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P3.086 Changing Patterns of Syphilis in Asia-Pacific
  1. K Verma
  1. All India Institute of Medical Sciences, New Delhi, India


The pattern of STIs has changed dramatically world over in the last 2 decades. Syphilis had decreased significantly till 90s, but re-emerged with alarming intensity in last decade. Of about 12 million new cases of syphilis annually globally, 90% occur in developing countries of which about 4 million are in Asia.

We analysed the pattern of syphilis in various Asian countries and possible factors leading to this change in the last 2 decades.

In China, syphilis increased from 0.2/100,000 cases in 1993 to 5.7/100,000 in 2005 and congenital syphilis had an annual increase of > 71%. High risk groups like CSWs and MSMs had syphilis 1 in 5–10 cases. In Singapore, it had risen from 10/100,000 cases in 1979 to 29/100,000 in 1986. Female prostitutes, reduced herd immunity, decreased penicillin use, greater population movement and decreased surveillance were main contributory factors to this change. Infectious syphilis increased from 3.1/100,000 in 2004 to 6.6/100,000 in 2007 in Australia. Blood donors in India had increased seroprevalence of syphilis. Also it was the commonest ulcerative STI seen 46% male inmates in a Delhi gaol in 1999. Similarly, 37% transsexuals in Karachi, Pakistan in 1999 and 20% in Indonesia had syphilis, where as 23% HIV drug users had syphilis in Bangladesh. In Southeast Asia and Western Pacific region also syphilis has increased in the last decade mainly due to booming sex industry, travel and tourism, migration of workers and poor control measures. However syphilis has decreased from > 17/100,000 in 1993 to < 2/100,000 cases in 2008 in Thailand and from 11/100,000 in 1998 to 3/100,000 in 2007 in Malaysia primarily due to strict control measures which lead to decline of other STIs and HIV also. Early recognition of cases, their adequate treatment and effective control measures are warranted to control syphilis.

  • Asia Pacific
  • Syphilis
  • Trends

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