Prevalence of Syphilis Among Men Serving in the Militaries of Sub-Saharan Africa

Background: The 2030 United Nations Agenda for Sustainable Development includes targets to end sexually transmitted infections (STIs) as a major public health threat. Prevalence data of STIs to inform strategies toward this goal are lacking in middle- and low-income countries, especially among men. Methods: Data from Seroprevalence and Behavioral Epidemiology Risk Surveys conducted among militaries in Cameroon, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Liberia, Malawi, Republic of the Congo, and Sierra Leone during 2013-2018 were used to estimate the prevalence of presumed active syphilis among active-duty military men. Associations of active syphilis infection with age, education, marital status, and rank for each country were assessed. Results: The prevalence of active syphilis was less than 1% among men in Cameroon (2018), Ethiopia (2018), Liberia (2018), Malawi (2013), Republic of the Congo (2014), and Sierra Leone (2013). In Chad (2014), 6.2% (95% confidence interval, 5.2%-7.4%; n = 121/1949) of men tested positive for active syphilis. In DRC (2014), the prevalence of active syphilis was 15.5% (95% confidence interval, 14.1%-16.9%; n = 404/2611) among men. Active syphilis was associated with older age in DRC (P < 0.01), with less education in Chad (P = 0.03) and DRC (P < 0.01), and with rank in DRC (P = 0.048). Conclusions: These data help address a paucity of information on prevalence of STIs in sub-Saharan Africa and demonstrate the need for improved surveillance among men.