Background: In the United States, primary and secondary (P&S) syphilis rates have been rising since 2000 (CDC, 2017). Untreated P&S syphilis can lead to severe neurological and cardiovascular damage (CDC, 2017). Syphilis is often transmitted to the fetus during pregnancy causing miscarriage, birth defects, stillbirth, and neonatal death (Arnold et al., 2000). Louisiana ranks third in the nation in P&S syphilis and first in congenital syphilis rates (14.5 per 100,000; 93.4 per 100,000 live births; CDC, 2017). Assessing patient and provider knowledge can inform education programs aimed at reducing syphilis transmission and increasing identification and treatment.
Methods: This is a survey study administered to a convenience sample of patients, providers, and ancillary staff in an urban academic Emergency Department. Each cohort completed a 19-question true/false questionnaire assessing knowledge regarding syphilis risk factors, symptoms, transmission, and treatments. The survey is internally consistent with a Cronbach α of 0.79. A total of 105 patients, 97 providers, and 83 ancillary staff were surveyed. STATA was used to conduct Student’s t-test and analysis of variance.
Results: Highest scores were seen in providers (79.65%, n=97), followed by ancillary staff (58.07%, n=83), and patients (48.71%, n=105), p= 0.0000. There were 2 questions answered incorrectly by over half of participants in all three cohorts. They tested knowledge of the state’s high syphilis rates and increased risk for infection in men who have sex with men. In patients, knowledge level was significantly related to whether they had previously heard of syphilis, with those who had (85.58%) scoring an average of 21.74 ± [33.13, 10.34] (p= 0.0003) points higher. School (53.47%) and healthcare professionals (38.61%) were the most common sources of information. Of the providers, nurses had a significantly lower score on the general questionnaire than attendings (p=0.003), residents (p=0.000), and medical students (p=0.005).
Conclusion: These results highlight the dire need for syphilis education, especially among patients. Questions with the lowest scores represent topics that need to be addressed by education and training programs.