Thesis (M.S.P.H.)--University of Michigan, 1939.

Thesis (M.S.P.H.)--University of Michigan, 1939.

No description available.

There is a definite lack of information on treponemal infections in Canada. This thesis attempts to add to the knowledge on treponemal infections from studying outbreaks of the disease from smaller geographic regions of Canada. The purpose of this thesis is to study an alleged outbreak of syphilis, known as St. Paul's Bay Disease (SPBD) and to learn as much as possible about this disease, including its clinical and epidemiological characteristics, diagnosis and origins. This thesis provides evidence to support the contention that this 18th century outbreak of SPBD was not venereal syphilis, but rather endemic syphilis. The findings of this study were drawn from multiple lines of qualitative and quantitative evidence. The descriptions of SPBD by the medical practitioners of that time period reflect a high degree of similarity between SPBD and endemic syphilis. These descriptions contain information on the symptoms, method of treatment, method of transmission and diagnosis of SPBD. Furthermore, when SPBD was compared to the Sibbens of Scotland (a confirmed outbreak of endemic syphilis) they were found to be almost indistinguishable. Lastly, the distribution and prevalence of SPBD among the affected populations were found to be more characteristic of endemic syphilis. It is suggested that future research be carried out in three major areas: the ethnohistory of the various towns in Lower Canada, the origins of SPBD, and lastly, why the disease 'suddenly' disappeared. All of which will bring us one step closer to both understanding this outbreak and the history of treponemal infections in general. / Thesis / Master of Arts (MA)

In early modern Europe, syphilis tormented individuals regardless of social standing. The various stages of infection rendered individuals with visible chancres or “pocky” marks throughout their body. The tertiary stage signaled the spreading of the disease from the infected parts into the brain and cardiovascular system, eventually leading to dementia and a painful death. Beginning with the initial medical responses to venereal disease in the sixteenth century and throughout the early modern period, medical practitioners attempted to identify the cause of syphilis. During the seventeenth century, English practitioners maintained that women were primarily responsible for both the creation and transmission of syphilis. In England, venereal disease became the physical manifestation of illicit sexual behavior and therefore women with syphilis demonstrated their sexual immorality. Contrastingly, French medical practitioners refrained from placing blame on women for venereal infection. The historiography of early modern discourse on venereal disease fails to account for this discrepancy between English and French perceptions of syphilis in the seventeenth century. This thesis seeks to fill the gap in this historiography and suggest why French practitioners abstained from singling out women as the primary source of venereal infection by suggesting the importance that cultural influences and religious practices had toward shaping medical perceptions. The cultural impact of the querelle des femmes and Catholic practices in France plausibly influenced the better portrayal of women within the medical treatises of seventeenth-century France when compared to Protestant England.

No description available.

Orientador: Adriano Dias / Banca: Iracema de Mattos Paranhos Calderon / Banca: Maria do Socorro Nantua Evangelista / Resumo: A sífilis na gestação é um grave problema de saúde pública, responsável por altos índices de morbimortalidade intrauterina. Estima-se que leve, em pelo menos 50% das gestações acometidas, a desfechos perinatais adversos. Esses dados remetem à falta de controle das doenças sexualmente transmissíveis (DST) e à deficiência na assistência pré-natal. O objetivo deste estudo transversal foi conhecer o perfil sócio-demográfico e os antecedentes obstétricos das gestantes com VDRL reagentes no DF no ano de 2010. Verificou-se o percentual de gestantes que tiveram acesso ao pré-natal e foram inadequadamente tratadas de acordo com as recomendações do MS. Foram entrevistadas 67 gestantes/ puérparas notificadas no SINAN, em cinco maternidades públicas do DF e consultadas as informações do prontuário e cartão da gestante quando disponível. Foram avaliados dados sóciodemográficos, obstétricos, informações relacionadas ao diagnóstico e tratamento da gestante/puérpara e parceiro. Apenas 41,8% gestantes foram adequadamente tratadas e o principal motivo para a inadequação do tratamento foi a falta (83,6%) ou inadequação do tratamento do parceiro (88,1%). Foi constatada a necessidade de novo tratamento da gestante na maternidade por falta de documentação do tratamento realizado no pré-natal. Os dados demonstram que a qualidade do pré-natal recebido pela gestante não é suficiente para garantir o controle da sífilis congênita e o atingimento da meta de controle da doença / Abstract: Syphilis during pregnancy is a serious public health problem responsible for high rates of intrauterine mortality. It is estimated that in at least 50% of pregnancies affected, adverse perinatal outcomes happen. These findings reflect the lack of control of sexually transmitted diseases (STDs) and disability in prenatal care. The goal of this survey was to understand the epidemiological profile of women with VDRL reagents in the Federal District in 2010. The study verified the percentage of pregnant women who had access to prenatal care and were inadequately treated in accordance with the recommendations of the Ministry of Health. We interviewed 67 pregnant and postpartum women who reported to the SINAN, users of five public hospitals of the DF and consulted information from medical records and from prenatal care charts, when available. Data were collected on sociodemographic, obstetric, information related to diagnosis and treatment of pregnant and puerperal women and their partners. Only 28 (41.8%) patients were adequately treated and the main reason for inadequacy was the lack of treatment (83.6%) or inadequate treatment of the partner (88.1%). The study demonstrated the need for new treatment of the mother at the hospital for lack of documentation of the treatment in prenatal care. Our data demonstrates that the quality of prenatal care received by pregnant women is not sufficient to ensure control of congenital syphilis and reaching the goal of controlling the disease / Mestre

Mathematical models applied to epidemiology are useful tools that help understand how infectious diseases spread in populations, and hence support public-health decisions. Over the last 250 years, these modelling tools have have developed at an increasing rate, both on the theoretical and computational sides. This thesis explores various modelling techniques to address debated or unanswered questions about the transmission dynamics of infectious diseases, in particular sexually transmitted ones. The role of sero-discordant couples (when only one partner is infected) in the HIV epidemic in Sub-Saharan Africa is controversial. Their importance compared to other sexual transmission routes is critical when designing intervention policies. In chapter 2, I used a compartmental model with an original partnership process to show that infection of uncoupled individuals is usually the predominant route, while transmission within discordant couples is also important, but to a lesser extent. Despite the availability of inexpensive antimicrobial treatment, syphilis remains prevalent worldwide, affecting millions of individuals. Development of a syphilis vaccine would be a potentially promising step towards control, but the value of dedicating resources to vaccine development should be evaluated in the context of the anticipated benefits. In chapter 3, I explored the potential impact of a hypothetical syphilis vaccine on morbidity from both syphilis and HIV using an agent-based model. My results suggest that an efficacious vaccine has the potential to sharply reduce syphilis under a wide range of scenarios, while expanded treatment interventions are likely to be substantially less effective. General concepts in epidemic modelling, that could be applied to any disease, are still debated. In particular, a rigorous definition and analysis of the generation interval – the interval between the time that an individual is infected by an infector and the time this infector was infected – needed clarification. Indeed, the generation interval is a fundamental quantity when modelling and forecasting epidemics. Chapter 4 clarifies its theoretical framework, explains how its distribution changes as an epidemic progresses and discuss how empirical generation-interval data can be used to correctly inform mathematical models. / Thesis / Doctor of Philosophy (PhD)

Introdução: A sífilis em gestantes é um problema de saúde pública, com casos crescentes a cada ano. O tratamento do parceiro sexual da gestante com sífilis, é de suma importância, pois a falta de tratamento deste pode invalidar todas as medidas de controle instituídas durante o cuidado pré-natal. Objetivo: Descrever a ocorrência de tratamento do parceiro sexual e avaliar fatores maternos que favorecem a realização do tratamento do parceiro sexual das gestantes com sífilis gestacional atendidas no Hospital Fêmina (HFE). Método: Estudo transversal descritivo onde foram descritos os casos de pacientes com diagnóstico de sífilis gestacional atendidas no Serviço de Obstetrícia do HFE no período de 01 de janeiro de 2007 a 31 de dezembro de 2014, e seus respectivos parceiros. A coleta de dados foi realizada através dos dados encaminhados pelo Serviço de Controle de Infecção Hospitalar do Hospital Fêmina à Vigilância em Saúde do Município de Porto Alegre em sífilis, em conjunto com os prontuários das pacientes estudadas. O projeto teve aprovação do Comitê de Ética em Pesquisa do Grupo Hospitalar Conceição com protocolo de número 47914815.2.0000.5530. Resultados: Foram identificados 771 casos de sífilis em gestantes, e desses 570 não tinham informações sobre o tratamento do parceiro sexual da gestante. Dos 201 casos de gestantes com informações sobre o tratamento do parceiro sexual, 25 (12,44%) parceiros foram adequadamente tratados. Na análise univariada comparando gestantes com parceiros tratados para sífilis e não tratados, identificaram-se características associadas à ocorrência de tratamento adequado do parceiro em relação a mulheres que apresentaram sífilis gestacional: a) mais de oito anos de estudo (p=0.022), b) acompanhamento pré-natal adequado (p=0.010) e diagnóstico da sífilis no pré-natal (p=0.003). Conclusão: Escolaridade, diagnóstico precoce de sífilis, e a realização de pré-natal adequado parecem ser fatores determinantes para o adequado tratamento do parceiro e prevenção da transmissão vertical da doença. / Introduction: Syphilis in pregnant women is a public health problem, with increasing cases each year. Treatment of the sexual partner of the pregnant women with syphilis is very important because the lack of treatment may invalidate all control measures imposed during prenatal care. Objective: to describe the occurrence of treatment of the sexual partner and evaluate maternal factors that favor the realization of the treatment of the sexual partner of pregnant women with gestational syphilis treated in Hospital Fêmina. Method: This is a cross-sectional descriptive study, in which were described the cases of patients diagnosed with gestational syphilis in the Obstetrics Department of Hospital Fêmina, and their partners, from January 1st 2007 to December 31st 2014. Data collection was done through the data sent by the Department of Infection Control to Department of Health Surveillance of Porto Alegre in syphilis, along with the records of patients. Ethical principles will be were respected. The project had approval of the ethics committee of Grupo Hospitalar Conceição under protocol number 47914815.2.0000.5530. Results: 771 cases of syphilis in pregnant women were identified. No information on the treatment of the sexual partners was available in 570 of these cases. Among the 201 cases presenting information about the partners treatment, 25 (12.44%) of them were adequately treated. In the univariate analysis comparing women whose partners were treated for syphilis with those untreated demonstrates the associated characteristics as: a) more than eight years of study (p =0.022); b) adequate prenatal care (p= 0.010) and diagnosis of syphilis in prenatal care (p= 0.003). Conclusion: The years of study, the early diagnosis of syphilis and an adequate prenatal care appear to be determining factors for appropriate partner treatment and prevention of the vertical transmission of the disease.

Introdução: A sífilis em gestantes é um problema de saúde pública, com casos crescentes a cada ano. O tratamento do parceiro sexual da gestante com sífilis, é de suma importância, pois a falta de tratamento deste pode invalidar todas as medidas de controle instituídas durante o cuidado pré-natal. Objetivo: Descrever a ocorrência de tratamento do parceiro sexual e avaliar fatores maternos que favorecem a realização do tratamento do parceiro sexual das gestantes com sífilis gestacional atendidas no Hospital Fêmina (HFE). Método: Estudo transversal descritivo onde foram descritos os casos de pacientes com diagnóstico de sífilis gestacional atendidas no Serviço de Obstetrícia do HFE no período de 01 de janeiro de 2007 a 31 de dezembro de 2014, e seus respectivos parceiros. A coleta de dados foi realizada através dos dados encaminhados pelo Serviço de Controle de Infecção Hospitalar do Hospital Fêmina à Vigilância em Saúde do Município de Porto Alegre em sífilis, em conjunto com os prontuários das pacientes estudadas. O projeto teve aprovação do Comitê de Ética em Pesquisa do Grupo Hospitalar Conceição com protocolo de número 47914815.2.0000.5530. Resultados: Foram identificados 771 casos de sífilis em gestantes, e desses 570 não tinham informações sobre o tratamento do parceiro sexual da gestante. Dos 201 casos de gestantes com informações sobre o tratamento do parceiro sexual, 25 (12,44%) parceiros foram adequadamente tratados. Na análise univariada comparando gestantes com parceiros tratados para sífilis e não tratados, identificaram-se características associadas à ocorrência de tratamento adequado do parceiro em relação a mulheres que apresentaram sífilis gestacional: a) mais de oito anos de estudo (p=0.022), b) acompanhamento pré-natal adequado (p=0.010) e diagnóstico da sífilis no pré-natal (p=0.003). Conclusão: Escolaridade, diagnóstico precoce de sífilis, e a realização de pré-natal adequado parecem ser fatores determinantes para o adequado tratamento do parceiro e prevenção da transmissão vertical da doença. / Introduction: Syphilis in pregnant women is a public health problem, with increasing cases each year. Treatment of the sexual partner of the pregnant women with syphilis is very important because the lack of treatment may invalidate all control measures imposed during prenatal care. Objective: to describe the occurrence of treatment of the sexual partner and evaluate maternal factors that favor the realization of the treatment of the sexual partner of pregnant women with gestational syphilis treated in Hospital Fêmina. Method: This is a cross-sectional descriptive study, in which were described the cases of patients diagnosed with gestational syphilis in the Obstetrics Department of Hospital Fêmina, and their partners, from January 1st 2007 to December 31st 2014. Data collection was done through the data sent by the Department of Infection Control to Department of Health Surveillance of Porto Alegre in syphilis, along with the records of patients. Ethical principles will be were respected. The project had approval of the ethics committee of Grupo Hospitalar Conceição under protocol number 47914815.2.0000.5530. Results: 771 cases of syphilis in pregnant women were identified. No information on the treatment of the sexual partners was available in 570 of these cases. Among the 201 cases presenting information about the partners treatment, 25 (12.44%) of them were adequately treated. In the univariate analysis comparing women whose partners were treated for syphilis with those untreated demonstrates the associated characteristics as: a) more than eight years of study (p =0.022); b) adequate prenatal care (p= 0.010) and diagnosis of syphilis in prenatal care (p= 0.003). Conclusion: The years of study, the early diagnosis of syphilis and an adequate prenatal care appear to be determining factors for appropriate partner treatment and prevention of the vertical transmission of the disease.