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. 2024 Apr 12:152:e63.
doi: 10.1017/S0950268824000566.

Serological follow-up after syphilis diagnosis in Israel

Galia Grauenfels Cohen  1 , Matan J Cohen  2 , Ze'ev Dveyrin  3 , Zohar Mor  4   5 , Efrat Rorman  3 , Ehud Kaliner  4
Affiliations

Serological follow-up after syphilis diagnosis in Israel

Galia Grauenfels Cohen et al. Epidemiol Infect. .

Abstract

The global incidence of syphilis is increasing. Continuity of care challenges the control of sexually transmitted diseases. In this study, we assessed the follow-up and serological decline differences between community- and hospital-diagnosed patients in Israel. A historical cohort study was conducted using the Israel National Syphilis Center (NSC) repository. Patients with a positive non-specific Venereal Disease Research Laboratory (VDRL) test between 2011 and 2020 were included. Rates of serological follow-up and serological titre decreases were compared between hospital- and community-diagnosed patients. The study included 4,445 patients, 2,596 (58.4%) were diagnosed in community clinics and 1,849 (41.6%) in hospitals. Of community-diagnosed patients, 1,957 (75.4%) performed follow-up testing, compared with 834 (51.2%) hospital-diagnosed patients (p < 0.001). On multivariate analysis, the odds ratio of serology follow-up among community-diagnosed patients was 2.8 (95 per cent confidence interval (95% CI): 2.2-3.5) that of hospital-diagnosed patients. There were 1,397 (71.4%) community-diagnosed patients with serological titre decrease, compared with 626 (74.9%) hospital-diagnosed patients (p = 0.03). On multivariate analysis, this difference diminished. Serological follow-up testing is suboptimal and was performed more often among patients initially diagnosed in the community compared to hospitals. Continuity of care should be improved to promote successful patient care and prevent disease spread.

Keywords: continuity of care; follow-up; serology; surveillance; syphilis.

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Conflict of interest statement

The authors declare no competing interests exist.

Figures

Figure 1.
Figure 1.
Percentage of significantly reduced serological titre of the first follow-up test, per the timing of days since the diagnostic test.
See this image and copyright information in PMC

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