Lima, Aliete Cunha-Oliveira, André Noronha, Cintia Brito, Fernando Farias, Sedir Morais, Jailton Paiva, Cintia Honorato, Paulo Queirós, Sagrario Gómez-Cantarino, Márcia Lucena and Ricardo Valentim
Int. J. Environ. Res. Public Health 2023, 20(7), 5258; https://doi.org/10.3390/ijerph20075258 - 24 Mar 2023
Cited by 7 | Viewed by 4127
Abstract
(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a [...] Read more.
(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a new platform (Salus) developed by the Laboratory of Technological Innovation in Health in the scope of notification and management of disease data, including syphilis. In addition, this analysis aimed to assess whether Salus fully meets the necessary data management fields and can be indicated as a tool to improve health management in the context of syphilis in Brazil. (3) Results: In this study, the Salus functionalities were demonstrated and compared with the current Brazilian systems by discovering the existing gaps in the evaluated systems. The gaps found may explain the delay in meeting demands, the difficulty of making routine therapeutic follow-ups, in addition to interference with the vital purpose of follow-up in the epidemiological surveillance of diseases. As a result, Salus demonstrates functionalities that surpass all others and meet case management demands in a superior way to the systems currently used in the country. (4) Conclusions: The Brazilian health information systems related to the response to syphilis do not fulfill the purpose for which they were developed. Instead, they contribute to the fragmentation of health data and information, delays in diagnosis, incomplete case management, and loss of data due to inconsistencies and inadequate reporting. In addition, they are systems without interconnection, which do not articulate epidemiological surveillance actions with primary health care. All these factors may be obscuring accurate data on syphilis in Brazil, resulting in high and unnecessary public spending and late care for users of the Unified Health System (SUS). Full article
(This article belongs to the Special Issue Improving Healthcare Quality)
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8 pages, 927 KiB  
Article
High Incidence of Congenital Syphilis after Implementation of the Brazilian Ministry of Health Ordinances Related to Maternal Diagnostics
by Ítala Santos Veras, Caroline Alves Feitosa, Amâncio José de Souza, Leila Carvalho Campos, Galileu Barbosa Costa and Viviane Matos Ferreira
Pathogens 2021, 10(5), 606; https://doi.org/10.3390/pathogens10050606 - 15 May 2021
Cited by 1 | Viewed by 2710
Abstract
The increasing rates of maternal and congenital syphilis (CS) infections are public health concerns and need further investigation in order to provide better assistance in epidemiological surveillance and new strategies for the assistance and prevention of CS. In December 2011, the Brazilian Ministry [...] Read more.
The increasing rates of maternal and congenital syphilis (CS) infections are public health concerns and need further investigation in order to provide better assistance in epidemiological surveillance and new strategies for the assistance and prevention of CS. In December 2011, the Brazilian Ministry of Health (BMH) implemented ordinance number 3.242, reinforced in 2012 by ordinance number 77, aiming to improve the quality of the syphilis diagnosis system using rapid tests. Here, we evaluate the incidence, lethality, and possible factors associated with CS in Salvador, Bahia, in the pre-resolution period (2007 to 2011) and post-resolution (2012 to 2016). An observational, ecological time-series study is conducted using secondary data collected from the National Notifiable Diseases Information System (SINAN). Linear regression analysis to estimate increases or reductions in the mean incidence over time is also performed. A total of 5470 CS cases are analyzed. The incidence ranges from 2.1 cases per 1000 live births in 2007 to 17.1 cases per 1000 live births in 2019, showing a progressive increase in incidence over the years and reduction of lethality in the post-resolution period. The number of CS cases reported prior to the implementation of the ordinances (2007–2011) does not reveal a significant increase in the incidence. However, in the post-ordinances period (2012–2019), there is an average increase of the number of CS cases by three times over the years, with an average increase of 1.8 new cases annually. Our findings highlight the importance of diagnosis and support information in strategies for CS prevention. Furthermore, these data show a positive impact of resolutions on the diagnosis and evolution of the disease. Full article
(This article belongs to the Special Issue Congenital and Perinatal Infections)
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14 pages, 2113 KiB  
Article
Syphilis Notifications and the Triggering Processes for Vertical Transmission: A Cross-Sectional Study
by Samara Isabela Maia de Oliveira, Cecília Olívia Paraguai de Oliveira Saraiva, Débora Feitosa de França, Marcos Antônio Ferreira Júnior, Libna Helen de Melo Lima and Nilba Lima de Souza
Int. J. Environ. Res. Public Health 2020, 17(3), 984; https://doi.org/10.3390/ijerph17030984 - 5 Feb 2020
Cited by 11 | Viewed by 4111
Abstract
Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is [...] Read more.
Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student’s and Fisher’s tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
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