title: Audit of the management of the syphilis outbreak in Herefordshire 2011-2013.
abstract: The objective of this audit was to evaluate a localised rural outbreak of syphilis against British Association of Sexual Health and HIV guidelines. Forty-nine cases were identified; 98% were men, and 88% were men who have sex with men (MSM). There was a low incidence of HIV co-infection (18%). All standards regarding monitoring and treatment were met, whereas the standard concerning contact tracing was narrowly missed, highlighting a number of issues and areas for improvement. This audit has highlighted that a proactive approach is necessary to identify cases of syphilis in rural communities. This is due to difficulties in outreach testing and contact tracing in the absence of designated meeting places for MSM.
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK jhc948@bham.ac.uk.
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Cox
authors.affiliation: Sexual Health Services, Wye Valley NHS Trust, Hereford, UK.
authors.forename: Enid
authors.initials: E
authors.lastname: Elliott
authors.affiliation: Department of Microbiology, Wye Valley NHS Trust, Hereford, UK.
authors.forename: Venkat
authors.initials: V
authors.lastname: Sivaprakasam
authors.affiliation: Sexual Health Services, Wye Valley NHS Trust, Hereford, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Chima-Okereke
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000453:epidemiology; D016358:Contact Tracing; D019468:Disease Management; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008485:Medical Audit; D012424:Rural Population; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Syphilis; Treponema pallidum; clinical audit; outreach; partner notification; sexually transmitted infection; treatment