ArticleBMC public health2025
Epidemiological characteristics of syphilis in China from 2005 to 2020: predominance of latent Infections, significant burden in the elderly population, and analysis of regional disparities.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSyphilis has emerged as a major public health challenge in China and is characterized by increasing incidence rates and shifting epidemiological patterns. Despite national control efforts, latent syphilis dominates case burdens, and older adults have become a high-risk subgroup, highlighting the need for updated prevention strategies.
methodsWe analyzed data from China’s National Notifiable Disease Surveillance System (2005–2020), including 5,899,261 syphilis cases and 994 deaths, to describe incidence, mortality, and stage-specific trends. Joinpoint regression was used to model annual percentage changes (APCs) in incidence/mortality, and descriptive statistics were used to assess age/regional distributions.
resultsLatent syphilis accounted for 64.02% of the total cases, with the incidence increasing rapidly from 2005 to 2010 (APC = 29.99%) before slowing (2010–2020: APC = 8.44%). Individuals aged ≥ 60 years presented the highest burden, with an incidence rate of 46.9224 /100,000 (23.90% of cases) and a mortality rate of 0.0133/100,000 (40.24% of deaths), driven by latent syphilis (80.25% of mortality). Regional disparities were evident, with eastern provinces as endemic hotspots and western regions experiencing rapid growth (e.g., Xizang). Primary/secondary syphilis initially increased but then decreased, whereas tertiary/congenital syphilis remained low but persistent.
conclusionWestern regions such as Xizang have shown a notable syphilis incidence growth rate, surpassing eastern endemic hotspots and revealing a distinct “reverse gradient”. Dominated by asymptomatic latent infections and marked by the aging population’s vulnerability, China’s syphilis epidemiology demands targeted interventions: universal screening, age-tailored education for older adults, and strengthened western-region surveillance. These measures tackle transmission dynamics, align with global STI elimination goals, and address regional inequities to advance tailored public health strategies.
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