Background:Thus, knowing the prevalence of syphilis will help inform public health policies, both in the planning and implementation of programs and in providing appropriate prevention, control and assistance. There are few population-sampling studies on the prevalence of syphilis in Brazil. Our goal was to determine the seroprevalence of syphilis, identify factors associated and diagnostic approach for the infection in patients attending Family Health Program (FHP) in the municipality of Vitória, Espírito Santo, Brazil.
Methods: A cross-sectional study conducted among adult population attending FHP in 2011. Venereal Disease Research Laboratory (VDRL) test and two treponemal tests (immunochromatographic and IgG ELISA tests) were performed. Demographic data, history of sexually transmitted diseases (STDs) and behavioral data were collected. Cases were considered positive for syphilis when VDRL titers were equal to or greater than 1:8 and confirmed by one treponemal test.
Results: Of the 1502 individuals included in the study, 47% were men and 53% were women. The mean age was 41.63±14.57 years. The prevalence of syphilis was 0.9% (95% CI: 0.4% - 1.3%). Multivariate analysis showed a significant association between syphilis and homosexual or bisexual behavior [OR 6.80, 95% CI: 1.00-46.20], a prior history of STDs [OR 16.30, 95% CI: 3.61-73.41], the presence of a tattoo [OR 6.21, 95% CI: 1.49-25.84] and cocaine use [OR 6.80, 95% CI1.15-40.30]. The prevalence of positive treponemal test was 10.4% (95% CI: 8.9%-11.9%). Of those 156 individuals, 27 were VDRL-positive with titers below 1:8.
Conclusions: The seroprevalence of syphilis in this population was low, which is similar to that observed in other populations studied in Brazil. The high prevalence of positive treponemal tests may be due to the positive serological memory of a cured infection, but they may also be due to cases of primary or late syphilis that were not detected by the VDRL test.