ArticleBMC public health2026
A 12-year hospital-based surveillance of syphilis in Hanzhong, China: shifting epidemics and implications for targeted prevention.
Article in BMC public health, 2026. 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
objectivesSyphilis remains a global public health priority. China has implemented a national control plan, yet local epidemic dynamics in resource-limited areas are poorly documented. This study aimed to analyze the 12-year trends and population-specific characteristics of syphilis in Hanzhong, China, to inform targeted prevention strategies.
methodsWe conducted a retrospective analysis of 561,718 syphilis tests performed at Hanzhong Central Hospital from 2012 to 2023. Case positivity was determined according to national diagnostic criteria (non-treponemal and treponemal tests). We calculated annual positivity rates and analyzed trends by sex and age using χ² and trend χ² tests.
resultsAmong 561,718 tests, 36,913 were positive (overall positivity rate: 6.57%). The positivity rate followed a statistically significant "rise-peak-decline" trend (P < 0.001), peaking at 9.47% in 2020 and decreasing to 5.19% in 2023. While the overall rate was higher among females than males (6.64% vs. 6.48%, P < 0.05), the male rate surpassed the female rate by 2023 (5.63% vs. 4.86%). Adults aged ≥ 60 years had the highest overall rate (9.05%). Neonates (aged 0 ~ 1 year) experienced alarmingly high rates, peaking at 36.24% in 2021 before declining to 17.60% in 2023. Neonates (0 ~ 1 year) had the highest overall positivity rate (15.36%), peaking at 36.24% in 2021 before declining to 17.60% in 2023. Adults aged ≥ 60 years had the second-highest overall rate (9.05%).
conclusionThe syphilis epidemic in Hanzhong has undergone dynamic shifts between 2012 and 2023, with a recent overall decline masking significant subpopulation disparities. Findings highlight a rising burden among men, a persistently high burden among older adults, and critical gaps in preventing mother-to-child transmission. Moving beyond generalized approaches to implement targeted interventions for the identified high-risk groups is essential for syphilis control in this and similar settings.
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