Delayed Access To Health Care Among Acquired Syphilis Infection: Root Cause Analysis

Background:Delay in health-seeking of chronic infected disease has been a commonphenomenon. But previous study mostly focus on leprosy, tuberculosis. While thegeneralizability of the study findings in sexually transmitted diseases is limited. Only onesimilar study have we found,it is defined the interval between onset of symptoms of earlysymptomatic syphilis among men who sex with men. It is true that if we define the delay time asthe interval between the onset of symptoms of acquired syphilis and its first health seeking canbetter reflect their patient delay time. But as we said in our manuscript, for latent syphilis, it isasymptomatic and difficult to diagnose without widespread screening. For symptomaticsyphilis(primary and secondary syphilis),some patients ignore their symptoms. What is more,they maybe infective latent syphilis and symptomatic syphilis before clinical manifestation. Soit is important to improve initially and timely seeking healthcare after infection or high-risk sex.Methods:we conducted a cross-sectional survey and retrospective chart review.Results:Two hundred seventy-eight patients were treated for acquired syphilis.The meantime to initial consultation of a health care professional was226days. for primary, secondaryand latent syphilis, the time was43,85and518days, respectively.The mean time for male andfemale patients was177and288days.farmers had the longest delay,424days,than hiscounterpart.patients from rural areas the delay was381days; while it was180days for urbandwellers.Female gender (P=0.008), occupation as a farmer (P <0.005), rural area (P=0.000),and latent syphilis (P=0.000) were significantly associated with a longer delay.Conclusion:Females, farmers, rural area and latent syphilis were factors associated withlonger time to health care consultation.