Late Neurosyphilis and Tertiary Syphilis in Guangdong Province, China: Results from a Cross-sectional Study.
Due to challenges in diagnosis and the need for complex laboratory tests, misdiagnosis of neurosyphilis and tertiary syphilis is common in China. We validated the diagnosis and examined the treatment of late neurosyphilis and tertiary syphilis in Guangdong Province, China. A cross-sectional study was conducted to collect data from late neurosyphilis and tertiary syphilis cases reported between 2009 and 2014 in Guangdong, China. Descriptive analysis, bivariate analyses and multiple logistic regressions were performed to determine the structural factors associated with correct diagnosis and standard treatment of late neurosyphilis and tertiary syphilis. Among the 3805 respondents (3805/3936, 96.7%), 1,837 (48.3%) met the misdiagnosed criteria. The misdiagnosis rate decreased over the study period (54.2% in 2009 and 41.8% in 2014). Only 27.1% and 24.9% of the correctly diagnosed late neurosyphilis and tertiary syphilis cases received standard treatment, respectively. Multiple logistic regression revealed that departments of dermatology or STDs [aOR = 3.24, 95% CI: 2.66-3.95], county or township level hospitals [aOR = 2.89, 95% CI: 2.14-3.89], and hospitals situated outside of Pearl River Delta area [aOR = 1.70, 95% CI: 1.46-1.97] had higher likelihood in misdiagnosis of neurosyphilis, compared to the reference groups. Targeted trainings for physicians and expanded syphilis screening services are urgently needed.
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.|University of North Carolina Project-China, Guangzhou, China.
Weiming
W
Tang
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
Shujie
S
Huang
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
Lei
L
Chen
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
Ligang
L
Yang
University of North Carolina Project-China, Guangzhou, China.
Joseph D
JD
Tucker
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
Heping
H
Zheng
Dermatology Hospital of Southern Medical University, Guangzhou, China.|Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
Bin
B
Yang
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors; D005260:Female; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
D000900:Anti-Bacterial Agents