Bulletin of the World Health Organization

Scaling up syphilis testing in China: implementation beyond the clinic

Joseph D Tucker, Sarah J Hawkes, Yue-Pin Yin, Rosanna W Peeling, Myron S Cohen & Xiang-Sheng Chen

Volume 88, Number 6, June 2010, 452-457

Table 2. Overview of potential syphilis screening entry points (times or places) in China

Screening entry point 1998 STI asymptomatic screening 2008 STI asymptomatic screening Estimated syphilis prevalencea Estimated target population sizeb Scalabilityc
Time
Marriage Yes Limited ca. 0.1−0.6% 8.3 million28 No
Pregnancy No Limited ca. 0.1–0.45% ca. 31 milliond Yes
Rural-to-urban migration No Limited ca. 0.4–1.0%e ca. 79 million29 Variable
Place
Entertainment centres (including venues frequented by MSM) No Variable ca. 0.5–18% Tens of millions Variable
Prisons No No Unknown ca. 1.6 million Yes
IDU, CSW, detention centres Variable Limited IDU ca. 6%, CSW ca. 12% ca. hundreds of thousands Yes

CSW, commercial sex worker; IDU, injecting drug users; MSM, men who have sex with men; STI, sexually transmitted infection

a Estimations based on data from the National Center for STI Control (Chinese Centers for Disease Control and Prevention) and the systematic review of syphilis seroprevalence among various groups,10 but included with ranges due to limited syphilis data in China.30

b Population statistics from the China Population Yearbook 2006 unless otherwise noted.

c The term “scalability” has been used in the public health literature to describe the ability of an innovation to be expanded in different contexts.31 In this case, it refers to the potential for the syphilis screening to be effectively scaled up to the entire estimated population.

d Total pregnant women in China estimated from the total number of births, stillbirths and miscarriages in China.

e The estimate for rural-to-urban migrants is based on two cross-sectional studies from eastern China.32,33

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