Re-emergence of syphilis: testing, treatment and follow up of an old disease in the new era; the role of the general practitioner
Valeska Padovese, Consultant-in-charge of Genito-Urinary Clinic & Yanica Vella, General Practice Trainee, Genito-Urinary Clinic, Mater Dei Hospital, Malta
In 2015 Malta reported 11.5 confirmed syphilis cases per 100 000 population, which is one of the highest rates in Europe. The majority of infections were reported in people older than 25 years while young people between 15 and 24 accounted for less than 10% of cases. The increases continue to be driven by increased cases among men, specifically among men who have sex with men (MSM), likely to be due to both behavioural and testing reasons. The concomitant rises in the trend for other STIs suggest that high-risk behaviour is increasing. This is particularly relevant when considering the high proportion of HIV co-infections, particularly among MSM. The authors describe epidemiological trends, clinical manifestations, laboratory investigation, treatment and HIV co-infection in patients diagnosed with syphilis at the genitourinary clinic (GUC) in the last decade. Promoting safer sexual behaviour and increasing testing rates among risk groups through targeted prevention campaigns is essential to prevent cases and reduce the risk of complications due to late diagnosis. Development of Point of Care Testing (POCT) for HIV and Syphilis in MSM and sex workers is under evaluation at the GU clinic.