A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the ...epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014.
Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts.
During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection.
Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment.
The World Health Organization (WHO) estimated that in 2008 there were 106.1 million newly registered cases of gonorrhea among adults worldwide. Of these cases, 3.4 million were in the WHO European ...Region. In the European Union and European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 population in 2012; the highest rate (45.4 per 100.000) was observed in the United Kingdom, while low rates (<5 per 100.000) were generally reported in the Central and Eastern Europe. In 2012, low incidence of gonorrhea (1.49/100.000) was reported in Serbia, as well.
The purpose of this study was to report on the epidemiology of gonorrhea in a Belgrade population (about 1.5 million inhabitants) during the period 2010 - 2014, and to discuss data on gonorrhea rates in the European Union.
In Serbia it is mandatory to report gonorrhea, and all reports of culture-proved gonorrhea are sent to the City Institute for Public Health in Belgrade. These reports were used as the source for data analysis of gonorrhea incidence. Incidence rates were calculated using data from the 2011 population census in Serbia for Belgrade population. Age-adjusted annual incidence rates were carried out by a direct method using the “world population” as a standard.
During the 2010 - 2014 period, the average gonorrhea incidence in Belgrade population was 9.2 per 100.000 in men, and 1.9 per 100.000 in women. The incidence was highest in men and women aged 20 - 29 years. In all age groups gonorrhea incidence was higher in men than in women, the average male/female ratio being 4.8. In both sexes, the incidence of gonorrhea was highest in persons who had never married, with secondary education and unemployed. Out of 357 men with gonorrhea, 92 (25.77%) were self-reported homosexuals.
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