title: Screening, diagnosis and management of early syphilis in genitourinary medicine clinics in the UK.
abstract: New diagnoses of syphilis in the UK increased eight-fold between 1997 and 2002. This study, conducted in 2002, demonstrated that 31% of clinics were not confident of their expertise to obtain an adequate specimen for dark ground microscopy (DGM), and 35% were not confident of their expertise to detect treponemes on DGM. In all, 64% of clinics had observed adherence problems in HIV-positive patients treated with parenteral regimens, as against 42% with oral regimens. Also, 51% of clinics waited more than a week for the results of initial serological tests for syphilis, and 88% of clinics waited more than a week for confirmatory test results. Other concerns include the failure to perform syphilis serology consistently whenever HIV-positive patients were at risk, and the widespread use of doxycycline as a therapy for syphilis in HIV-positive patients despite concerns that this is not known to be fully treponemicidal in cerebrospinal fluid.
authors.affiliation: Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Rogstad
authors.forename: I
authors.initials: I
authors.lastname: Simms
authors.forename: K A
authors.initials: KA
authors.lastname: Fenton
authors.forename: S
authors.initials: S
authors.lastname: Edwards
authors.forename: M
authors.initials: M
authors.lastname: Fisher
authors.forename: C A
authors.initials: CA
authors.lastname: Carne
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D052776:Female Urogenital Diseases; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases; D008403:Mass Screening; D010044:Outpatient Clinics, Hospital; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013588:Syphilis Serodiagnosis; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents