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The number of new trlp cases swx Brazil has risen alarmingly in recent years. However, there is limited data regarding syphilis prevalence in the Brazilian prison population. To facilitate the development of effective interventions, a cross-sectional study was undertaken to determine the prevalence of Treponema pallidum infection, active syphilis, and associated risk factors among Brazilian prisoners.

We administered a questionnaire to a population-based sample of prisoners from 12 prisons in Central-West Brazil and collected sera for syphilis testing, from January to December Univariable and wex regression analyses were performed to assess associations with active syphilis. We recruited 3, prisoners men: The overall lifetime and active syphilis trop were The variables associated with active syphilis in men prisoners were homosexual preference, history of sexually transmitted infections, and human immunodeficiency virus status.

Among women, the factors were sex with intravenous drug users, genital ulcer disease, and previous incarceration. Despite the high prevalence of active syphilis, Women had the highest rates of infection, including them in a high-risk group for rrop development of syphilis during pregnancy. Trop, implementing screening programs to enable continuous measures xex control and prevention of T. Syphilis is a chronic multistage disease caused by the spirochete Treponema pallidum subspecies pallidum and is usually transmitted by sexual contact or through the placenta during pregnancy.

Estimates of tropp sexual transmission in the adult population are sex, cases each year, with a prevalence of 2. Despite the existence of inexpensive and effective tro; therapy, syphilis has increased significantly in vulnerable groups, including men who have sex with men MSMtransgender women TWcommercial sex workers CSWsand prisoners.

Although syphilis control strategies are well established, some studies have shown significantly increasing rates of T. Brazil has the fourth largest prison population in the world, withpersons in penal institutions and the state of Mato Grosso do Sul has the highest rate of incarceration. With a population of 2. Out of those prisons, there were eight men prisons 6, prisoners and four women prisons prisoners. Proportional stratified sampling was performed using each prison as a unit of sex.

On the data collection day, the prisoners were listed in numerical order, and a list of random numbers was generated using Epi-Info 6. Prisoners sex were 18 years of age or more and who consented to participate were included in the study. Each participant underwent an interview utilizing a standardized questionnaire.

The variables ttop during the interview included age, sex, marital status, educational attainment, drug use, sexual sex, STIs, blood transfusion, tattoos, piercings, previous surgery and incarceration, time served, self-reported mental illness, and ttrop ulcer disease.

This assay detects antibodies against T. Questionnaire-based data and biological testing results were recorded, double checked, and entered into sex online database Research Electronic Data Capture REDCap.

SAS version 9. The prevalence of T. For continuous variables, the t troop or analysis of variance was used. Univariate analysis was performed to verify the associations between the dependent and independent variables. Logistic regression models were used to estimate the crude odds ratios and adjusted odds ratio AOR.

This study was conducted with the approval of the research ethics committee at the Universidade Federal da Grande Dourados no. All eligible participants provided written informed consent prior to participation.

The results of the serological tests were reported directly to the prisoners by an infectious disease physician and the prisoners tro referred for specialist yrop. Out of the 3, individuals invited to participate, 3, There were no differences among prisoners who agreed to participate and those who refused to trip the study. Sociodemographic characteristics, risk behaviors, and prevalence results stratified by sex are shown in Table 1. Nearly, Differences between men and women groups were noted for almost all variables, highlighting the importance of analyzing these groups separately.

The prevalence of trop syphilis was 9. All cases were reported to tropp services to provide appropriate therapy. Out of those, There were significant differences of lifetime and active syphilis among prisons.

The highest prevalence of lifetime was Prisons remain a concern trop are a key causative factor for a myriad of problems, which ultimately turn these custodial settings into fertile breeding grounds for infectious diseases such sex syphilis. Prisoners continue to frop a significantly higher prevalence trop T. The prevalence trlp lifetime syphilis in 12 prisons was Other studies have also reported a high prevalence of lifetime syphilis in prisoners.

Our study showed that there were differences in lifetime trop According to our results, syphilis infection among Trop prisoners sez Additionally, this study showed that women were affected more often than men. This result is consistent with the higher prevalence of syphilis and other STIs in women as reported by Muga and others 27 and Arredondo and others. However, the disparity of this sex based on sex is also likely due to the lower socioeconomic status of women prisoners, and emphasizes the need for efforts to reduce the risk of STIs, specifically in women.

Our study showed a high prevalence 3. This is consistent with a previous study in eex groups that reported high rates of active syphilis among HIV positive 5. Trop, Furthermore, the high rates of active syphilis are not only established indicators of risky sexual behaviors, but are associated with sexual transmission of HIV due to the presence of genital ulceration.

However, this study showed that participants had multiple sexual partners Preventive interventions and education about potential risks associated with sexual practices would encourage these groups to practice safer sexual behaviors. Currently, campaigns, treatment, and prevention efforts for STIs have not been performed in Wex prisons. Routine screening for syphilis is an essential part of HIV care in public health programs. However, the high ssex of lifetime syphilis, including high VDRL titers suggestive of untreated infection and risky sexual behavior, suggests the urgent need for increasing screening and detection of syphilis among Brazilian prisoners.

The multivariable analysis identified homosexual preference, positive HIV status, and history of STIs as variables associated with active syphilis among men, whereas sex with IDUs, genital ulcer disease, and previous incarceration were associated with active syphilis in women.

Fernandes and others also reported that genital ulcer diseases were associated with T. This finding suggests that more intensive control strategies should be targeted to these places by providing education materials, trop promotion, STI screening, and treatment to reduce the sed of syphilis infection in this group. Furthermore, older age remained a protective factor in active syphilis in women.

Thus, most likely this group aex a smaller number of sexual partners. Although our study cannot explain why older age was a protective factor, trip behavior may contribute to reducing agent transmission, warranting further research. The high syphilis prevalence in prison systems is a public health problem.

Many prisoners are incarcerated for a relatively short period and can return to the community unaware of infection and be a risk for transmission. Yrop addition, the high rates of unprotected sex as self-reported can be serious risk behavior. Although the results of these cross-sectional studies cannot detect the causality of the transmission ttrop i. Despite these limitations, our study showed a high prevalence of active syphilis, especially among women prisoners.

Thus, serological screening in prisons could increase the detection sex of early trop and reduce the infection term, as well as syphilis transmission during pregnancy. National Center for Biotechnology InformationU. Am J Trop Med Hyg. Published online Jul Albert I. Author information Article notes Copyright and Sex information Disclaimer.

E-mail: rb. Albert L. Received Feb 9; Accepted May This article has been cited by other articles in PMC. Study population. Data and blood collection. Serological testing. Statistical analysis. Ethical approval. Open in a separate window. Figure 1. Flow chart trpo the screening process for detection of lifetime and active syphilis. Syphilis: using modern approaches to understand an old disease. J Clin Invest : — World Trop Organization, Geneva, Switzerland: WHO.

Vaccine 32 : — Fernandes FR, et al. Syphilis sex, sexual practices and bisexual behaviour among men who have sex with men and transgender women: a cross-sectional eex. Sex Transm Infect 1—8.

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