Abstract:

Objective To analyse the epidemiological characteristics and incidence trends of syphilis in Hotan Prefecture of Xinjiang Uygur Autonomous Region from 2014 to 2023，in order to provide a basis for the development of future preventive and control measures and countermeasures. Methods Descriptive epidemiological methods were used to carry out statistics and analysis of syphilis cases with onset dates from 1 January 2014 to 31 December 2023 in Hotan Prefecture. Results The reported incidence rate of syphilis in Hotan Prefecture fluctuated significantly from 2014 to 2023，showing a decreasing and then increasing trend. Among them，the reported incidence rates of primary syphilis，secondary syphilis，tertiary syphilis and foetal-transmitted syphilis all showed a decreasing trend，with annual average decreases of 30.98%，7.95%，25.71%，and 25.41%，respectively，whereas the reported incidence rate of recessive syphilis showed an increasing trend（χ²=6 177.790，P<0.05），with an annual average increase of 12.82%，and had become the main type of syphilis case infection since 2016. Syphilis cases were reported in all counties and cities in Hotan Prefecture，and the top three counties in terms of annual average reported incidence were Moyu County，Minfeng County，and Yutian County，accounting for 58.89% of the total number of reported cases in the region. The male-to-female sex ratio was 1.08 ∶ 1，the top three age groups in terms of incidence rate were ≥60 years old（220.18/100 000），50-<60 years old（212.38/100 000），and 40-<50 years old（148.39/100 000），and the reported incidence rate of 20-<30 years old and 50-<60 years old showed a fluctuating upward trend，with an average annual growth rate of 7.03% and 4.45%，respectively，with statistically significant differences between the ten-year periods（χ²=561.436，563.734，both P<0.05）. The occupation of the reported cases was mainly farmers（78.14%）. Conclusion The decline in the reported incidence of primary syphilis，secondary syphilis，and foetal-transmitted syphilis in Hotan Prefecture reflects that the syphilis epidemic in Hotan Prefecture has been contained to a certain extent. However，the rapid rise in reported recessive syphilis and the youthfulness of new syphilis cases bring uncertainty to the prevention and control of syphilis epidemics，and prevention and treatment work in key counties and cities should be strengthened in response to the characteristics of the epidemic's incidence，and the capacity for syphilis discovery and reporting and management should be improved. In addition，publicity and education on syphilis prevention and treatment should be strengthened for key groups such as young and middle-aged people and farmers，and the coverage of behavioural interventions should be continuously expanded.

Key words: Syphilis, Epidemiological characteristics, Trend, Bloodborne and sexually transmitted infections, Disease prevention and control, Hotan，Xinjiang