2008～2014年广州市梅毒流行现状及防治策略探讨

Epidemic Situation and Control Strategy of Syphilis in Guangzhou during 2008～2014

目的：为了解广州市贯彻实施《中国预防控制梅毒规划（2010~2020）》的成效,为下一步更好的控制梅毒提供指导。方法：从中国疾病预防控制中心传染病网络直报系统下载2008~2014年广州市医疗机构网络直报的广州市常住人口梅毒病例,SPSS软件分析广州市各类型梅毒基本特征。结果：2014年,广州市梅毒、早期显性梅毒、胎传梅毒、三期梅毒报告发病率分别为54.0/10万、9.1/10万、32.0/10万、1.0/10万,2008年以来分别年均下降2.1%、10.2%、32.5%、0.3%;而2014年隐性梅毒报告发病率为42.2/10万,报告病例数为6 305例,2008年以来分别年均增长0.04%、5.8%。在五种监测的性传播疾病（STD）中,梅毒报告发病率已经降为第二位。病例构成比表明：2014年,早期显性梅毒、胎传梅毒病例构成比分别为16.8%、0.8%,2008年以来年均分别下降8.2%、24.8%,而三期梅毒、隐性梅毒构成比分别为1.8%、80.6%,2008年以来年均分别上升1.8%、3.5%。60岁以上离退休老年梅毒患者逐年上升。结论：过去的6年间,以隐性梅毒为主的广州市梅毒流行上升势头得到遏制,梅毒总体发病率已经退居STDs中第二位,继续落实梅毒综合防治策略、强化以隐性梅毒为主的梅毒疫情报告管理是广州市当前梅毒防治工作的主要任务。

Objective：To assess the performance of National Syphilis Prevention and Control Plan （2010 -2020） and provide better instruction for syphilis control in next steps. Methods：Da- ta of syphilis cases of permanent resident population were obtained from unified CDC National No- tifiable Disease Reporting System （NNDRS） and basic characteristics of subtype syphilis were an- alyzed by SPSS 17.0. Results： The incidence of syphilis, early symptomatic syphilis （ including both primary and secondary syphilis）, congenital syphilis and tertiary syphilis was 54. 0/100,000, 9. 1/100,000, 32. 0/100,000 and 1.0/100,000 respectively, which had decreased by 2. 1%, 10. 2%, 32. 5%, and 0. 3% annually respectively since 2008. In 2014,6 305 cases have been reported and the incidence of latent syphilis was 42. 2/100,000 which increased annually by 0. 04% ,5.8% respectively since 2008. The incidence of general syphilis ranked 2nd among monitored five sexually transmitted diseases （STDs） since 2012. It was also showed that cases pro- portion for early symptomatic syphilis, congenital syphilis was 16. 8%, 0. 8% in 2014 and had decreased annually by 8.2%, 24.8% from 2008 respectively. On the contrary, the cases propor- tion for tertiary syphilis and latent syphilis was 1.8%, 80. 6% respectively in 2014, which had increased annually by 1.8%, 3.5% respectively. The number of retirees older than 65 who suf- fered syphilis is rising year by year. Conclusion：The increasing prevalence of syphilis, mainly consist of latent syphilis, has been curbed during the past six years. The general incidence of syphilis now ranks 2nd in monitored STDs, and the strategies basing on ＂ one integrating＂, ＂two systems＂, ＂three rates＂ and ＂four high risk population of syphilis infection＂ have been played important role in the process of syphilis control.