However, blood donor data is a useful tool in providing information on the seroprevalence of syphilis in the population, making it suitable for monitoring the effects of public health programs ( 11, 12). Transmission via transfusion has not happened for over 15 years in Germany ( 10). Syphilis antibodies detected in blood donor samples must also be reported to the RKI ( 9). This offers a good insight into incident cases. Currently, most syphilis cases are diagnosed through serological testing ( 7) and, in Germany, all laboratories are obliged to anonymously report treponemal pallidum positive serological test results to the Robert Koch Institute (RKI) ( 8). Since the disease tends to manifest inconspicuously, an infection often remains undetected ( 6), resulting in an underassessment of infections. In addition, the clinical symptoms often indicate more than one possible differential diagnosis result ( 4, 5). While treatment of syphilis is assessable and cost effective, the diagnosis of syphilis is challenging because traditional tools like cultivation and gram staining are not available ( 3). neurosyphilis) and can even compromise pregnancy outcomes (including stillbirth and congenital syphilis) ( 2) thus it represents a serious health concern. Untreated or undetected infections can lead to severe health outcomes (f. The pathogen can be transmitted via transplacental transmission, sexual contact with infectious lesions, and blood transfusions ( 1). Syphilis is a systemic disease caused by the bacteria Treponema pallidum. It can help raise awareness in populations potentially at risk for infectious diseases, demonstrate the need to educate potential risk groups, and may help with predictive cost calculations and planning. Based on our model, we estimated a total average minimal annual burden of €20,292,110 for syphilis on the German healthcare system between 20.Ĭonclusions: The linking of claims data, results from EQA schemes, and blood donor surveillance can be a useful tool for assessing the burden of disease on the healthcare system. Results from EQA schemes indicated an average sensitivity of 92.8 % and an average specificity of 99.9 % for the recommended sequential testing for syphilis. The number of estimated inpatients was predicted with an accuracy of 89.8 %. This could be due to an underassessment of cases in Germany or due to limitations of the dataset. Results: The standardized results were slightly higher than the results reported between 20. The annual direct and indirect economic burden was estimated based on the outcomes of our model. The model analysis was validated with the reported cases and diagnosis-related group (DRG)-statistics from 2010 to 2012. The test quality was assessed by extrapolating the number of false-positive and false-negative results based on data from Europe-wide external quality assessment (EQA) schemes. Age standardized rates were calculated based on the standard German population. Methods: The model included gender- and age-stratified incident cases of syphilis (in- and outpatients) provided by a German statutory health insurance company, as well as seroprevalence data on syphilis in first-time blood donors. We chose the sexually transmitted disease syphilis for our model due to the good quality of reported data in Germany.
Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
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