山东省自然人群梅毒血清阳性率及影响因素分析

目的:了解山东省自然人群梅毒血清阳性率及影响因素并对梅毒网络报告数据质量进行评估。方法:采用多阶段复杂抽样法选择全省12个县(市、区)年龄为18~49岁的常住人口共8074人。收集梅毒感染的社会人口学特征及其影响因素,采用单因素和多因素回归分析梅毒感染的危险因素。估算山东省自然人群梅毒发病率并与传染病网络直报系统中梅毒数据进行比较。结果:本研究共纳入有效样本7256份,梅毒血清阳性例数为23例,梅毒血清阳性率为0.30%(95%CI 0.06%~0.53%)。其中鲁东地区梅毒血清阳性率为0.77%(95%CI 0.67%~0.86%),是其它地区的1.71~11.00倍;城镇居民梅毒血清阳性率为0.47%(95%CI 0.19%~0.74%),是农村居民的6.71倍。多因素logistic回归分析显示,居住地为城镇(a OR=6.67,95%CI 1.59~25.00)、职业为农民工(a OR=4.81,95%CI 2.78~8.31)、过去一年家庭人均月收入>1000元(a OR=10.51,95%CI 2.28~48.39)、饮酒间隔时间≤7天(a OR=2.66,95%CI 1.07~6.59)、不知道安全套的使用方法(a OR=2.19,95%CI 1.17~4.11)、过去一年去过娱乐场所(a OR=1.94,95%CI 1.31~2.87)和过去一年新性伴的个数≥2个(a OR=5.63,95%CI 1.14~27.86)是梅毒感染的危险因素。估算山东省自然人群梅毒发病率为41.32/10^(5),是报告发病率(15.46/10^(5))的2.67倍(95%CI 1.91~4.42)。结论:山东省梅毒防治应以鲁东地区和城镇居民为重点,对农民工、文化程度较低、酗酒、经常出入娱乐场所及多性伴人群也应重点关注。梅毒报告发病率低于实际水平,仍需进一步加强医疗机构的梅毒报告管理。

Seroprevalence and risk factors of syphilis infection among general population in Shandong Province,China

Objective: To explore the seroprevalence and risk factors of syphilis infection among general population in Shandong Province, China, and to evaluate the data of syphilis report in shandong province infectious disease network direct reporting system. Methods: A total of 8074 general population aged 18~49 in 12 counties and districts were selected by multi-stage complex sampling. The sociodemographic characteristics and risk factors of syphilis infection were collected. The risk factors of syphilis infection were analyzed using univariate and multivariate regression. The incidence of syphilis in the general population in Shandong was estimated and compared with the syphilis data in the infectious disease Network direct reporting system. Results: A total of 7256 valid samples were included in this study. 23 cases were seropositive for syphilis, and the syphilis serum positivity rate was 0.30% (95%CI 0.06%-0.53%). The positive rate of serum syphilis in Ludong district was 0.77% (95%CI 0.67%-0.86%), which was 1.71-11.00 times higher than that in other areas. The positivity rate of syphilis in urban residents was 0.47% (95%CI 0.19%-0.74%), 6.71 times higher than that rural residents. Multivariate logistic regression analysis showed that the risk factors for syphilis infection were living in urban areas (aOR=6.67, 95%CI 1.59-25.00), migrant workers (aOR=4.81, 95%CI 2.78-8.31), the per capita monthly income of the family in the past year was > 1000 yuan (aOR=10.51, 95%CI 2.28-48.39), the interval between drinking less than 7 days (aOR=2.66, 95%CI 1.07-6.59), no knowledge of condom use (aOR=2.19, 95%CI 1.17-4.11), visited entertainment place in the past year (aOR=1.94, 95%CI 1.31-2.87) and the number of new sexual partners in the past year more than 2 (aOR=5.63, 95%CI 1.14-27.86). The estimated incidence of syphilis in the general population of Shandong Province was 41.32/10⁵, which 2.67 times (95%CI 1.91-4.42) higher than the reported incidence (15.46/10⁵). Conclusion: The prevention and treatment of syphilis in Shandong Province should focus on the eastern Shandong region and urban residents, as well as the migrant workers, and the population with low education level, alcoholism, frequent access to entertainment places and multiple sexual partners. The reported incidence of syphilis is lower than the actual level, and the management of syphilis report in medical institutions should be further strengthened.