PMID- 28837558
OWN - NLM
STAT- MEDLINE
DCOM- 20171019
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 8
DP  - 2017
TI  - The prevalence and incidence of active syphilis in women in Morocco, 1995-2016:
      Model-based estimation and implications for STI surveillance.
PG  - e0181498
LID - 10.1371/journal.pone.0181498 [doi]
AB  - BACKGROUND: Evolving health priorities and resource constraints mean that
      countries require data on trends in sexually transmitted infections (STI) burden,
      to inform program planning and resource allocation. We applied the Spectrum STI
      estimation tool to estimate the prevalence and incidence of active syphilis in
      adult women in Morocco over 1995 to 2016. The results from the analysis are being
      used to inform Morocco's national HIV/STI strategy, target setting and program
      evaluation. METHODS: Syphilis prevalence levels and trends were fitted through
      logistic regression to data from surveys in antenatal clinics, women attending
      family planning clinics and other general adult populations, as available
      post-1995. Prevalence data were adjusted for diagnostic test performance, and for
      the contribution of higher-risk populations not sampled in surveys. Incidence was
      inferred from prevalence by adjusting for the average duration of infection with 
      active syphilis. RESULTS: In 2016, active syphilis prevalence was estimated to be
      0.56% in women 15 to 49 years of age (95% confidence interval, CI: 0.3%-1.0%),
      and around 21,675 (10,612-37,198) new syphilis infections have occurred. The
      analysis shows a steady decline in prevalence from 1995, when the prevalence was 
      estimated to be 1.8% (1.0-3.5%). The decline was consistent with decreasing
      prevalences observed in TB patients, fishermen and prisoners followed over
      2000-2012 through sentinel surveillance, and with a decline since 2003 in
      national HIV incidence estimated earlier through independent modelling.
      CONCLUSIONS: Periodic population-based surveys allowed Morocco to estimate
      syphilis prevalence and incidence trends. This first-ever undertaking engaged and
      focused national stakeholders, and confirmed the still considerable syphilis
      burden. The latest survey was done in 2012 and so the trends are relatively
      uncertain after 2012. From 2017 Morocco plans to implement a system to record
      data from routine antenatal programmatic screening, which should help update and 
      re-calibrate next trend estimations.
FAU - Bennani, Aziza
AU  - Bennani A
AD  - Ministry of Health, Directorate of Epidemiology and Disease Control, Rabat,
      Morocco.
FAU - El-Kettani, Amina
AU  - El-Kettani A
AD  - Ministry of Health, Directorate of Epidemiology and Disease Control, Rabat,
      Morocco.
FAU - Hancali, Amina
AU  - Hancali A
AD  - STIs Laboratory, Department of Bacteriology, National Institute of Hygiene,
      Rabat, Morocco.
FAU - El-Rhilani, Houssine
AU  - El-Rhilani H
AD  - UNAIDS Morocco country office, Rabat, Morocco.
FAU - Alami, Kamal
AU  - Alami K
AD  - UNAIDS Morocco country office, Rabat, Morocco.
FAU - Youbi, Mohamed
AU  - Youbi M
AD  - Ministry of Health, Directorate of Epidemiology and Disease Control, Rabat,
      Morocco.
FAU - Rowley, Jane
AU  - Rowley J
AD  - London, United Kingdom.
FAU - Abu-Raddad, Laith
AU  - Abu-Raddad L
AD  - Weill Cornell Medical College - Qatar, Cornell University, Doha, Qatar.
FAU - Smolak, Alex
AU  - Smolak A
AD  - Weill Cornell Medical College - Qatar, Cornell University, Doha, Qatar.
FAU - Taylor, Melanie
AU  - Taylor M
AD  - World Health Organization, Dept. of Reproductive Health and Research, Geneva,
      Switzerland.
AD  - Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, 
      Georgia, United States of America.
FAU - Mahiane, Guy
AU  - Mahiane G
AD  - Avenir Health, Glastonbury, Connecticut, United States of America.
FAU - Stover, John
AU  - Stover J
AD  - Avenir Health, Glastonbury, Connecticut, United States of America.
FAU - Korenromp, Eline L
AU  - Korenromp EL
AUID- ORCID: http://orcid.org/0000-0002-5301-8461
AD  - Avenir Health, Glastonbury, Connecticut, United States of America.
LA  - eng
GR  - Wellcome Trust/United Kingdom
PT  - Historical Article
PT  - Journal Article
DEP - 20170824
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Female
MH  - History, 20th Century
MH  - History, 21st Century
MH  - Humans
MH  - Incidence
MH  - *Models, Theoretical
MH  - Morocco/epidemiology
MH  - *Population Surveillance
MH  - Prevalence
MH  - Syphilis/*epidemiology
PMC - PMC5570350
EDAT- 2017/08/25 06:00
MHDA- 2017/10/20 06:00
CRDT- 2017/08/25 06:00
PHST- 2017/01/10 00:00 [received]
PHST- 2017/07/03 00:00 [accepted]
PHST- 2017/08/25 06:00 [entrez]
PHST- 2017/08/25 06:00 [pubmed]
PHST- 2017/10/20 06:00 [medline]
AID - 10.1371/journal.pone.0181498 [doi]
AID - PONE-D-17-01131 [pii]
PST - epublish
SO  - PLoS One. 2017 Aug 24;12(8):e0181498. doi: 10.1371/journal.pone.0181498.
      eCollection 2017.