Retrospective study regarding syphilis morbidity in hospitalized patients

Abstract

Syphilis detection remains a systemic issue, given the prevalence of latent but contagious forms, in which patients may not seek testing due to unawareness of their illness. Syphilis screening triage initiated by the healthcare system through serological screening is usually conducted for at-risk groups. Naturally, morbidity detected in this manner is expected to be higher than in the general population. When screening is selectively applied to the general population, there is the possibility of capturing the true morbidity in the community. In this regard, the results of syphilis testing in groups such as pregnant women, blood donors, or hospitalized patients, for whom syphilis testing is institutionalized, are useful. Aim Evaluation of the epidemiological characteristics and clinical-evolutionary aspects of syphilis in a sample of hospitalized subjects at Anenii Noi District Hospital during the period 1986-2023. Material and methods The retrospective study included data extraction from the annual medical statistical reports No. 34 “Statistical Report on Syphilis, Gonorrhea, and Dermatomycosis Patients” for the years 1986-2023, presented by Anenii Noi District Hospital, analysis of seroprevalence data for syphilis from the hospital’s serological laboratory, as well as medical records of syphilis patients for the respective period. Results Syphilis morbidity during the period 1986-2023 was disaggregated over certain time frames: in 19861990, 6 (15.79%) hospitalized patients out of a total of 38 were detected in Anenii Noi district; 1991-1995 - 49 (13.88%) out of 353; 1996-2000 - 106 (14.91%) out of 711; 2001-2005 - 73 (15.94%) out of 458; 2006-2010 - 53 (16.99%) out of 312; 2011-2015 - 51 (19.39%) out of 263; 2016-2020 - 53 (24.54%) out of 216; 2021-2023 - 44 (36.67%) hospitalized patients out of a total of 120 at the district level. Thus, in the reference years 1986-2023, 2471 syphilis patients were recorded statistically in Anenii Noi district, with 445 (18%) patients detected through testing of hospitalized patients. It was found that the male-to-female ratio was asymmetric at 180/265, i.e., 0.68. Rural residents accounted for 89.21%. The age distribution was typical, proportional to sexual activity. The distribution of clinical forms of syphilis was analyzed: in 1986-1990 out of 6 hospitalized patients detected with syphilis, 5 (83.3%) had secondary syphilis and 1 (16.7%) had latent syphilis; 1991-1995 out of 49 - 2 (4.1%) had primary syphilis, 38 (77.35%) had secondary syphilis, and 9 (18.7%) had recent latent syphilis; 1996-2000 out of 106 - 6 (5.7%) had primary syphilis, 81 (76.4%) had secondary syphilis, and 19 (17.9%) had recent latent syphilis; 2001-2005 out of 83 patients - 3 (3.6%) had primary syphilis, 33 (39.8%) had secondary syphilis, and 47 (36.6%) had recent latent syphilis; 2006-2010 out of 53 - 2 (3.8%) had primary syphilis, 18 (34%) had secondary syphilis, and 33 (62.3%) had recent latent syphilis; 2011-2015 out of 51 - 3 (5.9%) had primary syphilis, 12 (23.5%) had secondary syphilis, and 36 (70.59%) had recent latent syphilis; 2016-2020 out of 53 - 6 (11.3%) had primary syphilis, 7 (13.2%) had secondary syphilis, and 40 (75.5%) had recent latent syphilis; 2021-2023 out of 44 - 1 (2.3%) had primary syphilis, 6 (13.6%) had secondary syphilis, and 37 (84.1%) had recent latent syphilis. Thus, out of the total of 445 hospitalized patients detected with syphilis, 23 (5.1%) had primary syphilis, 200 (44.9%) had secondary syphilis, and 222 (49.9%) had recent latent syphilis. Discussion The case study on syphilis morbidity in hospitalized patients conducted at the level of Anenii Noi district allows for an overview in this field. Syphilis detection through institutionalized serological testing of the entire group of hospitalized patients represents an efficient method of active syphilis detection by the healthcare system. In dynamics, the proportion of syphilis cases detected through testing of hospitalized patients is constantly increasing, which argues for the maintenance of this form of serological testing of the general population. The gender profile in this group is dominated by women, emphasizing the transmissibility of the disease, including vertically. The net prevalence of infection in rural patients raises the issue of accessibility to medical services. Conclusion The latent forms of syphilis detected in hospitalized patients have constantly increased in recent years, which necessitates the maintenance and expansion of population screening in this group, as well as in other groups of the general population such as pregnant women and blood donors.