The challenge of diagnosis and treatment of neurosyphilis in China: results from a nationwide survey
Fang-Zhi Du A , Qian-Qiu Wang
A C , Zhi-Ju Zheng A , Xu Zhang A , Guo-Jun Liang A , Xiang-Sheng Chen A and Rui-Li Zhang B C
+ Author Affiliations
- Author Affiliations
A Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College; National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing 210042, China.
B Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
C Corresponding authors. Q.-Q. Wang, email: wangqianqiunj@126.com; R.-L. Zhang, email: reallyvictor@126.com
Sexual Health 18(4) 333-339 https://doi.org/10.1071/SH21023
Submitted: 3 February 2021 Accepted: 5 June 2021 Published: 2 September 2021
Abstract
Background: The uncertainty of how neurosyphilis is diagnosed and treated in clinical settings led us to investigate whether this serious manifestation of syphilis infection is properly managed in China. Methods: This national cross-sectional study of the diagnosis and treatment of neurosyphilis included 1392 clinicians at 398 hospitals located in 116 cities in China. Results: Of 398 hospitals, 244 (61.3%) failed to perform diagnostic laboratory tests and 181 (45.5%) failed to provide recommended treatment for neurosyphilis. Of 1392 clinicians, 536 (38.5%) had previously diagnosed patients with neurosyphilis, but 419 (78.2%) of the latter provided diagnoses that did not meet the criteria set by national guidelines. Of the 485 clinicians who had previously treated patients with neurosyphilis, 280 (57.7%) failed to follow national guidelines for treatment. Analysis indicated that clinicians working in North China (adjusted odds ratio (aOR), 4.24; 95% confidence interval (CI), 1.65–10.88), tertiary hospitals (aOR, 3.23; 95% CI, 1.63–6.41), and hospitals specialising in sexually transmitted infections (aOR, 2.49; 95% CI, 1.24–4.99) were more likely to follow national guidelines for neurosyphilis treatment. Conclusion: Lack of knowledge in disease management poses a great obstacle to prevent the serious consequences of neurosyphilis in Chinese patients. More effective measures are urgently needed to improve this suboptimal situation.
Keywords: neurosyphilis, diagnosis and treatment, national guidelines, hospital, clinician, sexually transmissible infections, China, cross-sectional study.
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