Epidemiological Analysis of Syphilis in China From 1985 to 2000

Objectives: To understand trends and epidemiological featuresof syphilis over the recent years in China and provide a scien-tific basis for developing prevention strategies. Methods: From 1985 to 2000, syphilis case-reporting datacollected from all provinces, autonomous regions and munici-palities were analyzed by applying epidemiological methods. Results: (1) Epidemic trends: syphilis incidence has steadilyrisen in China from 1985 to 2000, especially after 1993, when itassumed an exponential growth pattern. 80,406 cases of syphi-lis were reported in the country in 1999, which was almost 40times the number reported in 1993. During the period of1993-1999, the annual average growth of the syphilis incidencerate was 83.55%. Perhaps due to a recent national law en-forcement campaign, the number of reported syphilis casesdropped slightly in 2000. (2) Geographical distribution: Syphi-lis spread from coastal, open cities (especially some cities inFujian province) to inland urban areas, then to rural areas.Regions with a high incidence rate of syphilis in China were theMinjiang, Yangtze, and Zhujiang River Deltas, Beijing andTianjin municipalities, and Northeast China. There was a sig-nificant difference of syphilis incidence rates and growth ratesbetween these areas. A serious epidemic occurred in some ar-eas, with an incidence rate reaching over 200 cases out of100,000. (3) Population distribution: the ratio of male and fe-male cases gradually changed from 1.57:1 in 1993 to 1.02:1 in2000. The rate was the highest in the 20-29 age group and thelowest in 10-14 age group. A great difference existed in preva-lence between different population groups and different areas,and some areas with serious epidemics had high prevalencerates even amoung the general population. (4) Clinical stage ofsyphilis: Primary and secondary syphilis cases have beendominating with a percentage of 90% of all syphilis cases. Pri-mary syphilis was the most common in males and secondarysyphilis in females. Secondary and latent syphilis cases in fe-males were more than in males. (5) The congenital syphilisincidence has increased dramatically. Two cases were reportedin 1991 and 468 cases in 2000. Conclusion: The syphilis epidemic in China became muchmore severe between 1985 and 2000, and such increasingtrends deserve our serious attention.