Syphilis Mortality on the Decline in the United States, 2000-2010
methods: Using ICD-10 classification, all syphilis-related deaths were identified using the MCD dataset for the period 2000-2010. Descriptive statistics and age-adjusted mortality rates were calculated to examine trends of disease burden by age, sex, race/ethnicity, and geographic region. Poisson regression was used to analyze mortality trends over time. Planned analyses include a matched case-control to describe associations between syphilis and other comorbid conditions contributing to death.
results: Over the 11 year period, a total of 1,345 deaths were attributed to syphilis; 31% identified syphilis as the underlying cause of death. A majority of decedents were male (58%) and were primarily white or black (88%; n=1,188). Older adults had the highest mortality rates: 65-74 years (0.11; 95%CI = 0.09-0.12), 75-85 years (0.25; 95%CI = 0.22-0.27), and 85+ years (0.49; 95%CI=0.43-0.55). Blacks were disproportionally affected compared to whites (age-adjusted rate ratio = 11.9; 95%CI =10.9-12.9). Though the sample size is not large, there were 23 cases of neonatal syphilis. Age-adjusted time trends indicated a 4.25% annual decline in mortality for this period.
discussion: Despite the increasing incidence of disease, overall death attributed to syphilis appears to be declining. However, among elderly adults, this infection continues to be an important cause of death. Understanding the mortality patterns and related comorbid conditions can help aide clinical efforts to more quickly identify high-risk patients with syphilis and provide appropriate, potentially life-saving, treatment.
Discuss syphilis mortality trends in the United States from 2000-2010