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Syphilis prevalence is 5.20-fold higher in low-income countries among forcibly displaced populationsHigh Rates of Syphilis Found Among Displaced Populations

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Key Takeaway
Note high syphilis prevalence in low-income regions among displaced populations; prioritize screening in these areas.

This meta-analysis synthesized data from 82 reports involving 1.1 million test results to determine the prevalence of several sexually transmitted infections (STIs) among forcibly displaced populations, including refugees and internally displaced persons. The study specifically analyzed current and lifetime infections for syphilis, gonorrhea, chlamydia, and trichomoniasis.

Key findings indicate a current infection rate of 0.94% for syphilis and 2.78% for lifetime syphilis. Notably, syphilis prevalence was 5.20-fold higher in low-income countries compared to high-income countries (95% CI 1.47 to 18.38) and 2.90-fold higher in the African region compared to the Eastern Mediterranean (95% CI 1.58 to 5.33). Other infections showed lower current prevalence rates: 0.87% for gonorrhea, 0.14% for chlamydia, and 17.07% for trichomoniasis.

The authors note that evidence for gonorrhea, chlamydia, and trichomoniasis is more limited than for syphilis. The findings highlight a substantial burden of syphilis in these populations, suggesting the need for targeted screening campaigns and surveillance programs, particularly in low-resource settings.

How this fits prior evidence

This meta-analysis addresses gaps in understanding STI prevalence among forcibly displaced populations. It confirms the high burden of syphilis identified in other contexts, specifically highlighting that syphilis prevalence is 5.20-fold higher in low-income countries and 2.90-fold higher in the African region compared to the Eastern Mediterranean. While it provides a large scale look at multiple STIs, the authors note evidence for gonorrhea, chlamydia, and trichomoniasis is more limited.

Researchers analyzed over one million test results from 82 different reports to study the prevalence of sexually transmitted infections. The study focused on forcibly displaced populations, including refugees and asylum seekers globally. This large amount of data helps identify how common certain infections are in these specific groups.

The findings show that syphilis is a significant concern among these populations. While current infection rates for gonorrhea and chlamydia were lower, trichomoniasis showed a much higher prevalence rate. The study also noted that syphilis rates were significantly higher in low-income countries compared to high-income countries.

Because the data for some infections like trichomoniasis is limited, it is hard to draw firm conclusions for every condition. However, the results suggest that people in these communities face a heavy burden of disease. These findings highlight why screening and monitoring programs are important in areas with fewer resources.

What this means for you:
Syphilis and other infections are common among displaced populations, especially in low-income regions.

Common questions

How common is syphilis in displaced populations?

The study found a current infection rate of 0.94% for syphilis among those studied. However, the lifetime infection rate was higher at 2.78%. The data showed that syphilis prevalence was over 5 times higher in low-income countries compared to high-income countries.

What other infections were found in these groups?

The study also looked at gonorrhea, chlamydia, and trichomoniasis. Current infection rates were 0.87% for gonorrhea and 0.14% for chlamydia. Trichomoniasis showed a much higher prevalence of 17.07%.

Is the data for all infections equally reliable?

The evidence for some conditions is not as strong as others. Specifically, the study noted that the information available for gonorrhea, chlamydia, and trichomoniasis was more limited than the data provided for syphilis.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Curable sexually transmitted infections (STIs), including (syphilis), , and , remain a major global health concern; yet their epidemiology among forcibly displaced populations is poorly understood. Limited access to healthcare, high-risk exposures and structural vulnerabilities may contribute to a heightened burden of STIs in these populations. METHODS: A systematic review conducted up to 12 July 2024 assessed the prevalence of syphilis, and infections among refugees, asylum seekers and internally displaced populations globally. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Pooled mean prevalence of current and/or lifetime infection for each STI was estimated through random-effects meta-analyses. Random-effects meta-regression analysis was feasible for syphilis and investigated sources of heterogeneity, associated factors and temporal trends in prevalence. RESULTS: The review identified 82 reports contributing 232 prevalence measures based on over 1.1 million test results, with syphilis being the most frequently studied STI. The estimated pooled mean prevalence of current infection was 0.94% (95% CI 0.53% to 1.45%) for syphilis, 0.87% (95% CI 0.33% to 1.61%) for , 0.14% (95% CI 0.06% to 0.32%) for and 17.07% (95% CI 0.07% to 51.37%) for . The prevalence of lifetime syphilis was 2.78% (95% CI 1.54% to 4.31%). Meta-regression analyses explained 64% of the variation in syphilis prevalence. Populations displaced from the African region had a 2.90-fold higher prevalence of syphilis compared with those from the Eastern Mediterranean region (95% CI 1.58 to 5.33), and those hosted in low-income countries had a 5.20-fold higher prevalence than those in high-income countries (95% CI 1.47 to 18.38). Syphilis prevalence declined over time at a relative annual rate of 6%. CONCLUSION: This review highlights a substantial burden of syphilis among forcibly displaced populations, suggesting active transmission. Evidence for the other curable STIs is more limited, hindering a comprehensive understanding of their epidemiology in humanitarian settings. Systematic screening campaigns and effective STI surveillance are urgently needed, particularly in low-resource settings.
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