Prevalence of Syphilis Infections among the Iranian Population: A Systematic Review and Meta-Analysis
-
Firooz Esmaeilzadeh
,
Masoud Mohammadi
,
Abolfazl Amjadipour
,
Alireza Jafari
,
Mousa Ghelichi-Ghojogh
,
Rozhan Khezri
,
Abdolhalim Rajabi
Abstract
Background: Syphilis is one of the most important sexually transmitted infections (STI) and a public health problem, but the literature describing the true burden of syphilis is limited. In Iran, there are no accurate results on the prevalence of syphilis. This study aimed to conduct a systematic review and meta-analysis of syphilis in Iran.
Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of Syphilis in Iran. We systematically reviewed the literature to identify eligible studies as of Sep 13, 2020, in international and national databases. The results are presented in the form of forest plots and tables. Pooled prevalence and 95% confidence intervals were calculated using Der Simonian and Laird method. Perform subgroup analysis through population, gender, city, and diagnostic tests to assess the source of heterogeneity.
Results: We reviewed 1,229 papers and reports, and extracted data from 15 eligible records. The prevalence of combined syphilis in Iran is 0.1% (95% confidence interval [95% CI] 0.1-0.1%). The prevalence of syphilis was 0.4% in men (95% confidence interval [95% CI] -0.3, 1%) and 0.6% in women (95% confidence interval [95% CI] (0.1, 1%)). The cumulative meta-analysis showed a decline in the prevalence of syphilis between the years 1999 and 2015.
Conclusion: The prevalence of syphilis in Iran is low. In the past few decades, the prevalence of syphilis across the country has declined. Syphilis infection is a small burden that needs to be revised in the implementation of high-cost screening programs.
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14. Hashemi-Shahri SM, Sharifi-Mood B, Kouhpayeh H-R, et al (2016). Sexually Transmitted Infections Among Hospitalized Patients With Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) in Zahedan, Southeastern Iran. Int J High Risk Behav Addict, 5(3):e28028.
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16. Nikbin M, Faghreddin N, Tawfiqi Zavareh H, et al (2003). Prevalence of syphilis in women prisoners in Tehran province in 2001 and 2002. Iranian Journal of Forensic Medicine, 9(30):82-4.
17. Tabassi A, Salmasi AH, Sabeti A (2004). Acquired isolated abducens nerve palsies: a retrospective study on etiology in an Iranian population. Neuro-Ophthalmology, 28(4):155-61.
18. Sadeghi H, Arshi S, Habibzadeh S, et al (2007). Seroepidemiology of syphilis in a population of 50-20 years in the border areas of Ardabil province. Iranian Journal of Infectious Diseases and Tropical Medicine, 12(36):75-9.
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20. Vahdani P, HOSSEINI MS, FAMILI A, et al (2009). Prevalence of HBV, HCV, HIV, and syphilis among homeless subjects older than fifteen years in Tehran. Arch Iran Med,12(5):483-7.
21. Navadeh S, Mirzazadeh A, Mousavi L, et al (2012). HIV, HSV2 and Syphilis Prevalence in Female Sex Workers in Kerman, South-East Iran; Using Respondent-Driven Sampling. Iran J Public Health, 41(12):60-5.
22. Badie BM, Yavari Z, Esmaeeli S, et al (2013). Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran. Asian Pac J Trop Biomed, 3(4):334-6.
23. Mohammadali F, Pourfathollah AAJAoIm (2014). Changes in frequency of HBV, HCV, HIV and syphilis infections among blood donors in Tehran province 2005–2011. Arch Iran Med,17(9):613-20.
24. Shahesmaeili A, Karamouzian M, Shokoohi M, et al (2018). Symptom-based versus laboratory-based diagnosis of five sexually transmitted infections in female sex workers in Iran. AIDS Behav, 22(Suppl 1):19-25.
25. Khezri M, Shokoohi M, Mirzazadeh A, et al (2020). Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran. Int J STD AIDS, 31(7):671-679.
26. WHO (2012). Global incidence and prevalence of selected curable sexually transmitted infections-2008. https://apps.who.int/iris/bitstream/handle/10665/75181/9789241503839_eng.pdf?sequence=1
27. Kheirandish M, Maghsudlu M, Amini Kafi-abad S, et al (2018). Syphilis Screening in Donated Blood. Scientific Journal of Iran Blood Transfus Organ,15(1):71-86.
28. Sadeghi Bazargani H, Arshi S, Habibzadeh S, et al (2007). Seroepidemiology syphilis in the 50-20 year old population of the border areas of Ardabil Province. Iranian Journal of Infectious Diseases and Tropical Medicine, 12(36):75-9.
29. Chen Y-C, Liu H-Y, Li C-Y, et al (2015). The rising trend of sexually transmitted infections among HIV-infected persons: a population-based cohort study in Taiwan, 2000 through 2010. J Acquir Immune Defic Syndr, 68(4):432-8.
30. Massoud M, Javidi Z, Vahid M, et al (2008). Serological evaluation of HIV-1 and syphilis in patients with clinical genital warts. Medical Journal of Mashhad University of Medical Sciences, 51(100):87-94.
31. Rust G, Minor P, Jordan N, et al (2003). Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases? Sex Transm Dis, 30(9):723-7.
32. Pathela P, Braunstein SL, Blank S, et al (2015). The High Risk of an HIV Diagnosis Following a Diagnosis of Syphilis: A Population-level Analysis of New York City Men. Clin Infect Dis, 61(2):281-7.
33. Motta L, Sperhacke RD, De Gregori A, et al (2018). Syphilis prevalence and risk factors among young men presenting to the Brazilian Army in 2016: Results from a national survey. Medicine (Baltimore), 97(47):e13309.
34. Sparling PF, Holmes KK, Mardh PA (1990). Natural history of syphilis. NewYork: McGraw-Hill.
35. Mirzazadeh A, Shokoohi M, Khajehkazemi R, et al (2016). HIV and sexually transmitted infections among female sex workers in Iran: findings from the 2010 and 2015 national surveillance surveys. The 21st International AIDS Conference, Durban, South AfricaAt: Durban, South Africa.
2. Samkange-Zeeb FN, Spallek L, Zeeb H (2011). Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC Public Health,11:727.
3. Whitlow CB (2004). Bacterial sexually transmitted diseases. Clin Colon Rectal Surg, 17(4):209-14.
4. Radolf JD, Tramont EC, Salazar JC. Syphilis (treponema pallidum) (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases: Elsevier, p. 2684-709. e4.
5. Heymann DL (2008). Control of communicable diseases manual, 19th edn Washington. DC: American Public Health Association Publications. 2008:746.
6. Safari R, Shahesmaeili R, Nasirian M, et al (2014). Systematic review of Iraninan studies on sexually transmitted disease. Kerman. Kerman University of Medical Sciences, 15(3):168-74.
7. Khedmat H, Alavian SM, Miri SM, et al (2009). Trends in Seroprevalence of Hepatitis B, Hepatitis C, HIV, and Syphilis Infections in Iranian Blood Donors from 2003 to 2005. Hepatitis Monthly, 9(1):24-8.
8. World Health Organization (2012). Sexually Transmitted Infections (STIs); the importance of a renewed commitment to STI prevention and control in achiving global sexual and reproductive health. Switzerland, Geneva: WHO Website, [updated 15 February, 2013; cited 7 Agust, 2015]; Available from: http://apps.who.int/iris/bitstream/10665/82207/1/WHO_RHR_13.02_eng.pdf
9. Kazerooni PA, Motazedian N, Motamedifar M, et al (2014). The prevalence of human immunodeficiency virus and sexually transmitted infections among female sex workers in Shiraz, South of Iran: by respondent-driven sampling. Int J STD AIDS, 25(2):155-61.
10. Gewirtzman A, Bobrick L, Conner K, et al (2011). Epidemiology of sexually transmitted infections. Sexually transmitted infections and sexually transmitted diseases: Springer; 2011. p. 13-34.
11. Organization WH (2012). Strategies and laboratory methods for strengthening surveillance of sexually transmitted infections. Switzerland, Geneva.
12. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6(7):e1000097.
13. Munn Z, Moola S, Riitano D, et al (2014). The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag, 3(3):123-8.
14. Hashemi-Shahri SM, Sharifi-Mood B, Kouhpayeh H-R, et al (2016). Sexually Transmitted Infections Among Hospitalized Patients With Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) in Zahedan, Southeastern Iran. Int J High Risk Behav Addict, 5(3):e28028.
15. Khomisipour G, Tahmasbi R (1999). Infection of HBV, HCV, HIV and syphilis viruses in high-risk groups of Bushehr province in 1999. Iranian South Medical Journal, 3(3):53-9.
16. Nikbin M, Faghreddin N, Tawfiqi Zavareh H, et al (2003). Prevalence of syphilis in women prisoners in Tehran province in 2001 and 2002. Iranian Journal of Forensic Medicine, 9(30):82-4.
17. Tabassi A, Salmasi AH, Sabeti A (2004). Acquired isolated abducens nerve palsies: a retrospective study on etiology in an Iranian population. Neuro-Ophthalmology, 28(4):155-61.
18. Sadeghi H, Arshi S, Habibzadeh S, et al (2007). Seroepidemiology of syphilis in a population of 50-20 years in the border areas of Ardabil province. Iranian Journal of Infectious Diseases and Tropical Medicine, 12(36):75-9.
19. Maleki M, Javidi Z, Mashayekhi V, et al (2008). Serologic Evaluation of HIV-1 and Syphilis in Patients withClinical Anogenital Wart. Medical Journal of Mashhad University of Medical Sciences, 51(2):87-94.
20. Vahdani P, HOSSEINI MS, FAMILI A, et al (2009). Prevalence of HBV, HCV, HIV, and syphilis among homeless subjects older than fifteen years in Tehran. Arch Iran Med,12(5):483-7.
21. Navadeh S, Mirzazadeh A, Mousavi L, et al (2012). HIV, HSV2 and Syphilis Prevalence in Female Sex Workers in Kerman, South-East Iran; Using Respondent-Driven Sampling. Iran J Public Health, 41(12):60-5.
22. Badie BM, Yavari Z, Esmaeeli S, et al (2013). Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran. Asian Pac J Trop Biomed, 3(4):334-6.
23. Mohammadali F, Pourfathollah AAJAoIm (2014). Changes in frequency of HBV, HCV, HIV and syphilis infections among blood donors in Tehran province 2005–2011. Arch Iran Med,17(9):613-20.
24. Shahesmaeili A, Karamouzian M, Shokoohi M, et al (2018). Symptom-based versus laboratory-based diagnosis of five sexually transmitted infections in female sex workers in Iran. AIDS Behav, 22(Suppl 1):19-25.
25. Khezri M, Shokoohi M, Mirzazadeh A, et al (2020). Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran. Int J STD AIDS, 31(7):671-679.
26. WHO (2012). Global incidence and prevalence of selected curable sexually transmitted infections-2008. https://apps.who.int/iris/bitstream/handle/10665/75181/9789241503839_eng.pdf?sequence=1
27. Kheirandish M, Maghsudlu M, Amini Kafi-abad S, et al (2018). Syphilis Screening in Donated Blood. Scientific Journal of Iran Blood Transfus Organ,15(1):71-86.
28. Sadeghi Bazargani H, Arshi S, Habibzadeh S, et al (2007). Seroepidemiology syphilis in the 50-20 year old population of the border areas of Ardabil Province. Iranian Journal of Infectious Diseases and Tropical Medicine, 12(36):75-9.
29. Chen Y-C, Liu H-Y, Li C-Y, et al (2015). The rising trend of sexually transmitted infections among HIV-infected persons: a population-based cohort study in Taiwan, 2000 through 2010. J Acquir Immune Defic Syndr, 68(4):432-8.
30. Massoud M, Javidi Z, Vahid M, et al (2008). Serological evaluation of HIV-1 and syphilis in patients with clinical genital warts. Medical Journal of Mashhad University of Medical Sciences, 51(100):87-94.
31. Rust G, Minor P, Jordan N, et al (2003). Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases? Sex Transm Dis, 30(9):723-7.
32. Pathela P, Braunstein SL, Blank S, et al (2015). The High Risk of an HIV Diagnosis Following a Diagnosis of Syphilis: A Population-level Analysis of New York City Men. Clin Infect Dis, 61(2):281-7.
33. Motta L, Sperhacke RD, De Gregori A, et al (2018). Syphilis prevalence and risk factors among young men presenting to the Brazilian Army in 2016: Results from a national survey. Medicine (Baltimore), 97(47):e13309.
34. Sparling PF, Holmes KK, Mardh PA (1990). Natural history of syphilis. NewYork: McGraw-Hill.
35. Mirzazadeh A, Shokoohi M, Khajehkazemi R, et al (2016). HIV and sexually transmitted infections among female sex workers in Iran: findings from the 2010 and 2015 national surveillance surveys. The 21st International AIDS Conference, Durban, South AfricaAt: Durban, South Africa.
| Files | ||
| Issue | Vol 51 No 7 (2022) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i7.10085 | |
| Keywords | ||
| Sexually transmitted infection Syphilis Meta-analysis Iran | ||
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How to Cite
1.
Esmaeilzadeh F, Mohammadi M, Amjadipour A, Jafari A, Ghelichi-Ghojogh M, Khezri R, Rajabi A. Prevalence of Syphilis Infections among the Iranian Population: A Systematic Review and Meta-Analysis. Iran J Public Health. 2022;51(7):1513-1524.
