of Syphilis in China: A Biosocial Introduction · PART 1: SYPHILIS ROOTS PART 2: SYPHILIS ......
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Resurgence of Syphilis in China: A Biosocial Introduction Biosocial Introduction Joseph D. Tucker, MD, MA 周海青 Director, University of North Carolina Chapel Hill Project – China A it tP f fM di i AssistantProf essor ofMedicine
Transcript of of Syphilis in China: A Biosocial Introduction · PART 1: SYPHILIS ROOTS PART 2: SYPHILIS ......
Resurgence of Syphilis in China: A Biosocial IntroductionBiosocial Introduction
Joseph D. Tucker, MD, MA 周海青
Director, University of North Carolina Chapel Hill Project – China
A i t t P f f M di iAssistant Professor of Medicine
PART 1: SYPHILIS ROOTS
PART 2: SYPHILIS RESPONSEPART 2: SYPHILIS RESPONSE
PART 1: SYPHILIS ROOTS
PART 2: SYPHILIS RESPONSEPART 2: SYPHILIS RESPONSE
Increasing Reported Adult & Congenital Syphilis in China60
Congenital syphilis case reports (per
Congenital Syphilis in China
40
50 100,000 live births)
20
30
T t l hili t
10
20 Total syphilis case reports(per 100,000 total population)
0
1985 1990 1995 2000 2005 2010
Reported overall syphilis and congenital syphilis reported cases per 100,000 population and per 100,000 live births respectively. Data are from the National Center for STD Control and Prevention in Nanjing, China (Chen et al., Lancet, 2007; Tucker et al., NEJM, 2010).
Increasing Reported Adult & Congenital Syphilis in China60
Congenital syphilis case reports (per
Congenital Syphilis in China
40
50 100,000 live births)Congenital Syphilis Comparison:
United States (2008) – 10.1/100,000
20
30
T t l hili t
United States (2008) 10.1/100,000China (2008) – 56.7/100,000
10
20 Total syphilis case reports(per 100,000 total population)
0
1985 1990 1995 2000 2005 2010
Reported overall syphilis and congenital syphilis reported cases per 100,000 population and per 100,000 live births respectively. Data are from the National Center for STD Control and Prevention in Nanjing, China (Chen et al., Lancet, 2007; Tucker et al., NEJM, 2010).
“Guangdong Boils”
Reported syphilis cases per 100,000 population by county/district in 2008 PLoS ONE, 2011, PMID: 21573127
IndexIndex Syphilis Case
Biological DilemmasProtean clinical manifestationsProtean clinical manifestationsLesions naturally disappear
IndexIndex Syphilis Case
Biological DilemmasProtean clinical manifestationsProtean clinical manifestationsLesions naturally disappear50‐60% transmission rate
IndexIndex Syphilis Case
Biological DilemmasProtean clinical manifestations
Social IssuesSex partner contact tracing incompleteProtean clinical manifestations
Lesions naturally disappear50‐60% transmission rate
Sex partner contact tracing incompleteHomophobia in some contexts
John
Bob
Bill
Biological DilemmasProtean clinical manifestations
Social Devastation Sex partner contact tracing largely absentProtean clinical manifestations
Lesions naturally disappear50‐60% transmission ratePossible lack of immunity in ChinaH t l d h l
Sex partner contact tracing largely absentWidespread homophobiaBreak up families, relationships, loss of faceLarge commercial sex sectorHi h i k b i d lHeterosexual and homosexual cases High‐risk businessmen and surplus men
小王
小李
老张
PART 1: SYPHILIS ROOTS
PART 2: SYPHILIS RESPONSEPART 2: SYPHILIS RESPONSE
Nascent China‐US cooperationNascent China US cooperation
George Hatem (马海德 )George Hatem (马海德 )
Left: Porter, The People’s Doctor: George Hatem and China’s Revolution. 1997. University of Hawaii Press. Right: Courtesy B. Bloom.
New Syphilis Policies:Momentum for ChangeMomentum for Change
• National 2010‐2020 S hili P i dSyphilis Prevention and Control Program
E li it b h k f• Explicit benchmarks for decreasing adult and congenital syphiliscongenital syphilis
• Integration with other prenatal screening (HIVprenatal screening (HIV and HBV)
China Ministry of Health. Notice of the Ministry of Health on Issuing National Program for Prevention and Control of Syphilis in China (2010‐2020).[http://www.gov.cn/gzdt/2010‐06/21/content_1632301.htm]
“Compass for Action”
Social entrepreneurship f l h l hfor sexual health
• Sustained, multi‐ Sexual Health 2.0,sectoral responses1
• Horizontal l l korganizational links
emphasized1
• Decentralization of• Decentralization of testing, resources, and capacities
• Culturally appropriate and tailored responses
1Tucker et al PLoS Medicine In Press
Population Development and Community Association, Thailand
1Tucker et al., PLoS Medicine, In Press
Multisectoral & MultilateralMultisectoral & Multilateral
• Cultivate local networksCultivate local networks that bring together physicians, public health, entrepreneurs, and social tentrepreneurs
• Health diplomacy frameworkframework
