Ten-year retrospective cross-sectional trends in syphilis serology in a tertiary care hospital, Türkiye: impact of the COVID-19 pandemic

Abstract

Introduction: Syphilis remains an important public health concern worldwide. This study aimed to evaluate ten-year trends in syphilis serology test requests and seropositivity rates at Muğla Training and Research Hospital, with particular emphasis on the impact of the COVID-19 pandemic.

Methodology: This retrospective study included all patients tested for syphilis between 2014 and 2023. Extracted data comprised age, requesting department, anti-Treponema pallidum antibody results, and Venereal Disease Research Laboratory (VDRL) or Rapid Plasma Reagin (RPR) findings. Analyses were performed at the patient level, and repeated test requests from the same individual were excluded. A case was considered positive when both treponemal and non-treponemal assays were reactive.

Results: Annual test requests varied over the decade, ranging from 1,334 in 2018 to 3,331 in 2023. Testing declined sharply during the COVID-19 pandemic, then increased substantially. Most test requests originated from obstetrics/gynecology and infectious diseases; however, positivity rates were highest in infectious diseases and dermatology. Overall seropositivity ranged from 0.2–1.4 percent before the pandemic and increased to 3–4.3 percent in the post-pandemic period.

Conclusions: Positivity remained low among obstetric patients despite high test volumes, whereas infectious diseases and dermatology services demonstrated a clear rise in syphilis positivity after the pandemic. These findings highlight a resurgence of syphilis and underscore the need for continued surveillance, targeted screening strategies, and strengthened sexual health services.