Background According to the Robert-Koch-Institut (RKI) syphilis incidence is increasing in Germany especially among men who have sex with men (MSM). North Rhine-Westphalia (NRW) is the federal state with the highest number of syphilis infections. By order of the Ministry of Health the Landeszentrum Gesundheit (lzg.nrw) organises and supports anonymous syphilis testing by local public health authorities (LPHA). Aim of this study was to assess how many syphilis cases could be detected and if hard-to-reach risk groups use the possibility of syphilis testing in this public health setting.
Methods 46 out of 53 LPHA in NRW offered their clients after counselling a syphilis screening test (chemiluminiscent microparticle immunoassay, CMIA, Abbott) performed in the German syphilis consiliary laboratory (Labor Krone, Bad Salzuflen). Reactive tests were confirmed by treponema pallidum particle agglutination assay (TPPA) and fluorescent treponemal antibody absorption test (FTA-abs)-IgG and further tested by 19s-IgM-FTA-abs and rapid plasma reagin assay (RPR).
Results In 2011–2012, 7961 clients were tested. There were 54.8% men, 44.4% women, mean age was 32.8 years, 35.8% were MSM, 28.4% female sex workers (FSW). 705 reactive tests could be confirmed by further analysis. 17.2% positive results were classified as active infections, 7.5% as suspected latent infections, and 75.3% as known, already treated treponemal infections. In 2011, the LPHA detected 79 out of 986 notifiable syphilis infections in NRW with higher proportions of MSM (67.1%) and women (22.7%), most of them FSW, in comparison to 52.7% MSM and 9.1% women in NRW reported to RKI.
Discussion Approximately 87% of the LPHA in NRW offered syphilis testing. A relevant number of active and latent syphilis was detected among LPHA clients and it could be shown that the LPHA were able to detect syphilis especially in high risk groups such as MSM and FSW which might have otherwise not been tested.