Syphilis in females in Bialystok, Poland, 2000-2015

Introduction: Syphilis, similar to most other sexually transmitted infections, disproportionally affects females more than males, including the risk of adverse outcome of pregnancy and infection in foetus.
Objective: To describe and analyse all cases of syphilis among female patients (pregnant and non-pregnant) treated in Bialystok, Poland in 2000-2015.
Material and Methods: Retrospective analysis of sociodemographic, epidemiological and clinical characteristics of pregnant and non-pregnant syphilis-positive females.
Results: From 2000 to 2015, 47 females were treated for syphilis: 17 (36.2%) were pregnant and 30 (63.8%) non-pregnant. The majority of patients in both groups were residents of urban areas (64.7% and 73.3%, P=0.6), and were married or in a long-standing relationship (94.1% and 60.0%, P=0.01). At least five lifetime sexual contacts had 17.5% of pregnant and 3.3% of non-pregnant females (P=0.04). The steady partner was the most probable source of infection in both groups (76.6% and 66.6%, P=0.4). Early latent syphilis was the most frequent stage of the disease in the pregnant women (94.1%) and secondary syphilis in the non-pregnant females (43.3%). In 58.8% of the pregnant females the first serological test for syphilis was performed after 10th week of pregnancy and nearly half of them did not present to any follow-up visit after treatment. In about one third of patients sexual contacts were not examined.
Conclusions: Syphilis among females, especially pregnant ones, remains a problem in North-East Poland. Syphilis screening is frequently conducted too late in the pregnancy, increasing the risk of infection in the foetus. Pregnant females frequently do not attend follow-up visits. Contact notification should also be improved.