Characterizing the syphilis epidemic among men who have sex with men in Lima, Peru to identify new treatment and control strategies

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• 作者：Robert G Deiss (1)
  Segundo R Leon (3) (5)
  Kelika A Konda (2)
  Brandon Brown (4)
  Eddy R Segura (2)
  Jerome T Galea (3) (6)
  Carlos F Caceres (3)
  Jeffrey D Klausner (2)
  
• 关键词：Syphilis ; Peru ; Men who have sex with men (MSM) ; HIV ; T. pallidum ; Molecular epidemiology ; Cytokine ; Macrolide resistance
• 刊名：BMC Infectious Diseases
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：206 KB
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  35. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/13/426/prepub
  
• 作者单位：Robert G Deiss (1)
  Segundo R Leon (3) (5)
  Kelika A Konda (2)
  Brandon Brown (4)
  Eddy R Segura (2)
  Jerome T Galea (3) (6)
  Carlos F Caceres (3)
  Jeffrey D Klausner (2)
  
  1. Division of Infectious Diseases, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 466, Torrance, CA, 90502, USA
  3. Unit of Health, Sexuality and Human Development, Cayetano Heredia University School of Public Health, Lima, Peru. Av. Armendariz 445, Lima 18, Peru
  5. Department of Global Health, University of Washington, Harborview Medical Center, 325 9th Avenue, Box 359931, Seattle, WA, 98104, USA
  2. Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California, 10833 Le Conte Ave. CHS 12-105, Los Angeles, CA, 90095-1688, USA
  4. Program in Public Health, Department of Population Health & Disease Prevention, University of California, Irvine, 653 E. Peltason Road Suite 2010, Irvine, CA, 92697-3957, USA
  6. Centre for Sexual Health and HIV Research, Faculty of Population Health, University College London, Gower St, London, Greater London, WC1E 6BT, UK
  
• ISSN：1471-2334

文摘

Background Syphilis is an important sexually transmitted infection (STI) with serious public health consequences. Among men who have sex with men (MSM) in Lima, the prevalence and incidence are extraordinarily high. Current syndromic approaches, however, fail to identify asymptomatic cases, and in settings where large proportions of individuals test positive again after treatment, it is frequently difficult to distinguish treatment failure from re-infection. Thus, new approaches are needed to improve treatment strategies and public health control efforts. Methods/Design Study participants will undergo baseline testing for syphilis infection along with a behavioral survey covering demographics, sexual behavior, drug and alcohol abuse and health-care seeking behavior. The cohort will be followed for 18?months at three-month intervals. Blood and earlobe scrapings will also be collected for T. pallidum DNA testing, to create molecular markers for subtyping. We will also perform cytokine testing on collected samples in order to create host immunologic profiles associated with recurrence, re-infection, treatment failure and success. Discussion Advances in social epidemiology, molecular typing and characterization of host immune responses will offer promise in developing new understandings of syphilis management. We will share our findings with the Peruvian Ministry of Health and other public health organizations, to identify new approaches of case detection and successful treatment.