Epidemiological, diagnostic and medical-social aspects of latent syphilis

Objective — to study epidemiological, clinical and medical-social aspects of latent syphilis in Ukraine over the past 40 years. Materials and methods. Data of patients with latent syphilis that were examined and treated in the clinic of skin and venereal diseases of the SE «Dnipro State Medical University of the Ministry of Health of Ukraine». In our study we used the results of epidemiological (retrospective study of outpatient charts and medical histories of patients) and clinical research methods as well as serological blood tests. Results and discussion. We studied the medical-social and epidemiological features of latent syphilis in 1147 patients for the period from 1980 to 2000 and for the period from 2000 to 2024 — in 1670 patients.The diagnosis of latent syphilis was established on the basis of clinical, anamnestic and serological examination of patients using the generally accepted criteria for verification of syphilis (ICD-X). Particular attention was paid to anamnestic and clinical data on concomitant pathology, previous diseases, and confrontation data. A therapist, neurologist, ophthalmologist, otolaryngologist, specialists in instrumental diagnostic methods, and radiologist were involved in the detailed analysis and assessment of intercurrent diseases. All patients were also examined for urogenital infections (gonorrhea, trichomoniasis, chlamydia, mycoureaplasmosis, bacterial vaginosis, urogenital candidiasis, genital herpes, papillomavirus infection).We conducted an analysis of archival disease histories for the period 1980—2000 (1147 patients with latent syphilis) allowed us to draw the following conclusions: latent syphilis was diagnosed in 78.9 %, late latent in 12.8 % of patients and unspecified latent in 8.3 % of patients.During the period 2000—2024 (1670 medical histories were analyzed), the diagnosis of latent syphilis was established in 78.2 % of patients, late latent in 16.7 % and unspecified latent in 5.1 %.Thus, the above data over the past 44 years indicate a significant increase (by 16.3 %) in the proportion of latent syphilis. Conclusions. Over the past 40 years, the proportion of latent syphilis has increased by almost 20 %. The number of patients with latent syphilis living in cities has increased from 70 to 86 %.The features of the modern course of latent syphilis include the fact that 80 % of female patients have concomitant sexually transmitted infections, and 42 % of male patients suffer from alcoholism and drug addiction. Among patients, both men and women, 80 % did not have a family, more than 70 % of patients performed unskilled work. The average age of patients decreased by 10 years from 36 to 26 years, that is, latent syphilis conditionally «became younger». A significant increase in the frequency of concomitant diseases among patients with latent syphilis has been established over the past 44 years. In particular, if in previous decades (1980—2000) patients with latent syphilis were most often diagnosed with various cardiovascular pathologies, then in recent decades (2000—2024) in addition to this pathology, there has been an increase in diseases of the gastrointestinal tract, ENT organs, as well as tuberculosis, viral hepatitis, and HIV infection.Among the most significant reasons for the increase in the proportion of patients with latent syphilis are the uncontrolled use of antibiotics.