Syphilis among U.S.-Bound Refugees, 2009-2013

U.S. immigration regulations require clinical and serologic screening for syphilis for all U.S.-bound refugees 15 years of age and older. We reviewed syphilis screening results for all U.S.-bound refugees from January 1, 2009 through December 31, 2013. We calculated age-adjusted prevalence by region and nationality and assessed factors associated with syphilis seropositivity using multivariable log binomial regression models. 

Among 233,446 refugees, we identified 874 syphilis cases (373 cases per 100,000 refugees). The highest overall age-adjusted prevalence rates of syphilis seropositivity were observed among refugees from Africa (1340 cases per 100,000), followed by East Asia and the Pacific (397 cases per 100,000). In most regions, male sex, increasing age, and living in non-refugee camp settings were associated with syphilis seropositivity. 

Future analysis of test results, stage of infection, and treatment delivery overseas is warranted in order to determine the extent of transmission risk and benefits of the screening program.

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By:  Nyangoma EN1,2, Olson CK3, Painter JA3, Posey DL3, Stauffer WM3,4, Naughton M3, Zhou W3, Kamb M5, Benoit SR3.

• 1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. ENyangoma@cdc.gov.
• 2Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS E-03, Atlanta, GA, USA. ENyangoma@cdc.gov.
• 3Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS E-03, Atlanta, GA, USA.
• 4Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
• 5Division of Sexually Transmitted Diseases Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
• J Immigr Minor Health. 2016 Mar 18.  

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