Syphilis incidence among children in Canada skyrockets amid health care failures -Health

TORONTO, March 31 (Reuters) – The number of babies born with syphilis in Canada is rising at a much faster rate than records in the United States or Europe, with public health experts saying the increase is being driven by increased use and lack of access to methamphetamine. Public health system for tribals.

Although syphilis has made a global resurgence in the past five years, according to Health Canada, Canada is an outlier among wealthy nations in its rate of increase: 13 times in five years. According to Health Canada data, the incidence of babies born with syphilis will reach 26 per 100,000 live births in 2021, up from 2 in 2017, the most recent year available.

That total is set to rise further in 2022, according to preliminary government data obtained by Reuters.

According to the World Health Organization (WHO), children with congenital syphilis are at increased risk of low birth weight, bone deformities and sensory problems.

Syphilis during pregnancy is the second leading cause of stillbirth worldwide, WHO said.

Yet congenital syphilis is easily preventable if an infected person has access to penicillin during their pregnancy.

Among wealthy G7 countries for which data are available, only the United States had a higher prevalence of syphilis at birth: 74 per 100,000 live births in 2021, triple the rate in 2017, according to preliminary data from the US Centers for Disease Control and Prevention (CDC).

According to preliminary CDC data, there were 2,677 cases of congenital syphilis in the United States in 2021 for a population of 332 million. According to Health Canada, there are 96 cases in Canada for a population of 38 million.

People who experience poverty, homelessness and drug use and inadequate access to health care are more likely to contract syphilis through unprotected sex and pass it on to their children, public health researchers say.

“In high-income countries you see it in pockets of disadvantaged populations,” said Teodora Elvira Y, who works in the WHO’s HIV, Hepatitis and Sexually Transmitted Infections Programme.

“It’s a marker of inequality. It’s a marker of low-quality prenatal care.”

What sets Canada apart is its aboriginal population, which is discriminated against and often has poor access to health and social services, says Shaun Rourke, a scientist at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto, who focuses on preventing sexually transmitted infections. disease.

“It’s just the whole system, and all the things we’ve done in a bad way to not support Indigenous communities,” he said.

Health Canada told Reuters it has dispatched epidemiologists to help provinces control the rise in congenital syphilis. Spokesman Joshua Coke said the federal government is expanding access to testing and treatment in Indigenous communities.

Tessa, a 28-year-old Aboriginal woman who asked to be identified only by her middle name, said she had been addicted to crystal meth for a year and was homeless while pregnant in Saskatoon, Saskatchewan.

“I would just walk down the street crying: ‘Why am I living like this?'” she told Reuters.

She said she received no prenatal care until the November delivery, when she tested positive for HIV and syphilis during a routine check-up.

Her daughter was prescribed a 10-day course of antibiotics, administered by IV, and is now healthy, Tessa said. But she still thinks about the difficulties she experienced in accessing antenatal care

“Transportation, maybe, and a place to stay, and being sober, probably would have helped a lot of the time,” he said.

Suzanne Nicolay, nurse lead at the Wellness Wheel Clinic in Regina, Saskatchewan, which serves aboriginal and vulnerable populations, says providers need to do more to increase access to health care. “The system always talks about patients who are hard to reach. But I think it’s hard to reach health providers,” he said.

‘multiple failures’

Many things have to go wrong for a baby to be born with syphilis, said Jared Bullard, a Manitoba pediatrician who is studying babies born with syphilis through 2021 in an ongoing study for the Public Health Agency of Canada.

“It points to multiple failures along the way,” he said.

In Canada, the increase in children born with syphilis is concentrated in three prairie provinces: Manitoba, Saskatchewan and Alberta.

Crystal meth use is higher in the Prairie Province and remote populations and indigenous populations who may have trouble accessing health care, Bullard said.

Manitoba recorded the highest rate with about 371 cases per 100,000 live births in 2021.

The province said in an emailed statement that it is expanding training for health care providers to deal with sexually transmitted infections, encouraging frequent testing and early treatment. It is digitizing records of STI infections.

Provincial Health Ministry spokesperson Dale Hunter said Saskatchewan has launched a public awareness campaign urging people to practice safe sex and get tested. The province had 185 cases of congenital syphilis per 100,00 live births in 2021.

Alberta says women ages 15-29 account for more than half of what it calls a “significant increase” in syphilis rates. “The reasons for the increase are not fully known, but it is likely that several factors contributed to the increase,” said Alberta Health Services spokesman James Wood.

In preliminary results of a study of 165 children exposed to syphilis, Bullard and fellow pediatrician Kirsten Kruger found that at least two-thirds were born to women who reported a history of substance abuse.

About 45% of women identified as Aboriginal and another 40% had no ethnicity recorded. Aboriginal people make up about 5% of Canada’s population, according to census data.

About a quarter of people in the study were not tested because they did not receive any prenatal care; About one-fifth of those who tested positive were not treated. Bullard says she’s seen people get treated early in pregnancy and then relapse.

Public health researchers and clinicians say rates of congenital syphilis began to rise before the pandemic and worsened as public health agencies diverted resources to Covid-19 testing and other pandemic-related health measures.

“All the social conditions that contributed to this have worsened in the epidemic,” says Amita Singh, an infectious disease specialist with an HIV/STI practice in Edmonton, Alberta.

This month Health Canada approved a syphilis and HIV test that can provide results in less than a minute, allowing providers to start treatment right away.

Some public health researchers and providers are urging the Canadian government to buy and distribute the tests.

“We probably need a million tests to get there across the country,” Raurke said. “The solution is before us.”

Health Canada did not respond when asked about the purchase of test kits.

Reporting by Anna Mehler Pepperoni Editing by Denny Thomas and Suzanne Goldenberg

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