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      Scaling up syphilis testing in China: implementation beyond the clinic.

      Bulletin of the World Health Organization
      China, epidemiology, Disease Outbreaks, statistics & numerical data, Geography, Health Policy, Health Resources, Health Services Accessibility, Health Services Needs and Demand, Humans, Mass Screening, Point-of-Care Systems, Poverty, Prenatal Care, Public Health, methods, Risk Factors, Sexually Transmitted Diseases, diagnosis, prevention & control, Socioeconomic Factors, Syphilis, Time Factors

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          Abstract

          China is experiencing a syphilis epidemic of enormous proportions. The regions most heavily affected by syphilis correspond to regions where sexually transmitted HIV infection is also a major public health threat. Many high-risk patients in China fail to receive routine syphilis screening. This missed public health opportunity stems from both a failure of many high-risk individuals to seek clinical care and a disconnect between policy and practice. New point-of-care syphilis testing enables screening in non-traditional settings such as community organizations or sex venues. This paper describes the current Chinese syphilis policies, suggests a spatiotemporal framework (based on targeting high-risk times and places) to improve screening and care practices, and emphasizes a syphilis control policy extending beyond the clinical setting.

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