Room for improvement--syphilis; knowledge and delayed diagnosis among sexual health clinic attendees

Cases of early infectious syphilis are increasing in Ireland. A questionnaire distributed to sexual health clinic attendees assessed syphilis knowledge. A telephone survey in patients with secondary syphilis explored potential delays in diagnosis. 272 questionnaires were completed. 54% of respondents were male, 222 (81.6%) were Irish.31/268 (12%) who stated their sexual orientation were men who have sex with men (MSM). 226 (83%) had heard of syphilis. MSM had better knowledge compared to heterosexual males (p<0.05). Contact details were available for 60 patients with secondary syphilis. 37 patients were surveyed. 31/37 (84%) recalled symptoms prior to diagnosis, mean duration of symptoms 53 days (range 7-168). 23/37 (62%) reported consulting at least one physician before attending sexual health services. 12/23 (52%) were given an alternate or no diagnosis. Greater awareness of syphilis signs and symptoms is needed amongst patients and healthcare providers to prevent delayed diagnosis leading to ongoing transmission.