title: Infectious syphilis in women: what's old is new again?
abstract: The aim of this study was to examine trends in infectious syphilis epidemiology among women in Winnipeg, Canada. A descriptive study of syphilis among Winnipeg residents between 2003 and 30 June 2015 was undertaken. Adjusted rate ratios (ARR) and 95% confidence intervals (95%CI) from Poisson regression analyses are reported. Characteristics of men and women were compared using logistic regression, with adjusted odds ratios (AOR) reported. Between 2014 and 2015, the rate of syphilis was 1.7/100,000, representing a five-fold increase since 2006-2013. All cases have been heterosexual, 90% 20-39 years of age, and 59% living in Winnipeg's inner core. Approximately 24% were pregnant at diagnosis; no cases of congenital syphilis have been reported. Compared to men, women were more likely to report alcohol use (AOR: 3.8, 95% CI: 1.2-11.9) and co-infection with chlamydia (AOR: 5.0, 95% CI: 1.1-22.9). In conclusion, the rates of infectious syphilis are increasing among women. Prenatal screening and education for inner-core women and the health care providers serving them should be prioritized.
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.|2 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Souradet Y
authors.initials: SY
authors.lastname: Shaw
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Ross
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.|3 Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Nowicki
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Marshall
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Sandy
authors.initials: S
authors.lastname: Stephen
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Christina
authors.initials: C
authors.lastname: Davies
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Riddell
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Bailey
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.|2 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.|3 Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Elliott
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.|2 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.|4 Department of Family Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Joss N
authors.initials: JN
authors.lastname: Reimer
authors.affiliation: 1 Population and Public Health Program, Winnipeg Regional Health Authority, Winnipeg, Canada.|2 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.|3 Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
authors.forename: Pierre J
authors.initials: PJ
authors.lastname: Plourde
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
keywords: Syphilis; epidemiology; women