Sociodemographic characteristics and clinical description of congenital syphilis patients and their mothers in Japan: a qualitative study, 2016
Sociodemographic characteristics and clinical description of congenital syphilis patients and their mothers in Japan: a qualitative study, 2016
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DOI：
10.1071/sh18033
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发表时间：
2018-01-01
期刊：
影响因子：
1.6
通讯作者：
Oishi, Kazunori
中科院分区：
文献类型：
--
作者：
Kanai, Mizue;Arima, Yuzo;Oishi, Kazunori
背景：在日本，先天性梅毒（CS）的报告最近有所增加。然而，对CS病例或患者母亲的临床和社会人口学特征知之甚少。研究方法：2016年3月至12月期间，通过国家监测报告了12例CS病例，本研究纳入了7例患者的母亲。患者的母亲和医生完成了一份自填式问卷，提供了患者及其母亲的社会人口统计学和临床信息。此外，我们探讨的认识和知识，态度和做法，对CS的发生，通过半结构化的采访与母亲。结果：7例CS患者中，3例无症状，其余患者有一系列非特异性临床表现。这些母亲往往年龄较小，未婚，有商业性工作史，有其他性传播感染史，怀孕期间没有产前检查或产前检查不定期。在四位定期接受产前检查的母亲中，有两位在前三个月的产前筛查中梅毒检测呈阴性。出现的主题表明了预防CS的挑战，包括缺乏医生考虑在头三个月后进行梅毒检测的指导或指南，缺乏医生对梅毒或CS的认识或经验，以及缺乏孕妇对性传播感染的认识或知识。结论：揭示了日本最近CS患者及其母亲的主要特征，确定了以前报告的因素以及新的挑战。一个整体的方法，旨在解决在医疗保健系统，医疗保健提供者和孕妇及其合作伙伴的水平的挑战将是重要的，在预防CS。
Background: In Japan, congenital syphilis (CS) notifications have increased recently. However, little is known about the CS cases or the clinical and sociodemographic characteristics of the patients' mothers. Methods: Twelve cases of CS were reported through national surveillance in the period March-December 2016, and the mothers of seven patients were included in this study. The patients' mothers and physicians completed a self-administered questionnaire, providing sociodemographic and clinical information of the patients and their mothers. In addition, we explored the awareness and knowledge of, attitudes towards and practices regarding CS occurrence through semistructured interviews with the mothers. Results: Of the seven CS patients, three were asymptomatic, with a range of non-specific clinical manifestations in the rest. The mothers tended to be of young age, unmarried and to have a history of commercial sex work, other sexually transmissible infections (STIs) and no or irregular prenatal care visits during pregnancy. Of the four mothers who had had regular prenatal care visits, two had tested negative for syphilis at the first trimester antenatal screening. Themes emerged that indicated challenges in preventing CS, including a lack of guidance or guidelines for physicians to consider testing for syphilis after the first trimester, lack of physicians' awareness or experience of syphilis or CS and a lack of awareness or knowledge in pregnant women regarding STIs. Conclusions: Key characteristics of recent CS patients and their mothers in Japan were revealed, identifying previously reported factors as well as new challenges. A holistic approach, designed to address challenges at the level of the healthcare system, healthcare provider and the pregnant woman and her partner will be important in preventing CS.