Author:
Daey Ouwens Ingrid M.,Koedijk Femke D.H.,Fiolet Aernoud T.L.,van Veen Maaike G.,van den Wijngaard Kees C.,Verhoeven Willem M.A.,Egger Jos I.M.,van der Sande Marianne A.B.
Abstract
ObjectiveNeurosyphilis is caused by dissemination into the central nervous system of Treponema pallidum. Although the incidence of syphilis in the Netherlands has declined since the mid-1980s, syphilis has re-emerged, mainly in the urban centres. It is not known whether this also holds true for neurosyphilis.MethodsThe epidemiology of neurosyphilis in Dutch general hospitals in the period 1999–2010 was studied in a retrospective cohort study. Data from the Dutch sexually transmitted infection (STI) clinics were used to analyse the number of patients diagnosed with syphilis in this period.ResultsAn incidence of neurosyphilis of 0.47 per 100 000 adults was calculated, corresponding with about 60 new cases per year. This incidence was higher in the western (urbanised) part of the Netherlands, as compared with the more rural areas (0.6 and 0.4, respectively). The number of patients diagnosed with syphilis in STI clinics increased from 150 to 700 cases in 2004 and decreased to 500 new cases in 2010. The sex ratio was in favour of men, yielding a percentage of 90% of the syphilis cases and of 75% of the neurosyphilitic cases. The incidence of neurosyphilis was highest in men aged 35–65 years, and in women aged 75 years and above. The most frequently reported clinical manifestation of neurosyphilis was tabes dorsalis. In this study, 15% of the patients were HIV seropositive.ConclusionThe incidence of neurosyphilis in a mixed urban–rural community such as the Netherlands is comparable to that in other European countries. Most patients are young, urban and men, and given the frequent atypical manifestations of the disease reintroduction of screening for neurosyphilis has to be considered.
Publisher
Cambridge University Press (CUP)
Subject
Biological Psychiatry,Psychiatry and Mental health
Reference45 articles.
1. Neurosyphilis presenting with psychotic symptoms and status epilepticus
2. Koedijk FDH , Vriend HJ , Broek van den IVF et al. Sexually transmitted infections, including HIV, in the Netherlands in 2010. RIVM Report No 210261009, 2011.
3. Zellan J , Augenbraun M . Syphilis in the HIV-infected patient: an update on epidemiology, diagnosis, and management. Current HIV/AIDS Reports 2004; 1, 142–147.
4. Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective
5. The Oslo study of the natural history of untreated syphilis
Cited by
39 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献