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Sample records for tuskagee syphilis experiment

  1. Syphilis

    Science.gov (United States)

    ... Menu Ask Us Health Guides Guías de la Salud Dicas de Saúde Parents Clinicians About Us Donate ... and can cause death. Tertiary syphilis can cause: Mental illness Blindness Heart disease Paralysis Brain damage How ...

  2. Syphilis

    Science.gov (United States)

    ... have a period of the illness called latent (hidden) syphilis. This means that all the signs of ... Privacy Policy & Terms of Use Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  3. Syphilis

    Science.gov (United States)

    ... An ancient disease, syphilis is still of major importance today. The Centers for Disease Control and Prevention ... Review Committees Careers & Training Career & Training Opportunities Fellowships, Internships, & Training Clinical Training Programs Allergy and Immunology Training ...

  4. Ethics and experimentation on human subjects in mid-nineteenth-century France: the story of the 1859 syphilis experiments.

    Science.gov (United States)

    Dracobly, Alex

    2003-01-01

    This article examines a series of experiments involving the deliberate infection of human subjects with syphilis that were performed in Paris in 1859 by Dr. Camille Gibert and Dr. Joseph Alexandre Auzias-Turenne. Using the scientific literature on syphilis, the contemporary reaction in the French medical press to Gibert's and Auzias-Turenne's experiments, and the private papers of Auzias-Turenne, this paper places these experiments within a context of scientific and professional rivalry, and seeks to show how both moral and scientific concerns shaped and limited experimental practices in mid-nineteenth-century France.

  5. Syphilis - primary

    Science.gov (United States)

    ... for treatment because it is dangerous to the unborn baby. Erythromycin may not prevent congenital syphilis in ... be permanently disabling, and it may lead to death. Possible Complications Complications of syphilis may include: Cardiovascular ...

  6. Congenital syphilis

    Science.gov (United States)

    Congenital syphilis is caused by the bacteria Treponema pallidum , which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they ...

  7. Prevalence of Syphilis among Blood and Stem Cell Donors in Saudi Arabia: An Institutional Experience

    Science.gov (United States)

    Elyamany, Ghaleb; Al amro, Mohamed; Pereira, Winston Costa; Alsuhaibani, Omar

    2016-01-01

    Introduction Syphilis is one of the known transfusion-transmissible infections and causes 100,000 deaths yearly, with around 90% of these deaths occurring in the developing world. Little data is available regarding the prevalence of syphilis among Saudi blood and stem cell donors. We conducted a survey on the incidence of syphilis among all blood and stem cell donors. Methods This study was conducted at the Prince Sultan Military Medical City in Riyadh, Saudi Arabia in the 10 years period data during 2006–2015. Data were analyzed about full history, physical examination, age, sex, weight, profession, marital status, number of the donations, data of last donation, having a relation who received blood transfusion, as well as the screening test results of the donated blood. We determined the seroprevalence of infection and compared by sex and other variable through frequency analysis, Chi square, Fisher, and prevalence ratios. Results Approximately 240,000 blood donors were screened and studied in the period of study. Most of the blood donors were male (98.3%) and 89% of them were citizens of Saudi Arabia. According to our findings, we estimated that, in the last 10 years, approximately 0.044% of all the blood donors were syphilis positive cases. No cases were detected as positive for syphilis among stem cell donors. Only 60 blood donors tested positive for syphilis. In addition, we studied 202 stem cell transplant donors during the same period, of which 59% were male and none texted positive for syphilis. Conclusions A concerted effort between the government, health care providers, regulatory bodies and accreditation agencies have all contributed in eliminating the risk of spreading syphilis among blood donors.

  8. Tracing partners of patients with syphilis infection remains challenging: experience of Geneva Hospital.

    Science.gov (United States)

    de Lorenzi, Caroline; Angèle, Gayet-Ageron; Martine, Girard-Strohbach; Laurence, Toutous Trellu

    2017-01-01

    Syphilis has been reinstated on the list of notifiable diseases in Switzerland since 2006 and the active management of sexual partners is encouraged to avoid reinfection. However, contact tracing has yielded unsatisfactory results and the incidence of syphilis remains important, especially in high-risk populations. The aim of this study was to compare the proportions of notified sexual partners of patients diagnosed with syphilis by the laboratories of Geneva University Hospitals (HUG) with those diagnosed in private laboratories (non-HUG) and to assess the risk factors for no notification to sexual partners. All syphilis cases notified to the Office of the Surgeon General in Geneva (Switzerland) between 1 January 2011 and 31 December 2013 were analysed. The proportions of partner notification (PN) between HUG and non-HUG laboratories were compared by Chi square test and the main risk factors for no notification to sexual partners were assessed by binomial log-linear regression. Among a total of 720 notifications reported, 244 cases were diagnosed with contagious syphilis stages and 263 with non-contagious stages (i.e. successfully treated patients with or late latent cases). Overall, PN was higher among contagious than non-contagious cases (58.4% versus 31.0%; p = 0.030) and it was significantly higher in the non-HUG compared to the HUG group (75.9% versus 50.0%, respectively; p 45 years (RR 1.36; 95% CI: 1.05-1.76) and if the patient had received treatment for syphilis (RR 1.91; 95% CI: 1.38-2.66). Our results illustrate the difficulty of contact tracing in syphilis infection and the necessity to improve this crucial part of sexually transmitted infection management.

  9. Congenital syphilis

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    Lee, Sang Wook; Kim, Kyung Soo; Hur, Don [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    1983-12-15

    In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)

  10. Periungual Lesion due to Secondary Syphilis.

    Science.gov (United States)

    Noriega, Leandro; Gioia Di Chiacchio, Nilton; Cury Rezende, Flávia; Di Chiacchio, Nilton

    2017-01-01

    Several countries experience a new epidemic of syphilis, mainly due to the changes in risk behaviors. Dermatologists play an important role in the diagnosis, since cutaneous manifestations are frequent during disease progression. We report a rare case of secondary syphilis with periungual involvement. Syphilis, especially in the secondary form, may present with different clinical features, affecting different organs, and mimicking many diseases. Although nail apparatus lesions are more common in the primary form of the disease, they may also be present in the secondary and tertiary forms. Therefore, a comprehensive knowledge of the diverse forms of syphilis presentation is important for an early diagnosis and timely treatment.

  11. Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience

    Science.gov (United States)

    Mallma, Patricia; Garcia, Patricia; Carcamo, Cesar; Torres-Rueda, Sergio; Peeling, Rosanna; Mabey, David; Terris-Prestholt, Fern

    2016-01-01

    Studies have addressed cost-effectiveness of syphilis testing of pregnant women in high-prevalence settings. This study compares costs of rapid syphilis testing (RST) with laboratory-based rapid plasma reagin (RPR) tests in low-prevalence settings in Peru. The RST was introduced in a tertiary-level maternity hospital and in the Ventanilla Network of primary health centers, where syphilis prevalence is approximately 1%. The costs per woman tested and treated with RST at the hospital were $2.70 and $369 respectively compared with $3.60 and $740 for RPR. For the Ventanilla Network the costs per woman tested and treated with RST were $3.19 and $295 respectively compared with $5.55 and $1454 for RPR. The cost per DALY averted using RST was $46 vs. $109 for RPR. RST showed lower costs compared to the WHO standard costs per DALY ($64). Findings suggest syphilis screening with RST is cost-effective in low-prevalence settings. PMID:26949941

  12. Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience.

    Science.gov (United States)

    Mallma, Patricia; Garcia, Patricia; Carcamo, Cesar; Torres-Rueda, Sergio; Peeling, Rosanna; Mabey, David; Terris-Prestholt, Fern

    2016-01-01

    Studies have addressed cost-effectiveness of syphilis testing of pregnant women in high-prevalence settings. This study compares costs of rapid syphilis testing (RST) with laboratory-based rapid plasma reagin (RPR) tests in low-prevalence settings in Peru. The RST was introduced in a tertiary-level maternity hospital and in the Ventanilla Network of primary health centers, where syphilis prevalence is approximately 1%. The costs per woman tested and treated with RST at the hospital were $2.70 and $369 respectively compared with $3.60 and $740 for RPR. For the Ventanilla Network the costs per woman tested and treated with RST were $3.19 and $295 respectively compared with $5.55 and $1454 for RPR. The cost per DALY averted using RST was $46 vs. $109 for RPR. RST showed lower costs compared to the WHO standard costs per DALY ($64). Findings suggest syphilis screening with RST is cost-effective in low-prevalence settings.

  13. Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience.

    Directory of Open Access Journals (Sweden)

    Patricia Mallma

    Full Text Available Studies have addressed cost-effectiveness of syphilis testing of pregnant women in high-prevalence settings. This study compares costs of rapid syphilis testing (RST with laboratory-based rapid plasma reagin (RPR tests in low-prevalence settings in Peru. The RST was introduced in a tertiary-level maternity hospital and in the Ventanilla Network of primary health centers, where syphilis prevalence is approximately 1%. The costs per woman tested and treated with RST at the hospital were $2.70 and $369 respectively compared with $3.60 and $740 for RPR. For the Ventanilla Network the costs per woman tested and treated with RST were $3.19 and $295 respectively compared with $5.55 and $1454 for RPR. The cost per DALY averted using RST was $46 vs. $109 for RPR. RST showed lower costs compared to the WHO standard costs per DALY ($64. Findings suggest syphilis screening with RST is cost-effective in low-prevalence settings.

  14. Hepatitis C virus infection and biological false-positive syphilis test:a single-center experience

    Institute of Scientific and Technical Information of China (English)

    Wei-Fang Zhu; Shui-Ying Lei; Lan-Juan Li

    2011-01-01

    BACKGROUND: Rapidplasmaregainpositiveand/ortreponema pallidum hemagglutination negative [RPR(+)/TPHA(-)] results were designated as biologic false-positive (BFP). There are limited data about BFP reactions against syphilis in patients with hepatitis C virus (HCV) infection. This study aimed to determine the prevalence of BFP reactions for syphilis in patients with HCV infection in a large sample and assess the relationship between BFP reactions and HCV infection. METHODS:  A total of 2656 patients with positive anti-HCV and 5600 healthy control subjects were enrolled in this study. Hepatitis C serology was determined by a second generation ELISA test for HCV antibody. Syphilis serology was determined by the RPR test. Those subjects with reactive RPR positive underwent the TPHA test. Demographics and laboratory data were collected by trained clinicians. RESULTS: Among 2656 patients, 111 (4.2%) had a reactive RPR test. Of the 111 patients who were subjected to reactive RPR test, 30 (27.0%) showed HCV(+)/RPR(+). Of 5600 healthy controls, 80 (1.4%) had a reactive RPR test. Fourteen (17.5%) controls with HCV(-)/RPR(+) had a non-reactive TPHA test. These represented 1.1% of all HCV-positive and 0.3% of all HCV-negative subjects (P0.05). CONCLUSIONS: The data of this study demonstrate that HCV infection is associated with a false-positive RPR test. In this study BFPs were significantly more common in HCV positive patients compared to HCV-negative ones. Eosinophil abnormality can be considered as a predictor for BFP. Excessive BFPs must be considered in assessing the frequency of syphilis in a HCV-positive population and the importance of the treponemal specific serologic test should be emphasized for a diagnosis of syphilis in such population.

  15. Prozone effect in the diagnosis of syphilis using the vdrl method: experience of a reference service in southern Brazil

    Directory of Open Access Journals (Sweden)

    Danieli Luiza Jung

    2014-01-01

    Full Text Available Backgound and Objectives: Syphilis is a systemic infectious disease caused by the spirochete Treponema pallidum. VDRL (Venereal Diseases Research Laboratory test is the most often used laboratory method for syphilis diagnosis. The prozone effect may occur in 1% to 2% of patients, especially at late stages of syphilis and during pregnancy. The objective of this study was to evaluate the frequency of this effect in analyses performed at Laboratório Regional de Santa Cruz do Sul do Laboratório Central do Rio Grande do Sul, from April to May 2013. Methods: A descriptive study was performed, in which 2018 samples were analyzed by the VDRL method and subsequently, low titers (≤ 1:4 were confirmed by the immunoblot method. Results: A total of 68 (3.37% samples were positive, of which 49 (72.1% belonging to women and of these, 38 (77.5% pregnant women. The VDRL method showed no prozone effect. The 32 samples with titers ≤ 1:4 were confirmed by the treponemal method, resulting in 6 false-positive results, of which 4 were observed in pregnant women. Conclusion: Although not prozone effect was observed in this study, it was concluded that the VDRL method results must be evaluated individually, with the possibility of confirmation through the treponemal test.

  16. Gastric syphilis - Case report*

    Science.gov (United States)

    Guimarães, Tais Ferreira; Novis, Camila Freitas Lobo; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José

    2016-01-01

    Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described. PMID:27828649

  17. Syphilis management and treatment

    NARCIS (Netherlands)

    van Voorst Vader, PC

    1998-01-01

    Syphilis poses a serious health problem in many developing countries and in some areas of North America and Europe, especially Eastern Europe. This article initially addresses the state of the art regarding the interaction between syphilis and HIV infection and its consequences for management and tr

  18. Syphilis in pregnancy

    Science.gov (United States)

    ... in your uterus (womb) help push your baby out through the vagina. When your baby is born with syphilis, it’s called congenital syphilis . At your ... know GO donate sign-up sign-in Sign out account ... Contact us Tools & Resources Born Too Soon Global Map Premature birth report card ...

  19. Early malignant syphilis*

    Science.gov (United States)

    Ortigosa, Yara Martins; Bendazzoli, Paulo Salomão; Barbosa, Angela Marques; Ortigosa, Luciena Cegatto Martins

    2016-01-01

    Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment. PMID:28300925

  20. Congenital Syphilis: literature review

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    Eduardo Chaida Sonda

    2013-06-01

    Full Text Available Syphilis is an infectious disease caused by Treponema pallidum and has high rates of vertical transmission, which can reach 100% depending on the maternal disease and stage of pregnancy. The diagnosis of gestational syphilis is simple and its screening is required during the prenatal period. However, this disease still has a high prevalence, affecting two million pregnant women worldwide. The procedures performed in newborns with congenital syphilis represent costs that are three-fold higher than the ones spent with a baby without this infection. The treatment is generally carried out with penicillin and must be extended to sexual partners. Inadequate or lack of treatment of congenital syphilis can result in miscarriage, premature birth, acute complications and other fetal sequelae. KEYWORDS: Congenital syphilis. Treponema pallidum. Vertical transmission.

  1. The Rationalization of Unethical Research: Revisionist Accounts of the Tuskegee Syphilis Study and the New Zealand "Unfortunate Experiment".

    Science.gov (United States)

    Paul, Charlotte; Brookes, Barbara

    2015-10-01

    Two studies, widely condemned in the 1970s and 1980s-the Tuskegee study of men with untreated syphilis and the New Zealand study of women with untreated carcinoma in situ of the cervix-received new defenses in the 21st century. We noted remarkable similarities in both the studies and their defenses. Here we evaluate the scientific, political, and moral claims of the defenders. The scientific claims are largely based on incomplete or misinterpreted evidence and exaggeration of the uncertainties of science. The defenders' political arguments mistakenly claim that identity politics clouded the original critiques; in fact such politics opened the eyes of the public to exploitation. The moral defenses demonstrate an overreliance on codes of conduct and have implications for research ethics today.

  2. Congenital syphilis, still a reality.

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    Gupta, Rajat; Vora, Rita V

    2013-01-01

    Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. Even one case of congenital syphilis is a sentinel public health event, since timely diagnosis and treatment of syphilis infected pregnant woman should prevent transmission almost entirely. Here, we are reporting a case of early symptomatic congenital syphilis presented with severe desquamating papulosquamous lesions over multiple body parts along with erosive lesions around oral cavity and nostrils.

  3. Syphilis D′ Emblee

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    Sunil K Gupta

    2012-01-01

    Full Text Available A 28-year-old male patient presented to Skin, V.D. and Leprosy outpatient with a single gray white plaque on the left side of the lower lip for last 8 months and multiple papulosquamous lesions all over the body for last 6 months. There was history of blood transfusion for anemia 1 year back. Histopathology of lip lesion and reactive VDRL and TPHA tests confirmed the diagnosis as syphilis. We report this rare case of Syphilis d′ emblee.

  4. Early detection of congenital syphilis

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    Nagalakshmi Chowdhary

    2014-01-01

    Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson′s teeth.

  5. Congenital syphilis surveillance

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    Antonella Marangoni

    2011-06-01

    Full Text Available Congenital syphilis (CS is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections.The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy.Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. Due to the frequently absence of specific signs of infection at birth, laboratory tests are often the only method for a correct CS diagnosis. The aim of this study was to evaluate the usefulness of Treponema pallidum IgM Western Blot (WB and Polymerase Chain Reaction (PCR on cerebrospinal fluid (CSF as an aid in the diagnosis of CS during a prospective surveillance study carried out at St. Orsola Hospital in Bologna, Italy, from November 2000 through June 2010. All pregnant women during pregnancy and at delivery were screened for syphilis by ARCHITECT® Syphilis TP, Abbott. Positive samples were further analysed by Treponema Pallidum Hemagglutination Test (TPHA and Rapid Plasma Reagin (RPR tests, Radim.An in-house Western Blot (WB was also performed. Infants born to syphilis seropositive mothers were enrolled in a prospective follow up. At birth, tests were performed (including IgM WB. Infants with positive RPR tests at birth born to mothers not adequately treated received also a long bone radiograph as well as a complete CSF analysis, including Veneral Disease Research Laboratori (VDRL (Siemens Healthcare Diagnostics and PCR testing. All seroreactive infants received careful follow up examinations and serological testing at 0, 3, 6, 9, 12 months or until the tests became negative. In this study, positive syphilis serology was noted in 151 pregnant women delivering in our hospital. Fifteen women had never been adequately treated, and 9 out 15 gave birth to infected newborns.All these 9 infants had positive IgM WB results on serum samples. Two babies had characteristic long bone lesions at X-ray examination and 3 were born

  6. Eponyms in syphilis

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    Deepak Vashisht

    2015-01-01

    Full Text Available Eponym has originated from the Greek word "eponymos" meaning "giving name". It is a tribute to the pioneers in the field who have significantly contributed towards present understanding of the subject. Syphilis has amazed and plagued mankind since eternity. This disease is a great masquerade and can humble best of physicians with its varied presentations. Keen and immaculate observations of these workers have eased our understanding of many signs and phenomenon associated with this disease. This has led to evolution of number of eponyms, perhaps no other disease has as many eponyms associated with it, as does syphilis. Eponyms such as Kassowitz′s law, Clutton′s joints, Higoumenaki sign, Argyll-Robertson pupil etc. help in providing easy milieu for remembering. Besides paying tributes to stalwarts in the field, who dedicated their lives for this cause, they also facilitated our current understanding of the great masquerade.

  7. Syphilis soars in Russia.

    Science.gov (United States)

    Ingram, M

    1995-07-08

    The number of adults with syphilis in Russia has increased 15-fold since the collapse of the Soviet Union. The rate in children is 20 times higher than it was 4 years ago. 126,500 cases were registered with the health ministry over the past year, while 7900 were in 1990. The number of cases in children increased from 38 in 1991 to 761 this year; most of these cases were acquired via sexual transmission. Lilia Tikhonova, the health ministry's chief specialist on sexually transmitted diseases (STDs), blamed the increases on "the complete perversion of our society's morals," the rapid growth of child prostitution, the influx of homeless people and refugees into the cities, and miracle cures that are used in place of seeing a specialist. In communist Russia, patients were required to register passport details and previous sexual contacts, and future sexual contact was forbidden for a period; anyone breaking these rules faced 5 years in jail. Current law only punishes those who knowingly infect their sexual partners. Health officials in the Ukraine, where a similar increase in the number of STDs has been noted, blame black market condoms. Over the past 5 years, cheap foreign condoms have flooded the market.

  8. Nodular tertiary syphilis in an immunocompetent patient*

    Science.gov (United States)

    Bittencourt, Maraya de Jesus Semblano; de Brito, Arival Cardoso; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães

    2016-01-01

    Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755

  9. Annular lichenoid syphilis: A rare entity.

    Science.gov (United States)

    Khurana, Ananta; Singal, Archana; Gupta, Seema

    2014-01-01

    Syphilis is a disease known for centuries, but still continues to be a diagnostic challenge as the myriad manifestations of secondary syphilis can mimic a lot many dermatological disorders. Lichenoid syphilis is an uncommon entity, reported only occasionally in the penicillin era. We present the case of a 32-year-old woman presenting with localized annular lichenoid lesions on the neck.

  10. Congenital syphilis: The continuing scourge.

    Science.gov (United States)

    Agrawal, Prachi G; Joshi, Rajesh; Kharkar, Vidya D; Bhaskar, M V

    2014-01-01

    Congenital syphilis is a severe, disabling infection that occurs due to the transmission of Treponema pallidum across the placenta during pregnancy or from contact with an infectious genital lesion during delivery. However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific. Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality. We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario. The report also stresses upon the importance of implementing the Centres for Disease Control and Prevention recommendation that all the pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in late pregnancy.

  11. Atypical Cutaneous Manifestations in Syphilis.

    Science.gov (United States)

    Ivars Lleó, M; Clavo Escribano, P; Menéndez Prieto, B

    2016-05-01

    Although the diversity of the clinical manifestations of syphilis is well-known, atypical presentations can also occur. Such atypical presentations are associated with a high risk of transmission as a result of diagnostic confusion and treatment delays owing to the disease's ability to mimic other common skin diseases, deviate from classic clinical presentations, and adopt unique forms. Cases of atypical syphilis have been described most frequently in patients with concomitant human immunodeficiency virus (HIV) infection. Because the incidence of syphilis has been growing over recent years -particularly in patients with HIV co-infection- dermatologists need to be familiar with the less well-known clinical presentations of this venereal disease. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  12. Did Adolf Hitler have syphilis?

    Science.gov (United States)

    Retief, F P; Wessels, A

    2005-10-01

    The evidence that Adolf Hitler might have suffered from incapacitating syphilis is reviewed. Rumors that he acquired syphilis from a prostitute at the age of 20 years, with possible re-infection during World War I, can no longer be verified. Evidence is that he was sexually rather inactive throughout his life. Suggestions that Hitler's cardiac lesion and complaints such as transitory blindness, tremor of his left arm and leg, recurring abdominal pain and a skin lesion of the leg were of syphilitic aetiology cannot be supported. Hitler's progressive mental and physical deterioration after 1942, his growing paranoia, fits of rage, grandiosity and symptoms of possible dementia would fit in neurosyphilis. There are, however, also other explanations for his terminal syndrome, and evidence that repeated clinical examinations did not show the characteristic signs of dementia paralytica or tabes dorsalis, swings the balance of probability away from tertiary syphilis.

  13. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru

    Science.gov (United States)

    García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.

    2013-01-01

    Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV

  14. Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru.

    Directory of Open Access Journals (Sweden)

    Patricia J García

    Full Text Available Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening.The study was implemented from September 2009-November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability.Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the "two for one strategy", offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%.Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1 engaging the authorities; (2 dissipating tensions between providers and identifying champions; (3 training according to the needs; (4 providing monitoring, supervision, support and recognition; (5 sharing results and discussing actions together; (6 consulting and obtaining feedback from users; and (7 integrating with other services such as with rapid HIV testing.

  15. Secondary Syphilis With Hepatitis and Nephrotic Syndrome: A Rare Concurrence.

    Science.gov (United States)

    Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar

    2016-07-01

    Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis.

  16. Analytical and clinical comparison of Elecsys syphilis (Roche(®)) - Architect syphilis TP and reformulated Architect syphilis TP (Abbott(®)) assay.

    Science.gov (United States)

    De Keukeleire, Steven; Desmet, Stefanie; Lagrou, Katrien; Oosterlynck, Julie; Verhulst, Manon; Van Besien, Jessica; Saegeman, Veroniek; Reynders, Marijke

    2017-03-01

    The performance of Elecsys Syphilis was compared to Architect Syphilis TP and Reformulated Architect Syphilis TP. The overall sensitivity and specificity were 98.4% and 99.5%, 97.7% and 97.1%, and 99.2% and 99.7% respectively. The assays are comparable and considered adequate for syphilis screening.

  17. OCULAR SYPHILIS IN A KIDNEY TRANSPLANT RECIPIENT

    Science.gov (United States)

    ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel

    2016-01-01

    We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748

  18. Ocular syphilis presenting as unilateral chorioretinitis

    Directory of Open Access Journals (Sweden)

    Anand Pai

    2012-01-01

    Full Text Available Syphilis is a multi systemic infection caused by Treponema pallidum. Ocular manifestations of Syphilis have a myriad of presentations and severity. A 31year old male patient was referred from ophthalmology department as a case of chorioretinitis for screening for syphilis. Patient had diminished vision and redness of right eye for 2 months duration. History of premarital exposure and extramarital contact was present. Ocular examination revealed - Rt eye: conjunctival congestion and Argyll Robertson pupil; Lt eye: normal. Fundoscopy of right eye showed yellowish white retinal lesions, macular edema and hyperaemia and left eye was normal .No genital lesion, scars or cutaneous lesion was present.VDRL was reactive in 1 dilution,TPHA was positive ; HIV test was negative ; CSF revealed VDRL - Negative and TPHA -Negative.Patient was treated with Injection procaine penicillin 1.2 Million units intramuscularly daily for 21 days. The patient responded well to treatment and there was improvement in his vision. Ocular Syphilis can occur at any stage of Syphilis and may be the only presenting sign. Syphilis serology was positive confirming the disease.This case highlights the importance of syphilis with ocular manifestation - there by proving that diagnosis of syphilis based on ocular finding is clinically challenging.

  19. Oral manifestations of syphilis: a review

    Directory of Open Access Journals (Sweden)

    A.B. Soares

    2004-01-01

    Full Text Available Syphilis is an infectious disease presenting stages associated with specific oral lesions. Therefore, health professionals should be familiar with the different syphilis oral manifestations at each stage and be prepared to refer any suspected patient for further evaluation. This report describes the most important clinical factors of each stage, emphasizing the oral manifestations.

  20. [Primary oral syphilis. A sometimes difficult diagnosis].

    Science.gov (United States)

    Cousteau, C; Leyder, P; Laufer, J

    1984-01-01

    There recently treated cases of primary buccal syphilis are reported. The lesions are discussed, with the aid of photographs, and overall symptomatology described with the aim of providing permanent training of the young. A review of primary, secondary and tertiary syphilis is followed by a summary of diagnostic criteria and therapy.

  1. Syphilis: An Old Disease With Present-Day Implications.

    Science.gov (United States)

    McNeil, Candice J; Bachmann, Laura H

    2016-01-01

    Syphilis continues to be a burden on the public health system. While men who have sex with men and HIV-infected individuals are the most affected populations, syphilis rates have also increased in reproductive-aged women, resulting in concurrent increases in congenital syphilis. Prompt diagnosis and treatment are requisite components of syphilis control.

  2. Prozone phenomenon in secondary syphilis

    Directory of Open Access Journals (Sweden)

    Ruchi Sidana

    2011-01-01

    Full Text Available Prozone phenomenon is a false negative response resulting from high antibody titer which interferes with formation of antigen- antibody lattice, necessary to visualize a positive flocculation test. We present a case of secondary syphilis who presented to us with features of contact irritant dermatitis. She initially tested non- reactive for VDRL testing but tested positive with higher dilution. The prozone phenomenon is attaining importance because of increasing prevalence of Acquired immune deficiency syndrome. So one needs to be familiar with the occurrence of prozone phenomenon.

  3. Endoscopic Aspects of Gastric Syphilis

    Directory of Open Access Journals (Sweden)

    Mariana Souza Varella Frazão

    2012-01-01

    Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.

  4. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  5. Syphilis

    Science.gov (United States)

    ... soles of their feet. Later symptoms may include deafness, teeth deformities and saddle nose — where the bridge ... sensations Sexual dysfunction in men (impotence) Bladder incontinence Sudden, lightning-like pains Cardiovascular problems These may include ...

  6. Syphilis

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  7. Management of Adult Syphilis: Key Questions to Inform the 2015 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines.

    Science.gov (United States)

    Ghanem, Khalil G

    2015-12-15

    A panel of experts generated 8 "key questions" in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these important questions. Penicillin is the drug of choice to treat syphilis. Doxycycline to treat early and late latent syphilis is an acceptable alternate option if penicillin cannot be used. There is no added benefit to enhanced antimicrobial therapy when treating human immunodeficiency virus-infected persons with syphilis. If a patient misses a dose of penicillin in a course of weekly therapy for late syphilis, clinical experience suggests that an interval of 10-14 days between doses might be acceptable before restarting the sequence of injections. Pharmacologic considerations suggest that an interval of 7-9 days between doses, if feasible, may be more optimal. Missed doses are not acceptable for pregnant women. A cerebrospinal fluid examination to diagnose neurosyphilis is recommended in persons diagnosed with tertiary syphilis (eg, cardiovascular syphilis or late benign syphilis), persons with neurological signs or symptoms consistent with neurosyphilis, and asymptomatic persons whose serological titers do not decline appropriately following recommended therapy and in whom reinfection is ruled out. Infection and reinfection rates, particularly among men who have sex with men, are high. Frequent serological screening of this population appears to be the most cost-efficient intervention. The Centers for Disease Control and Prevention continues to recommend the use of the traditional rapid plasma reagin-based screening algorithm. The positive predictive value for syphilis associated with an isolated unconfirmed reactive treponemal chemiluminescence assay or enzyme immunoassay is low if the epidemiological risk and clinical probability for syphilis are low. Among pregnant women with serodiscordant serologies (positive treponemal tests and a negative nontreponemal test), the risk of

  8. Neuro syphilis: Portrayals by Sir Arthur Conan Doyle

    OpenAIRE

    Somasundaram, O.

    2009-01-01

    The developments in neuro syphilis in the 19th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.

  9. Neuro syphilis: Portrayals by Sir Arthur Conan Doyle.

    Science.gov (United States)

    Somasundaram, O

    2009-01-01

    The developments in neuro syphilis in the 19 th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.

  10. Syphilis and HIV co-infection (PhD-afhandling)

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten

    2015-01-01

    The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent...... HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact...... on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten...

  11. Syphilis on the rise: A prolonged syphilis outbreak among HIV-infected patients in Northern Greece

    Science.gov (United States)

    Tsachouridou, Olga; Skoura, Lemonia; Christaki, Eirini; Kollaras, Panagiotis; Sidiropoulou, Eleni; Zebekakis, Pantelis; Vakirlis, Efstratios; Margariti, Apostolia; Metallidis, Symeon

    2016-01-01

    Introduction Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. Methods This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients’ data. Results Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p=0.008; OR: 9.4, 95%CI: 4.49, 19.64, phomosexual contact (p=0.003), were separate risk factors for syphilis in the general population in the same area. Conclusion Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician’s suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients. PMID:27622160

  12. Varied presentations of early congenital syphilis.

    Science.gov (United States)

    Basu, Sriparna; Kumar, Ashok

    2013-06-01

    In spite of availability of cost-effective preventive measures and treatment, a resurgence of congenital syphilis has currently been noted. During the past 4 years, we came across five low birth weight neonates with unusual symptoms, which subsequently proved to be manifestations of early congenital syphilis. All the mothers had apparently uneventful antenatal period. No investigation was done during pregnancy. They were unaware about their disease and were found to be positive for syphilis by Venereal Disease Research Laboratory Test and fluorescent treponemal antibody (absorbed) IgM test only after childbirth. Screening for other congenital infections was negative. All the neonates were positive for Venereal Disease Research Laboratory Test. They were treated with intravenous crystalline penicillin G for 10 days. Recovery was uneventful. We reemphasize the importance of raising public awareness, routine antenatal screening and treatment for all pregnant mothers to avoid such a potentially treatable condition.

  13. Shakespeare's chancre: did the bard have syphilis?

    Science.gov (United States)

    Ross, John J

    2005-02-01

    Shakespeare's obsessive interest in syphilis, his clinically exact knowledge of its manifestations, the final poems of the sonnets, and contemporary gossip all suggest that he was infected with "the infinite malady." The psychological impact of venereal disease may explain the misogyny and revulsion from sex so prominent in the writings of Shakespeare's tragic period. This article examines the possibility that Shakespeare received successful treatment for syphilis and advances the following new hypothesis: Shakespeare's late-life decrease in artistic production, tremor, social withdrawal, and alopecia were due to mercury poisoning from syphilis treatment. He may also have had anasarca due to mercury-related membranous nephropathy. This medical misadventure may have prematurely ended the career of the greatest writer in the English language.

  14. [Treatment of syphilis with malaria or heat].

    Science.gov (United States)

    Verhave, Jan Peter

    2016-01-01

    Until the end of the Second World War, syphilis was a common sexually transmitted infection. This stigmatising infectious disease caused mental decline, paralysis and eventually death. The history of syphilis was given public attention because of 'malaria therapy', which had been applied from the First World War onwards in patients with paralytic dementia. In 1917, the Austrian physician Julius Wagner-Jauregg (1857-1940) induced fever in these patients by infecting them with malaria parasites; in 1927, he received the Nobel Prize for his discovery of the healing properties of malarial fever. One source, not cited anywhere, is an interview that the American bacteriologist and science writer/medical journalist Paul de Kruif conducted with Wagner-Jauregg in 1930. The reporting of this meeting, and De Kruif's later involvement in the mechanical heat treatment of patients with syphilis, form the inspiration for this article. When penicillin became available, both treatments became obsolete.

  15. PROBLEM OF DIAGNOSIS OF EARLY CONGENITAL SYPHILIS

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    G. P. Martynova

    2013-01-01

    Full Text Available The paper presents a case of delayed diagnosis of early congenital syphilis in a child whose mother was observed in prenatal clinic starting from the 14th week of pregnancy. The child had specific skin rash already in maternity. The child was discharged home without examination in the hospital. Only manifestations of nephritis lead to admission of the child into an inpatient hospital. Only at the age of 1 month and 23 days the child was suspected of early congenital syphilis with severe polisimptomnym, and the patient was transferred to specialized hospital. 

  16. Syphilis and HIV/Syphilis Co-infection Among Men Who Have Sex With Men (MSM) in Ecuador.

    Science.gov (United States)

    Hernandez, Isabel; Johnson, Ayesha; Reina-Ortiz, Miguel; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

    2016-12-05

    There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.

  17. [Maternal syphilis and congenital syphilis in Latin America: big problem, simple solution].

    Science.gov (United States)

    Valderrama, Julia; Zacarías, Fernando; Mazin, Rafael

    2004-09-01

    From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1% and to range from 1.00% in Peru to 6.21% in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1000 live births in El Salvador to 12.0 per 1000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5% to 15%. Factors that determine the persistence of congenital syphilis as public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care, and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination.

  18. Forgotten but Not Gone! Syphilis Induced Tenosynovitis

    Directory of Open Access Journals (Sweden)

    Felicia Ratnaraj

    2016-01-01

    Full Text Available Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint (MCP. He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole/trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal (PIP joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis.

  19. Can HIV Drugs Boost Syphilis Risk?

    Science.gov (United States)

    ... The finding might explain why new and repeat cases of syphilis in gay and bisexual men have risen sharply compared to other sexually transmitted infections over the past decade, the researchers wrote. The study team was led by Dr. Michael Rekart, from ...

  20. Origin and evolution of syphilis: drifting myth.

    Science.gov (United States)

    Sehgal, Virendra N; Verma, Prashant; Chatterjee, Kingshuk; Chaudhuri, Anita; Chatterjee, Gautam; Rasool, Farhan

    2012-01-01

    The venereal form of treponematosis, caused by the spirochete Treponema pallidum, plagued every major city in the preantibiotic era. "Civilization means syphilization," was an idea touted by Richard von Krafft-Ebing in the late 19th, and early 20th centuries that the effects of modern life make men more susceptible to syphilis and other diseases. Christopher Columbus was thought of as an importer of syphilis to Europe. Because his serendipitous voyages to the New World initiated the process of Spanish colonization, which foreshadowed general European colonization of the New World, it is difficult to rule out the cultural and political animosity created by Columbus and his men. These recent revelations are intriguing and may create dialogue that may subsequently challenge the age-old theory of "East to West" spread of venereal syphilis. This contribution warrants the continuation of study in this direction, taking into account skeletal studies that utilized radiocarbon dating technique and the phylogenetic analysis of the bacterial strains, offering a possible consensus on the origin and evolution of syphilis.

  1. Facial Nerve Palsy In Secondary Syphilis

    Directory of Open Access Journals (Sweden)

    Masuria B.L

    1999-01-01

    Full Text Available A case of secondary syphilis with right facial nerve palsy is reported. A 28 year old unmarried male presented with diffuse maculopapular rash and facial nerve palsy. He had elevated while cells and protein in cerebrospinal fluid. Serum and cerebrospinal fluid were positive for VDRL and TPHA tests. Facial nerve palsy and maculopapular rash improved with penicillin therapy.

  2. Syphilis in art: an entertainment in four parts. Part 1.

    Science.gov (United States)

    Morton, R S

    1990-02-01

    It is widely recognised that the history of art reveals the contemporary attitudes of societies and artists to changing patterns of social and sexual behaviour. This collection of artistic creations shows that representations of syphilis in art, over more than five centuries, are consistent with this view. The first quarter century of the morbus gallicus in Europe, starting in 1493, coincided with the spread of Renaissance influence, including printing. A host of pamphlets with woodcut illustrations reflected public alarm at the epidemic proportions and severity of the new disease, with its disabling and sometimes deadly consequences. Also revealed in these early works are the astrological and theological beliefs of disease causation as well as identifiable and serious attempts at public education. These twinned themes of understanding and educational endeavour recur together throughout the centuries and take many forms as man attempts to outline and influence attitudes and so improve his medico-social health. Attitudes to causation changed with experience so that by the beginning of the 17th century the morbus gallicus is no longer a mere contagion but recognised socially and represented artistically, as a morbus venereus. Its clinical presentation had changed remarkably from the alarming early days; and so too had its prevalence--from epidemic to endemic proportions. We find that the artists of both the 16th and 17th centuries, while somewhat reticent about syphilis, are nonetheless at pains to suggest that sex is not without its serious side effects. Their artistic exhortations suggest women as the source of the disease, so that we find Venus shown as both ideal love and the source of contamination. Such attitudes contrast strikingly with what follows. The 18th century is characterised by the sophisticated elements of European societies taking an irreverent or satirical view of sex and syphilis. In England this is reflected in the works of Hogarth and other

  3. Syphilis and the endemic treponematoses : clinical, (histo-) pathological and laboratory studies

    NARCIS (Netherlands)

    H.J.H. Engelkens (Herman)

    1993-01-01

    textabstractTreponemal diseases important to mankind are sexually transmitted syphilis and the endemic nonvenereally transmitted treponematoses (yaws, pinta, and endemic syphilis). Historically, the most important disease caused by treponemes is syphilis. During the last few decades, yaws, endemic s

  4. Syphilis presenting as retinal detachment and orchitis in a young man with HIV.

    Science.gov (United States)

    Yogo, Norihiro; Nichol, Aran Cunningham; Campbell, Thomas B; Erlandson, Kristine M

    2014-02-01

    Retinal detachment and testicular lesions are 2 rare presentations of syphilis. We describe a man with bilateral retinal detachment from ocular syphilis and syphilitic orchitis as a manifestation of syphilis and HIV coinfection.

  5. Epidemiological Analysis of Syphilis in China From 1985 to 2000

    Institute of Scientific and Technical Information of China (English)

    龚向东; 张国成; 叶顺章; 张君炎; 邵长庚; 梁国钧; 俞进

    2001-01-01

    Objectives: To understand trends and epidemiological features of syphilis over the recent years in China and provide a scientific basis for developing prevention strategies. Methods: From 1985 to 2000, syphilis case-reporting data collected from all provinces, autonomous regions and municipalities were analyzed by applying epidemiological methods. Results: (1) Epidemic trends: syphilis incidence has steadily risen in China from 1985 to 2000, especially after 1993, when it assumed an exponential growth pattern. 80,406 cases of syphilis were reported in the country in 1999, which was almost 40 times the number reported in 1993. During the period of 1993-1999, the annual average growth of the syphilis incidence rate was 83.55%. Perhaps due to a recent national law enforeement campaign, the number of reported syphilis cases dropped slightly in 2000. (2) Geographical distribution: Syphilis spread from coastal, ""open"" cities (especially some cities in Fujian province) to inland urban areas, then to rural areas.Regions with a high incidence rate of syphilis in China were the Minjiang, Yangtze, and Zhujiang River Deltas, Beijing and Tianjin municipalities, and Northeast China. There was a significant difference of syphilis incidence rates and growth rates between these areas. A serious epidemic occurred in some areas, with an incidence rate reaching over 200 cases out of 100,000. (3) Population distribution: the ratio of male and female cases gradually changed from 1.57:1 in 1993 to 1.02:1 in 2000. The rate was the highest in the 20-29 age group and the lowest in 10-14 age group. A great difference existed in prevalence between different population groups and different areas,and some areas with serious epidemics had high prevalence rates even amoung the general population. (4) Clinical stage of syphilis: Primary and secondary syphilis cases have been dominating with a percentage of 90% of all syphilis cases. Primary syphilis was the most common in males and secondary

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

    Science.gov (United States)

    Hawkes, Sarah J; Yin, Yue-Pin; Peeling, Rosanna W; Cohen, Myron S; Chen, Xiang-Sheng

    2010-01-01

    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. PMID:20539859

  7. Clinical manifestations of primary syphilis in homosexual men

    Directory of Open Access Journals (Sweden)

    Milan Bjekić

    2012-08-01

    Full Text Available At the beginning of a new millennium, syphilis incidence has been increasing worldwide, occurring primarily among men who have sex with men (MSM. The clinical features of primary syphilis among MSM is described, a case-note review of the primary syphilis (PS patients who attended the Institute of Skin and Venereal Diseases. The diagnosis was assessed based upon the clinical features and positive syphilis serology tests. Among 25 patients with early syphilis referred during 2010, PS was diagnosed in a total of 13 cases. In all patients, unprotected oral sex was the only possible route of transmission, and two out of 13 patients had HIV co-infection. Overall, 77% of men presented with atypical penile manifestation. The VDRL test was positive with low titers. The numerous atypical clinical presentations of PS emphasize the importance of continuing education of non-experienced physicians, especially in countries with lower reported incidence of syphilis.

  8. Clinical manifestations of primary syphilis in homosexual men

    Directory of Open Access Journals (Sweden)

    Milan Bjekić

    Full Text Available At the beginning of a new millennium, syphilis incidence has been increasing worldwide, occurring primarily among men who have sex with men (MSM. The clinical features of primary syphilis among MSM is described, a case-note review of the primary syphilis (PS patients who attended the Institute of Skin and Venereal Diseases. The diagnosis was assessed based upon the clinical features and positive syphilis serology tests. Among 25 patients with early syphilis referred during 2010, PS was diagnosed in a total of 13 cases. In all patients, unprotected oral sex was the only possible route of transmission, and two out of 13 patients had HIV co-infection. Overall, 77% of men presented with atypical penile manifestation. The VDRL test was positive with low titers. The numerous atypical clinical presentations of PS emphasize the importance of continuing education of non-experienced physicians, especially in countries with lower reported incidence of syphilis.

  9. Cytokine expression during syphilis infection in HIV-1-infected individuals

    DEFF Research Database (Denmark)

    Knudsen, Andreas; Benfield, Thomas; Kofoed, Kristian

    2009-01-01

    syphilis.IL-10 and TNF-alpha levels correlated positively with plasma HIV RNA values at the time of diagnosis (r = 0.38, P = 0.023, and r = 0.64, P ... stage syphilis coinfection were associated with an increase in IL-10. IL-10 and TNF-alpha both decreased after treatment of syphilis. TNF-alpha and IL-10 correlated with low CD4 T cell counts and high plasma HIV RNA values....

  10. Serum Treponema IgM Antibody Test for Syphilis Diagnosis

    Institute of Scientific and Technical Information of China (English)

    郑占才; 张荣富; 溪茜

    2003-01-01

    Objective: To evaluate the clinical utility of testing serum anti-treponema pallidum IgM antibody in the diagnosis of syphilis patients. Methods: Seventy-two cases of syphilis were tested for specific IgM antibody with ELISA, and the results were compared with RPR and TPPA.Results: The sensitivity of IgM antibody was 73.3 %(11/15) in primary syphilis, 88.9% (16/18) in sec-ondary syphilis, and there was no significant differ-ence between these values (x2=1.6363, P>0.10). The sensitivity of IgM antibody in diagnosing latent syphi-lis was only 26.1% (6/23), much lower than the detec-tion rate in symptomatic earlv svDhilis (x2=17.6189. P<0.005). RPR and TPPA were both 100% sensitive in latent and early symptomatic syphilis. Two were posi,five for IgM in the 16 cases who had received regular treatments 2 to 24 months before enrolled.Conclusions: Specific IgM antibody detection doees not appear superior to RPR and TPPA in diagnosing primary syphilis. The diagnosis of latent syphilis should mainly rely on RPR and TPPA, since there are low titers of IgM antibody at that stage. IgM antibody testing alone should not be recommended for monitor-ing syphilis development or treatment efficacy. Fur-ther studies should be concerned.

  11. Malignant syphilis with human immunodeficiency virus infection

    Directory of Open Access Journals (Sweden)

    Jiby Rajan

    2011-01-01

    Full Text Available Malignant syphilis or Lues maligna, commonly reported in the pre-antibiotic era, has now seen a resurgence with the advent of human immunodeficiency virus (HIV. Immunosuppression and sexual promiscuity set the stage for this deadly association of HIV and Treponema pallidum that can manifest atypically and can prove to cause diagnostic problems. We report one such case in a 30-year-old female who responded favorably to treatment with penicillin.

  12. Syphilis testing practices in the Americas.

    Science.gov (United States)

    Trinh, Thuy T; Kamb, Mary L; Luu, Minh; Ham, D Cal; Perez, Freddy

    2017-09-01

    To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations). The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%). Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing. © 2017 John Wiley & Sons Ltd The Pan-American Health Organization retains

  13. Inadequate syphilis screening among women with prenatal care in a community with a high syphilis incidence.

    Science.gov (United States)

    Trepka, Mary Jo; Bloom, Sharon A; Zhang, Guoyan; Kim, Sunny; Nobles, Robert E

    2006-11-01

    This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery. Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices. Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery. Attending a private clinic, having more than adequate prenatal care and having private insurance were associated with not being screened at least twice before delivery. Few women were screened according to standard recommendations, and provider or institutional-related factors affected adequacy of screening.

  14. Syphilis: an atypical case of sepsis and multiple anogenital lesions in secondary syphilis

    Directory of Open Access Journals (Sweden)

    Nichole Smith

    2016-10-01

    Full Text Available The incidence of syphilis has historically been cyclical in nature, often in relation to the rise and fall of public health initiatives directed toward eradication along with social attitudes toward sexual practices. The incidence of syphilis has increased by 15% in the last 6 years in the United States, with similar increases worldwide. Herein, we present an atypical case of syphilis presenting with severe septic shock and multiple anogenital lesions in an immunocompetent host. A 22-year-old male with no significant past medical history presented with fevers, chills, sore throat, diaphoresis, and diarrhea. He was febrile, tachycardic, hypotensive, and unresponsive to fluid resuscitation requiring short-term vasopressor support. Physical exam revealed diffuse lymphadenopathy; lower extremity macular rash involving the soles of the feet; papular non-pustular lesions on the scrotum; and a 0.5 cm non-tender irregular, healing lesion on the shaft of the penis. Laboratory analysis was significant for leukocytosis and elevated creatinine. Serum screening rapid plasma reagin was positive, and further testing revealed a titer of 1:32, with confirmation via fluorescent treponemal antibody absorption test. The patient was diagnosed with secondary syphilis, which was determined to be the underlying etiology of the sepsis as all other serological evaluations were negative. He was treated with penicillin G benzathine 2.4 million units intramuscular and supportive management, with improvement of symptoms. The patient engaged in high-risk sexual behaviors, including prior unprotected sexual contact with males. New research indicates that up to one-third of patients may present with atypical cutaneous manifestations, as demonstrated by this patient. It is important for physicians to familiarize themselves with the varied clinical presentations of syphilis, which include multiple anogenital lesions and tender primary lesions in primary or secondary syphilis.

  15. Strong Country Level Correlation between Syphilis and HSV-2 Prevalence

    Directory of Open Access Journals (Sweden)

    Chris Richard Kenyon

    2016-01-01

    Full Text Available Background. Syphilis is curable but Herpes Simplex Virus-2 (HSV-2 is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods. Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results. The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: R2=0.54, P<0.001; 2008: R2=0.41, P<0.001 and 40–44-year-olds: 1990–99: R2=0.42, P<0.001; 2008: R2=0.49, P<0.001. Conclusion. The prevalence of syphilis and HSV-2 is positively correlated. This could be due to a common set of risk factors underpinning both STIs.

  16. Syphilis oculaire : à propos de deux cas

    DEFF Research Database (Denmark)

    Gauthier, A; Graffe, A; Beucher, A-B

    2011-01-01

    Whereas syphilis is a classical cause of uveitis, it is still often under-recognized. Treatment recommendations are not based on specific clinical studies.......Whereas syphilis is a classical cause of uveitis, it is still often under-recognized. Treatment recommendations are not based on specific clinical studies....

  17. Secondary syphilis in HIV infection - a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Panvelker V

    1997-01-01

    Full Text Available A case of secondary syphilis in HIV infection is being reported. The patient presented with skin rash only. VDRL was found to be negative and HIV testing was positive. He was treated for secondary syphilis with clinical response. Blood VDRL test was subsequently reported as reactive.

  18. A case of congenital syphilis with Hutchinson′s triad

    Directory of Open Access Journals (Sweden)

    Priyanka Singhal

    2011-01-01

    Full Text Available Late congenital syphilis is a rare entity and its early diagnosis and treatment is essential to prevent significant morbidity. We are reporting a case of late congenital syphilis presenting with Hutchinson′s triad at an age of 14 years.

  19. Recall of symptoms and treatment of syphilis and yaws by healthy blood donors screening positive for syphilis in Kumasi, Ghana

    Directory of Open Access Journals (Sweden)

    Francis Sarkodie

    2016-09-01

    Conclusions: A small proportion of confirmed seroreactive donors in this sample had any recall of symptoms or treatment for yaws or syphilis. These data suggest that clinical questioning adds little further information to the current screening algorithm. The relative contribution of yaws and syphilis to frequent positive tests in endemic areas remains speculative.

  20. Reduced Treponema pallidum–Specific Opsonic Antibody Activity in HIV-Infected Patients With Syphilis

    Science.gov (United States)

    Marra, Christina M.; Tantalo, Lauren C.; Sahi, Sharon K.; Dunaway, Shelia B.; Lukehart, Sheila A.

    2016-01-01

    Background. Human immunodeficiency virus (HIV)–infected individuals may have poorer serological responses to syphilis treatment and may be more likely to experience neurosyphilis. Treponema pallidum is cleared from sites of infection by opsonization, ingestion, and killing by macrophages. Methods. Serum samples from 235 individuals with syphilis were tested for T. pallidum–specific opsonic activity. Blood T. pallidum concentrations were determined by real-time polymerase chain reaction amplification of the tp0574 gene, and T. pallidum was detected in cerebrospinal fluid (CSF) by reverse-transcriptase polymerase chain reaction of 16S ribosomal RNA. Results. Opsonic activity was higher with higher serum rapid plasma reagin titers (P VDRL reactivity. Conclusions. Serum T. pallidum–specific opsonic activity is significantly lower in HIV-infected individuals. Impaired T. pallidum–specific immune responses could contribute to differences in the course of disease or treatment response. PMID:26655298

  1. High prevalence of syphilis among street-based female sex workers in Nanchang, China

    Directory of Open Access Journals (Sweden)

    Xiao Hua Tao

    2014-01-01

    Full Text Available Background: Female sex workers (FSWs play a critical role in the heterosexual transmission of human immunodeficiency virus (HIV/sexually transmitted infections (STIs in China. Several studies reported that street-based FSWs have higher risk behaviors than establishment-based FSWs. Therefore, street-based FSWs should be specifically targeted for HIV and STIs intervention programs. Objectives: This study aims to investigate the prevalence rates and risk factors of HIV and syphilis among FSWs in Nanchang, China. Materials and Methods: Using convenience sampling methods, 361 street-based FSWs were recruited from August 2011 to February 2012. All participants completed an anonymous questionnaire on socioeconomic and sex behavioral information and were tested for HIV and syphilis. Risk for HIV and syphilis infection was assessed using univariate and multivariate logistic regression analyses. Results: No HIV infections were found. The prevalence rate of syphilis was 43.5%. Nearly 46.1% of street-based FSWs reported having education for no more than 6 years. Having reproductive tract infections at current visit, duration of sex work more than 5 years, indulgence in unprotected sex trade in the last time, unprotected sex trade in the last month, and unprotected sex with boyfriend or spouse in the last month were reported by 35.2%, 43.5%, 33.8%, 60.4%, and 93.1% street-based FSWs, respectively. In multivariate logistic regression analysis, having reproductive tract infections at current visit [odds ratio (OR, 12.10; 95% confidence interval (CI, 6.01-24.37], duration of sex work more than five years (OR, 4.26; 95% CI, 2.40-7.54, and unprotected sex trade in the last month (OR, 1.85; 95% CI, 1.06-3.22 were independently associated with syphilis infection. Conclusion: The prevalence rate of syphilis among street-based FSWs is very high. Most street-based FSWs in our survey had low education, long experience of commercial sex, and high rate of inconsistent

  2. Gastric syphilis: a case-report

    Directory of Open Access Journals (Sweden)

    P. Del Duca

    2013-05-01

    Full Text Available CLINICAL CASE A 43-year-old Romanian woman was referred with the clinical suspicion of gastric lymphoma; she had complained from two months nausea, vomiting and weight loss (7 kg; 3 esophagogastroduodenoscopic examinations had evidenced reduced distensibility of stomach body and antrum, ulcered and congestive mucosa, the histopathological examinations revealed a non specific inflammation. There was no response to therapy with omeprazolo. A computer-assisted tomoghraphy scan of the thorax and abdomen, obtained after the oral and intravenous administration of contrast material, showed diffuse thickening of the gastric wall, lymphadenopathies were seen in the retrocrural space, lesser curvature, and paraaortic region. It was performed another upper endoscopy with “deep” biopsy specimen, comprehensive of spirochetal immunohistochemistry, that was diagnostic for gastric syphilis. DISCUSSION Even though gastritis is a rare clinical manifestations of the secondary stage of syphilis, it must be considered in the differential diagnosis of erosive gastritis unresponsive to medical therapy, especially in young patients; screening tests like VDRL (routinely used until few years ago in internal medicine divisions may be useful to identify those patients needing a further diagnostic evaluation.

  3. Congenital syphilis in a two-month-old infant

    Directory of Open Access Journals (Sweden)

    Daniele Serranti

    2011-06-01

    Full Text Available This report describes a rare case of congenital syphilis in a two-month-old Romanian infant. Diagnosis was possible when the baby showed decrease in the left upper limb movements and a papular rash. Her father had been infected and transmitted the infection to the mother, who had two non-treponemal serological tests during pregnancy, both with negative results. Congenital syphilis was confirmed by serological tests and the newborn was successfully treated. A global overview on diagnosis and treatment of children with suspected congenital syphilis is presented.

  4. Multiple ulcers in primary syphilis with negative rapid plasma reagin and Venereal Disease Research Laboratory tests: an unusual presentation during the re-emergence of syphilis in Albania.

    Science.gov (United States)

    Harxhi, A; Kraja, D; Shehu, E; French, P

    2010-03-01

    Since 1995 infectious syphilis has re-emerged in Albania. As syphilis has become more common, more unusual presentations are being recognized. We present a case of an HIV-negative man with primary syphilis presenting with multiple penile ulcers and negative rapid plasma reagin and Venereal Disease Research Laboratory tests. The case illustrates the challenges of diagnosing early syphilis and the importance of not relying on non-treponemal tests.

  5. Syphilis and human experimentation from the first appearance of the disease to World War II: a historical perspective and reflections on ethics.

    Science.gov (United States)

    Cuerda-Galindo, E; Sierra-Valentí, X; González-López, E; López-Muñoz, F

    2014-10-01

    Physicians have conducted research on syphilis for centuries, seeking to understand its etiology and the means of transmission as well as find ways to prevent and cure the disease. Their research practices often strayed from today's ethical standards. In this paper we review ethical aspects of the long history of research on syphilis with emphasis on the experiments performed in the 20th century. The description of research around the time of World War II covers medical experiments carried out in US prisons and in the experimentation centers established by Japanese doctors in occupied territory, as well as experiments in Nazi Germany and the treatment of syphilitics there.

  6. Recall of symptoms and treatment of syphilis and yaws by healthy blood donors screening positive for syphilis in Kumasi, Ghana

    DEFF Research Database (Denmark)

    Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver;

    2016-01-01

    ) and later by rapid plasma reagin (RPR) test, 526 were seroreactive. Four hundred and seventy-one (89.5%) of these subjects were confirmed with the Ortho-Vitros Syphilis TP test as the gold standard and were interviewed to determine past or present clinical manifestations of yaws and syphilis. Results......: Of the 471 respondent donors, 28 (5.9%) gave a history of skin lesions and sores; four (14.3%) of these subjects, who were all male and RPR-positive, recalled a diagnosis of syphilis. All four reported having had skin lesions/bumps with slow-healing sores, but only one of them had had these symptoms before...

  7. [Introduction of rapid syphilis and HIV testing in prenatal care in Colombia: qualitative analysis].

    Science.gov (United States)

    Ochoa-Manjarrés, María Teresa; Gaitán-Duarte, Hernando Guillermo; Caicedo, Sidia; Gómez, Berta; Pérez, Freddy

    2016-12-01

    Interpret perceptions of Colombian health professionals concerning factors that obstruct and facilitate the introduction of rapid syphilis and HIV testing in prenatal care services. A qualitative study based on semi-structured interviews was carried out. A convenience sample was selected with 37 participants, who included health professionals involved in prenatal care services, programs for pregnant women, clinical laboratories, and directors of health care units or centers, as well as representatives from regional departments and the Ministry of Health. Colombia does not do widespread screening with rapid syphilis and HIV tests in prenatal care. The professionals interviewed stated they did not have prior experience in the use of rapid tests-except for laboratory staff-or in the course of action in response to a positive result. The insurance system hinders access to timely diagnosis and treatment. Health authorities perceive a need to review existing standards, strengthen the first level of care, and promote comprehensive prenatal care starting with contracts between insurers and health service institutional providers. Participants recommended staff training and integration between health-policymaking and academic entities for updating training programs. The market approach and the characteristics of the Colombian health system constitute the main barriers to implementation of rapid testing as a strategy for elimination of mother-to-child transmission of syphilis and HIV. Measures identified include making changes in contracts between insurers and health service institutional providers, adapting the timing and duration of prenatal care procedures, and training physicians and nurses involved in prenatal care.

  8. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2016. In this Table, provisional* cases of selected†notifiable diseases (≥1,000 cases reported during...

  9. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2014.In this Table, all conditions with a 5-year average annual national total of more than or equals...

  10. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  11. Ultrastructural Study of Dermatic Tissues in Secondary Syphilis

    Institute of Scientific and Technical Information of China (English)

    张晓东; 脱朝伟; 张庆瑞; 宋芳吉

    2001-01-01

    Objective: For the purpose of understanding the changing process of syphilis histomorphology and its injury mechanism,the ultrastructure of dermatic tissues of secondary syphilis was studied.Methods: Different skin injury tissues of secondary syphilis patients, whose serum RPR and TPHA tests in the lab both appeared positive reaction, were observed through transmission electron microscope (TEM).Results: Inflammations appeared on epidermides and coria,a great deal of neutrocytes, lymphocytes and a small amount of plasma infiltrated them. Karyopyknosis, karyorrhexis,epicyte lysis and mitochondrion vacular degeneration occurred. Spirocheta pallida was distributed on intercellular substances, epicytes and coilagenous fibers. The epicytes were pressed to foveation. Conclusion The pathological change of characteristic tissue ultrastructure reported here is a histomorphological foundation to study the organism injury mechanism caused by syphilis.

  12. Cost utility analysis of diagnostic method of syphilis

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2008-04-01

    Full Text Available Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR and for confirmation, the fluorescent treponemal antibody (FTA and the treponema pallidum hemagglutination (TPHA tests. The four alternative modes for diagnosis of syphilis can be a VDRL + FTA, b VDRL + TPHA, c RPR + FTA and d RPR + TPHA. Here the author reports an evaluation of cost utility of these tests in medical practice. It is shown that the cost per accurate diagnosis with VDRL + TPH is the least expensive choice. Therefore, this alternative is the best method for serological diagnosis for syphilis, based on medical laboratory economics principles

  13. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  14. Syphilis screening practices in blood transfusion facilities in Ghana

    DEFF Research Database (Denmark)

    Sarkodie, Francis; Hassall, Oliver; Owusu-Dabo, Ellis

    2016-01-01

    OBJECTIVES: The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis...... of 58 (48%) transfusion facilities tested donors for syphilis, with an estimated 3.7% seroprevalence (95% confidence interval 3.6-3.8%). A total of 62782 out of 91386 (68.7%) donations were tested with assays that are not recommended. The estimated syphilis seroprevalence in voluntary donations was 2.......9%, compared to 4.0% in family donations (p=0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs). CONCLUSIONS: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening...

  15. The Great Pretender: Rectal Syphilis Mimic a Cancer

    Directory of Open Access Journals (Sweden)

    Andrea Pisani Ceretti

    2015-01-01

    Full Text Available Rectal syphilis is a rare expression of the widely recognised sexual transmitted disease, also known as the great imitator for its peculiarity of being confused with mild anorectal diseases because of its vague symptoms or believed rectal malignancy, with the concrete risk of overtreatment. We present the case of a male patient with primary rectal syphilis, firstly diagnosed as rectal cancer; the medical, radiological, and endoscopic features are discussed below.

  16. Integrated syphilis/HIV screening in China: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Yin Yue-Pin

    2010-03-01

    Full Text Available Abstract Background The last decade has seen enormous advances in HIV treatment and care, but how to implement scaled up HIV testing, prevention, and treatment in low-income areas still presents a formidable public health challenge. South China faces expanding syphilis and sexually transmitted HIV epidemics, but health systems characteristics important for scaling up syphilis and HIV testing have not been defined. Methods A purposive sample to ensure public, private, and public-private hybrid STI clinic inclusion was selected in a South China city. Eight key informant interviews were conducted with the STI clinic manager, followed by eight focus group discussions with physicians. Data collection relied on a semi-structured format that included questions in each of the following domains: 1 clinical facilities; 2 laboratory capacity with a focus on syphilis/HIV diagnosis; 3 clinic personnel; 4 physical space with a focus on locations to disclose confidential results; 5 financial support. Results Public STI clinics had free syphilis testing/treatment and laboratory facilities to perform essential syphilis and HIV tests. However, despite serving a large number of STI patients, private STI clinics lacked nontreponemal syphilis testing, HIV testing, and had fewer connections to the public health infrastructure. Formally trained assistant physicians were 2.5 times as common as physicians at STI clinics. Only one of the 8 sites had onsite voluntary counseling and testing (VCT services available. Conclusion These STI case studies reveal the potential for expanding integrated syphilis/HIV services at public STI clinics in China. More health services research is needed to guide scale-up of syphilis/HIV testing in China.

  17. Towards the Elimination of Syphilis in a Small Developing Country

    Directory of Open Access Journals (Sweden)

    Kameel Mungrue

    2015-01-01

    39 per 100 000 population in 2009 to 29 per 100 000 in 2012. We identified 3 “hot spots,” in urban areas of Trinidad. Young men and particularly young women in childbearing age 15–35 living in urban high density populations were commonly infected groups. Conclusion. The incidence of syphilis continues to be very high in Trinidad. New initiatives will have to be formulated in order to attain the global initiative to eradicate syphilis by 2015.

  18. Yellowish dots in the retina: a finding of ocular syphilis?

    OpenAIRE

    Renan Albert Mendonça Rodrigues; Heloisa Moraes do Nascimento; Cristina Muccioli

    2014-01-01

    Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT) were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 1...

  19. Demographic Characteristics of Syphilis Patients Followed Between 1994 and 2006

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    Esra Adışen

    2008-05-01

    Full Text Available Backgorund and Design: We undertook this retrospective study to analyze demographics of patients with syphilis that had attended to Gazi University, Faculty of Medicine, Department of Dermatology between 1994 and 2006. Material and Method: In this retrospective study, data including age, sex, stage of the disease, clinical finding at the time of presentation, transmission route and source, and serology results of 53 patients with syphilis were recorded. Positive VDRL test and TPHA was essential in the diagnosis of the disease. Results: Fifty-three patients (43 male, 10 female were evaluated in the study. Male/female ratio was 4.3. Patients’ age ranged between 19-58 (mean, 32.92±8.7. Forty-two (80.6%; 34 male, 8 female of 53 patients were married. Of 53 patients 50 (94.3% was Turkish, 3 (5.6% was foreigner. The source of the transmission was not defined in 26 patients (49.1% while all of married women defined their husbands as source of the infection. Of 53 patients, 40 (75.47% were primary syphilis, 7 (12.8% were secondary syphilis, 6 (11.32% were latent syphilis. 14 had (++++, 20 had (+++, one had (++ and 18 had (+ VDRL. All patients were positive for TPHA. In 1994, syphilis patients attending to outpatient clinic constituted 0.027% of the total visits of the outpatient clinic, whereas it was 0.004% in 2006.Conclusion: Syphilis is still an epidemiologic problem in our country. Prevalence is higher in some other countries. This disease may mimic almost every disease, therefore it should be considered in the differential diagnosis of disorders affecting oral and genital mucosal surfaces. Our study shows that syphilis have a tendency to decrease in Ankara and patients’ preference regarding the health services have changed during past years, in our country. (Turkderm 2008; 42: 9-12

  20. Serologic screening for syphilis. Rationale, cost, and realpolitik.

    Science.gov (United States)

    Schmid, G P

    1996-01-01

    Serologic testing for syphilis is a cornerstone of syphilis control efforts, but our objectives for doing it and the costs involved are not always recognized. Tests applied to individuals with symptoms or signs may be viewed as diagnostic tests, and tests applied to individuals with no clinical indications for testing may be viewed as screening tests. Infected individuals whom we detect through screening efforts are important, mostly from an individual and economic standpoint, because treatment will prevent the late complications of syphilis and thus avoid high medical costs. Because they are uncommonly infectious for others, however, they are relatively unimportant from a public health intervention standpoint. The prevalence of infection above which we should screen is based mostly on economic grounds, but is undetermined. We intuitively recognize such a threshold, however, when we use epidemiologic markers to restrict our efforts to groups in whom we think the yield is worth the effort (i.e., targeted [focused] screening). In deciding whether to institute or increase screening efforts for syphilis, we must consider not only the dollar costs of these efforts, but also the opportunity costs (i.e., what programs we will forgo so that we can devote our resources to the increased efforts). Similarly, because syphilis is not the only priority with which governments, health departments, and sexually transmitted disease programs must contend, any broader plan to significantly enhance syphilis control must acknowledge this reality and show the benefit, economic and otherwise, of its adoption.

  1. Papulonodular Secondary Syphilis Presenting as Multiple Distinct Cutaneous Lesions in an HIV-Positive Transgender Woman

    Directory of Open Access Journals (Sweden)

    Kristina Navrazhina

    2017-03-01

    Full Text Available We present the first reported case of papulonodular secondary syphilis in an HIV-positive transgender female. Syphilis is classified into primary, secondary, latent, and tertiary stages, with secondary syphilis having notably diverse cutaneous manifestations. Our patient presented with diverse lesions throughout her body, all pathologically consistent with papulonodular secondary syphilis. Proper identification of the multiple presentations of syphilis is crucial to early diagnosis and treatment. This report seeks to broaden the scope of dermatological manifestations that arise secondary to papulonodular syphilis in HIV-positive patients.

  2. Prevalence and determinants of HSV-2/syphilis co-infection and HSV-2 mono-infection among HIV-positive men who have sex with men: a cross-sectional study in Northeast China.

    Science.gov (United States)

    Hu, Qing-Hai; Xu, Jun-Jie; Chu, Zhen-Xing; Zhang, Jing; Yu, Yan-Qiu; Yu, Huan; Ding, Hai-Bo; Jiang, Yong-Jun; Geng, Wen-Qing; Wang, Ning; Shang, Hong

    2016-10-31

    We aimed to assess the prevalence and determinants of herpes simplex virus type 2 (HSV-2) mono-infection and HSV-2/syphilis co-infection in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in China. A cross-sectional study was conducted on 545 HIV-positive MSM in Shenyang between February 2009 and October 2014. Participants received physical examinations and serological tests for HSV-2 and syphilis. A multinomial logistic regression was used to identify risk factors associated with HSV-2/syphilis co-infection and HSV-2 mono-infection. The HSV-2 mono-infection, syphilis mono-infection, and HSV-2/syphilis co-infection prevalence (95% confidence interval) was 48.6% (44.4-52.8%), 34.3% (30.3-38.3%), and 22.9% (19.4-26.5%), respectively. In regression analysis, after controlling within HSV-2/syphilis-seronegative cases, related factors for HSV-2/syphilis co-infection were age (25-50 years vs. ≤24 years, aOR: 4.55; >50 years vs. ≤24 years, aOR: 43.02), having regular female sexual partner(s) in the past 6 months (aOR: 0.43) and age at first MSM experience (>18 years vs ⩽18 years, aOR: 2.59) (all P HSV-2 infection and HSV-2/syphilis co-infection in HIV-positive MSM indicates high HIV secondary transmission risk. A campaign for detection and treatment of HSV-2 and syphilis is urgently required for HIV-positive MSM in China.

  3. Prevalence and risk factors of syphilis infection among drug addicts

    Directory of Open Access Journals (Sweden)

    Kuhlmann Thomas

    2005-05-01

    Full Text Available Abstract Background Recent epidemiological data show an increased trend of official estimates for syphilis infection in the general population. Many of the infected cases remain undetected leaving an underestimation of the true prevalence of syphilis in the general population, but also among subpopulations such as illicit drug users. There is limited epidemiological data published on the proportion and risk factors of syphilis infections associated with illicit drug abuse. Methods Illicit drug addicts (n = 1223 in inpatients units in Germany were screened (2000–01 for syphilis and interviewed regarding patterns of drug use and sexual behaviour. TPHA-test for initial screening and FTA-ABS-IgM test in TPHA-positive patients were used. Results In total, TPHA-tests were positive in 39 (3.3% and 7 patients (0.6% were IgM positive. The prevalence rate for syphilis in males was 1.9% and for women it was 8.5%. Female patients were 4.56 (CI 95% 2.37–8.78 times more likely to have a positive TPHA test than males. Sexual behaviours such as high number of sexual partners, sex for drugs/money, sex on the first day were associated with syphilis infection only in women. Females with frequent sex for drugs or money had 4.31 (CI 95% 2.32–8.52 times more likely a reactive TPHA test than remaining patients. Neither the sociodemographic factors nor sexual behaviour were statistically significant associated with syphilis infection among men at all. Conclusion Our data suggest the need for screening for syphilis among these illicit drug users in inpatient settings, in particular among sexual active women. This conclusion is corroborated by the finding of increasing numbers of syphilis infections in the general population. The identification of syphilis cases among drug addicts would give treatment options to these individuals and would help to reduce the spread of infection in this population, but also a spread into heterosexual populations related to

  4. Serological response to treatment of syphilis according to disease stage and HIV status.

    Science.gov (United States)

    Knaute, Damaris Fröhlich; Graf, Nicole; Lautenschlager, Stephan; Weber, Rainer; Bosshard, Philipp P

    2012-12-01

    Serology is the mainstay for syphilis diagnosis and treatment monitoring. We investigated serological response to treatment of syphilis according to disease stage and HIV status. A retrospective cohort study of 264 patients with syphilis was conducted, including 90 primary, 133 secondary, 33 latent, and 8 tertiary syphilis cases. Response to treatment as measured by the Venereal Disease Research Laboratory (VDRL) test and a specific IgM (immunoglobulin M) capture enzyme-linked immunosorbent assay (ELISA; Pathozyme-IgM) was assessed by Cox regression analysis. Forty-two percent of primary syphilis patients had a negative VDRL test at their diagnosis. Three months after treatment, 85%-100% of primary syphilis patients had reached the VDRL endpoint, compared with 76%-89% of patients with secondary syphilis and 44%-79% with latent syphilis. In the overall multivariate Cox regression analysis, serological response to treatment was not influenced by human immunodeficiency virus (HIV) infection and reinfection. However, within primary syphilis, HIV patients with a CD4 count of VDRL (P = .092 and P VDRL should not be recommended as a screening test owing to lack of sensitivity. The syphilis disease stage significantly influences treatment response whereas HIV coinfection only within primary syphilis has an impact. VDRL test titers should decline at least 4-fold within 3-6 months after therapy for primary or secondary syphilis, and within 12-24 months for latent syphilis. IgM ELISA might be a supplement for diagnosis and treatment monitoring.

  5. Prevalence of HIV, syphilis, HCV and their high risk behaviors among migrant workers in eastern China.

    Directory of Open Access Journals (Sweden)

    Xiaohong Pan

    Full Text Available OBJECTIVE: The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. METHODS: A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. RESULTS: 17,377 (92.8% of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73% of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4% had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently was associated with being divorced or widowed (P<0.05 for single; male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job; having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%-0.06% and 0.40% (95%CI: 0.31%-0.51%, respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%-0.70%. Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. CONCLUSIONS: Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant

  6. Prevalence of HIV, Syphilis, HCV and Their High Risk Behaviors among Migrant Workers in Eastern China

    Science.gov (United States)

    Wang, Qing; Zheng, Hui; Chen, Xin; Su, Jing; Peng, Zhihang; Yu, Rongbin; Wang, Ning

    2013-01-01

    Objective The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. Methods A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. Results 17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (Pmarket or domestic service (Pjob); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. Conclusions Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China. PMID:23451193

  7. A Web Application to Facilitate Syphilis Reactor Grid Evaluations.

    Science.gov (United States)

    Avoundjian, Tigran; Khosropour, Christine M; Golden, Matthew R; Barbee, Lindley A; Dombrowski, Julia C

    2017-08-28

    Many health departments use a "reactor grid" to determine which laboratory-reported syphilis serologic test results require investigation. We developed a Web-based tool, the Syphilis Reactor Grid Evaluator (SRGE), to facilitate health department reactor grid evaluations and test the tool using data from Seattle & King County, Washington. We developed SRGE using the R Shiny Web application framework. When populated with a data set including titer results and final disposition codes, SRGE displays the percent of verified early syphilis cases by serologic titer result and patient age in each cell of the grid. The results can be optionally stratified by sex, test type, and previous rapid plasma reagin titer. The impact of closing laboratory results without investigation in cells selected by the user is dynamically computed. The SRGE calculates the percent of all laboratory reports closed ("efficiency gained"), the proportion of all early syphilis cases closed without investigation ("case finding loss"), and the ratio of percent of cases identified for investigation to percent of all laboratory reports investigated ("efficiency ratio"). After defining algorithms, users can compare them side-by-side, combine subgroup-specific algorithms, and export results. We used SRGE to compare the current Public Health-Seattle & King County (PHSKC) reactor grid to 5 alternate algorithms. Of 13,504 rapid plasma reagin results reported to PHSKC from January 1, 2006, to December 31, 2015, 1565 were linked to verified early syphilis cases. Updating PHSKC's current reactor grid could result in an efficiency gain of 4.8% to 25.2% (653-3403 laboratory reports) and case finding loss of 1% to 8.4% (10-99 fewer cases investigated). The Syphilis Reactor Grid Evaluator can be used to rapidly evaluate alternative approaches to optimizing the reactor grid. Changing the reactor grid in King County to close more laboratory results without investigation could improve efficiency with minimal impact on

  8. VDRL titres in early syphilis before and after treatment.

    Science.gov (United States)

    Talwar, S; Tutakne, M A; Tiwari, V D

    1992-04-01

    To observe the pretreatment VDRL titres in different stages of early syphilis and evaluate the changes in VDRL titre following treatment using different treatment schedules. Retrospective study was carried out by analysing the records of cases of early syphilis treated between 1976 to 1981. Armed Forces personnel treated at different service hospitals in India. Of 3183 cases of early syphilis treated with different regimens during this period, 1532 were fully followed-up for a period of 30 months. Records of these 1532 cases were analysed. Assessment of VDRL titres before treatment and during post treatment surveillance period of 30 months. Attainment of non-reactivity of VDRL test in various stages of early syphilis using different treatment schedules was evaluated. Relatively higher titres were observed in secondary syphilis. Following treatment it was observed that VDRL test was still reactive at the end of 6 months in 16.47% of primary, 27.56% of secondary and 18.95% of early latent cases; at the end of 12 months in 11.38% of primary, 17.25% of secondary and 15.79% of early latent cases while at 30 months reactivity was still observed in 6.60% of primary, 8.39% of secondary and 11.58% of early latent cases. CSF was examined in 1173 cases at 6 months, of which one case revealed VDRL reactivity while two cases showed reactivity amongst 1188 CSF examined at 30 months. There has been no significant difference with broad spectrum antibiotics and 2.4 MU benzathine penicillin. Results were better with 4.8 MU benzathine penicillin and procaine penicillin. VDRL test appears to be a reliable test for the follow-up of treated patients in early syphilis. Early treatment prevents development of seropositivity in seronegative syphilis while majority of seropositive cases attain seronegativity by 6 months. Higher doses of benzathine penicillin and procaine penicillin accelerate the speed of seroconversion.

  9. Evaluation of the HISCL Anti-Treponema pallidum Assay as a Screening Test for Syphilis

    OpenAIRE

    An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting; Tao, Chuanmin; Wang, Lanlan

    2015-01-01

    The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive sample...

  10. A novel strategy for screening blood donors for syphilis at Komfo Anokye Teaching Hospital, Ghana

    DEFF Research Database (Denmark)

    Sarkodie, F; Ullum, H; Owusu-Dabo, E

    2016-01-01

    OBJECTIVE: To implement and describe a novel syphilis screening strategy for blood donors. BACKGROUND: The seroprevalence of syphilis in blood donors is often high in low- and middle-income countries (LMIC) although the proportion of infectious donations is probably low. Syphilis screening may...... to a positive syphilis screen. CONCLUSION: In other LMIC, this novel strategy can contribute to improving blood safety without jeopardising blood supply....

  11. Premature loss of primary teeth associated with congenital syphilis: a case report.

    Science.gov (United States)

    Antonio, Andréa Gonçalves; Kelly, Alice; Maia, Lucianne Cople

    2005-01-01

    Congenital syphilis is an infectious disease transmitted by an infected mother to her fetus. Several reports in the literature have focused on oral manifestations of congenital syphilis, mainly about Hutchinson's teeth and dysplastic molars, which are more common. However, this paper describes an unusual feature of congenital syphilis in a four-year-old child. A case of premature loss of primary teeth associated with congenital syphilis is reported.

  12. Syphilis in composers and musicians--Mozart, Beethoven, Paganini, Schubert, Schumann, Smetana.

    Science.gov (United States)

    Franzen, C

    2008-12-01

    In the pre-antibiotics era, syphilis was an extremely common disease. The first well-recorded European outbreak of what is now known as syphilis occurred in 1494, when it appeared among French troops besieging Naples. Thereafter, the disease spread all over Europe and, in the 18th and 19th centuries, many artists became victims of syphilis, among them poets, painters, philosophers, and musicians and composers. This review presents biographies of several musicians and composers that probably suffered from syphilis.

  13. Rapid Syphilis Testing Uptake for Female Sex Workers at Sex Venues in Southern China: Implications for Expanding Syphilis Screening

    Science.gov (United States)

    Chen, Xiang-Sheng; Yin, Yue-Ping; Shen, Crystal; Liu, Guo-Gu; Zhu, Zheng-Jun; Wei, Wan-Hui; Wang, Hong-Chun; Huang, Shui-Jie; Li, Jing; Tucker, Joseph D.; Mabey, David C.; Peeling, Rosanna W.

    2012-01-01

    Background Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs), but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST) into outreach programs for FSWs will help improve test uptake. Methods Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated. Results A total of 2812 FSWs were offered RST and 2670 (95.0%) accepted syphilis testing. 182 (6.8%) FSWs had a positive RST result among whom 136 (74.7%) were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4%) of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15–2.77), older age (AOR, 2.11, 95% CI, 1.17–3.79 for age of 31 years or above), and not working at a service venue (AOR, 1.60; 95% CI, 1.10–2.34). Conclusions RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs. PMID:23300709

  14. Rapid syphilis testing uptake for female sex workers at sex venues in Southern China: implications for expanding syphilis screening.

    Directory of Open Access Journals (Sweden)

    Xiang-Sheng Chen

    Full Text Available BACKGROUND: Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs, but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST into outreach programs for FSWs will help improve test uptake. METHODS: Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated. RESULTS: A total of 2812 FSWs were offered RST and 2670 (95.0% accepted syphilis testing. 182 (6.8% FSWs had a positive RST result among whom 136 (74.7% were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4% of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15-2.77, older age (AOR, 2.11, 95% CI, 1.17-3.79 for age of 31 years or above, and not working at a service venue (AOR, 1.60; 95% CI, 1.10-2.34. CONCLUSIONS: RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs.

  15. Serodiagnosis of syphilis in a community: An evaluatory study

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    Rajendran P

    2003-01-01

    Full Text Available PURPOSE: To analyse the prevalence of syphilis in the apparently healthy population and to provide data for implementation of the joint STD/HIV control programme, a population based study was undertaken by using ′probability proportional to size′ cluster survey method in three randomly chosen districts of Tamil Nadu, India namely Dindigul, Ramnad and Tanjore. METHODS: Blood samples were collected from adults (n=1873 aged 15-45 years, from the selected households enrolled in this study. The sera were tested parallelly by rapid plasma reagin (RPR and Treponema pallidum haemagglutination (TPHA tests. Reactive samples by RPR and/or TPHA were later analysed by fluorescent treponemal antibody absorption (FTA-ABS test. RESULTS: The prevalence of syphilis in the community of Tamil Nadu as per RPR positivity was 2.7% (50/1873 as against 0.7% by TPHA (13/1873. FTA-ABS positivity was observed in only 12 out of 48 (25% RPR/TPHA reactive samples tested. By taking the positivity by two of the three tests, the community prevalence of acute ongoing syphilis in Tamil Nadu was determined as 1.1% (20/1873. CONCLUSIONS: The results confirmed that no single serological test for syphilis can act as the marker of ongoing acute infection in an apparently healthy population. The study suggests that for specific diagnosis of ongoing syphilis, the FTA-ABS test may be performed along with RPR and TPHA.

  16. Prevalence of syphilis among HIV-seroreactive patients

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    Turbadkar D

    2007-01-01

    Full Text Available Presence of genital ulcer disease facilitates human immunodeficiency virus (HIV transmission and their -diagnosis is essential for the proper management. Venereal Disease Research Laboratory (VDRL test is used as a screening test for the diagnosis of syphilis. However, unusual VDRL test results have been reported in HIV-infected persons with syphilis. There are reports showing higher than expected VDRL titers as well as biological false positive in most of the studies. A negative Rapid Plasma Reagin (RPR test or VDRL test result may not rule out syphilis in patients with HIV infection. For laboratory confirmation of syphilis, one specific Treponemal test, namely, Fluroscent Treponemal Antibody Absorption (FTA-ABS test or Treponema Pallidum Haemagglutination Assay (TPHA should be done along with VDRL. In the present study, 88 HIV-seropositive patients with history of high-risk behaviour were screened for syphilis by VDRL test. Out of these 88 cases, 42 (47.7% patients were positive for TPHA and eight (9.1% patients were reactive for VDRL in various titers. All the eight patients who were reactive for VDRL test were also positive for TPHA test. Persons with HIV infection acquired through sexual route should be screened for sexually transmitted infections (STIs, and all patients with STIs should be counselled for HIV testing. This will help in proper management of patients having STIs and HIV coinfection.

  17. Histopathologic ear findings of syphilis: a temporal bone study.

    Science.gov (United States)

    Hızlı, Ömer; Hızlı, Pelin; Kaya, Serdar; Monsanto, Rafael da Costa; Paparella, Michael M; Cureoglu, Sebahattin

    2016-09-01

    To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mm² surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P < 0.05).

  18. Diagnostic approaches in unsuspected oral lesions of syphilis.

    Science.gov (United States)

    Siqueira, C S; Saturno, J L; de Sousa, S C O M; da Silveira, F R X

    2014-12-01

    Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Evaluation of the Determine Syphilis TP assay for the detection of antibodies against Treponema pallidum for the serodiagnosis of syphilis.

    Science.gov (United States)

    Zhuang, Y-H; Tian, Y; Chen, Y; Tang, J; Wang, J-Q; Li, P; Li, Q; Jiang, Y-Q

    2012-06-01

    Currently, infectious syphilis has been resurgent in China and has become a significant public health problem. The rapid expansion of syphilis screening programs is urgently required. In the present study, the performance of the Determine Syphilis TP assay (Determine TP assay) for the detection of antibodies against Treponema pallidum (T. pallidum) for syphilis serodiagnosis was evaluated. In total, 300 serum samples were tested for the presence of treponemal-specific antibodies using the Treponema pallidum particle agglutination (TPPA) assay, the Determine TP assay, and the InTec immunochromatography assay (InTec assay). The Determine TP assay detected 99, 11, and 5 positive results, whereas the InTec assay detected 97, 3, and 3 positive samples from group I (100 TPPA-positive sera), group II (13 TPPA 1:80 +/- sera), and group III (187 TPPA-negative sera), respectively. The sensitivity, specificity, and the rate concordant with TPPA for the Determine TP assay were 97.35, 98.91, and 97.33%, respectively. In comparison to the TPPA, the Determine TP assay is simple to perform and time-saving, making it a favorable alternative for the detection of T. pallidum-specific antibodies where other T. pallidum-specific confirmatory tests are not available. In addition, this rapid treponemal test promotes prompt treatment for syphilis by providing early laboratory diagnosis.

  20. Ultrasound examination in diagnostic of early congenital syphilis

    Directory of Open Access Journals (Sweden)

    V. D. Zavadovskaya

    2012-01-01

    Full Text Available A peculiarity of the congenital syphilis of recent years is an increase of the number of cases of latent forms of the disease, marked with osteopathy. With the help of an examination of 50 children with early congenital syphilis, the following ultrasonic signs of a musculoskeletal system lesion were revealed: osteochondritis 90%, osteosclerosis 80%, and periostitis 30%.The comparison of the nature of a musculoskeletal system lesion with serological data of the specific process activity showed that complex manifestations of lesions with periostitis being a component were of the greatest clinical significance.

  1. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality

    Directory of Open Access Journals (Sweden)

    Berman Stuart

    2011-04-01

    Full Text Available Abstract Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98% with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90% (8 studies, a 64% reduction in preterm delivery (95% c.i. 53 – 73% (7 studies and an 80% reduction in neonatal deaths (95% c.i. 68 – 87% (5 studies. Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.

  2. Time Series Modelling of Syphilis Incidence in China from 2005 to 2012.

    Science.gov (United States)

    Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau

    2016-01-01

    The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis.

  3. Pustular secondary syphilis: report of three cases and review of the literature.

    Science.gov (United States)

    Kazlouskaya, Viktoryia; Wittmann, Christa; Tsikhanouskaya, Iryna

    2014-10-01

    Pustular syphilis is an extremely rare manifestation of secondary syphilis. Failure to recognize the disease can have devastating consequences. We present three patients with pustular syphilis as the primary manifestation of secondary syphilis. Patient 1 was initially diagnosed by Venereal Disease Research Laboratory (VDRL) test (titers 1 : 32) and confirmed by enzyme immunoassay (EIA) for Treponema pallidum. Patient 2 was screened for syphilis by VDRL (titers 1 : 64), yielding a positive result, and tested negative for HIV. Secondary syphilis was confirmed by EIA. In Patient 3, a diagnosis of secondary syphilis was established by VDRL (titers 1 : 128) and EIA. Treponema pallidum was detected by dark field microscopy in three patients. Testing for HIV infection was negative in all patients. Diagnosis in secondary syphilis remains challenging because of the diversity of clinical presentations. The most commonly observed cutaneous presentation is a generalized, non-pruritic, papulosquamous eruption varying from pink to violaceous to brown, with mucous membrane involvement. The diagnostic methods used to identify secondary syphilis are the same as those used to diagnose other stages of syphilitic infection. The persistence of syphilis in both developed and underdeveloped regions highlights the importance of considering syphilitic infection in the setting of a cutaneous pustular eruption, especially one that fails to respond to standard therapy. Testing for other sexually transmitted diseases, including HIV, should be performed in all patients diagnosed with syphilis. © 2014 The International Society of Dermatology.

  4. The impact of syphilis screening among female sex workers in China: a modelling study.

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    Kate M Mitchell

    Full Text Available BACKGROUND: In China, female sex workers (FSWs are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved. METHODS: A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%, and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored. RESULTS: All model structures suggest yearly syphilis screening could substantially reduce (by 72-88% syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30% the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings. CONCLUSIONS: Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact.

  5. The Impact of Syphilis Screening among Female Sex Workers in China: A Modelling Study

    Science.gov (United States)

    Mitchell, Kate M.; Cox, Andrew P.; Mabey, David; Tucker, Joseph D.; Peeling, Rosanna W.; Vickerman, Peter

    2013-01-01

    Background In China, female sex workers (FSWs) are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved. Methods A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%), and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored. Results All model structures suggest yearly syphilis screening could substantially reduce (by 72–88%) syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30%) the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings. Conclusions Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact. PMID:23383249

  6. Syphilis screening practices in blood transfusion facilities in Ghana

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    Francis Sarkodie

    2016-02-01

    Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.

  7. Seroprevalence of syphilis in a tertiary care hospital

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    Kawal Preet Kaur

    2014-02-01

    Full Text Available Objective: To determine the prevalence of syphilis in a tertiary care hospital situated in Hisar, Haryana. Methods: The study is a five year study (Jan 2006 to Dec 2010, in which a total of 1550 sera obtained from clinically suspected cases of syphilis and pregnant females were screened for cardiolipin antibodies by the rapid plasma reagin (RPR test. The total number of males was 650 while the total number of females was 900. Results: The RPR test was positive in 48 patients (3.09%. Out of a total of 850 pregnant females, 10 (1.18% were tested positive through RPR test. Among the remaining 38 positive patients, males were 35 and females were 3. The most common age group affected was 19-24 years in both the sexes. Conclusions: Our findings showed that there is a substantial benefit of using an economical test like RPR for the diagnosis of syphilis in resource-poor setting. Great importance should be given to the screening of pregnant females for syphilis.

  8. Extracutaneous atypical syphilis in HIV-infected patients.

    Science.gov (United States)

    Prieto, Paula; Imaz, Arkaitz; Calatayud, Laura; García, Olga; Saumoy, María; Podzamczer, Daniel

    2017-07-21

    We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients. Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed. A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them. Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  9. Evaluation of a new chemiluminescence immunoassay for diagnosis of syphilis

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    Mo Xiaohui

    2010-02-01

    Full Text Available Abstract Objective To assess the sensitivity, specificity, and feasibility of a new chemiluminescence immunoassay (CLIA in the diagnosis of syphilis. Methods At first, a retrospective study was conducted, using 135 documented cases of syphilis and 30 potentially interfering samples and 80 normal sera. A prospective study was also performed by testing 2, 071 unselected samples for routine screening for syphilis. CLIA was compared with a nontreponemal test (TRUST and a treponemal test (TPPA. Results There was an agreement of 100% between CLIA and TPPA in the respective study. The percentage of agreement among the 245 sera tested was 100.0%. Compared with TPPA, the specificity of CLIA was 99.9% (1817/1819, the sensitivity of CLIA was 100.0% (244/244 in the prospective study. CLIA showed 99.5% agreement with TPPA by testing 2, 071 unselected samples. And CLIA seemed to be more sensitive than TPPA in detecting the samples of primary syphilis. Conclusions CLIA is easy to perform and the indicator results are objective and unequivocal. It may be suitable for large-scale screening as a treponemal test substituted for TPPA.

  10. Late endemic syphilis: case report of bejel with gummatous laryngitis.

    OpenAIRE

    Pace, J. L.; Csonka, G. W.

    1988-01-01

    An elderly Bedouin woman originally thought, on clinical and histological grounds, to have tuberculosis of the larynx was found to have gummatous laryngitis due to late endemic syphilis (bejel). This disease is highly prevalent in the Bedouin tribes of the Middle East. Doctors dealing with Arab patients, either in the Middle East or elsewhere, should be aware of this possibility.

  11. Evaluation of ID-PaGIA syphilis antibody test.

    Science.gov (United States)

    Naaber, Paul; Makoid, Ene; Aus, Anneli; Loivukene, Krista; Poder, Airi

    2009-01-01

    Laboratory diagnosis of syphilis is usually accomplished by serology. There are currently a large number of different commercial treponemal tests available that vary in format, sensitivity and specificity. To evaluate the ID-PaGIA Syphilis Antibody Test as an alternative to other specific treponemal tests for primary screening or confirmation of diagnosis. Serum samples from healthy adults (n = 100) were used for detection of specificity of ID-PaGIA. To evaluate sensitivity of ID-PaGIA serum samples (n = 101) from patients with confirmed or suspected syphilis were tested for syphilis antibodies with FTA-Abs IgM, ID-PaGIA, ELISA IgM and TPHA tests. No false-positive results were found with ID-PaGIA. Sensitivity of various treponemal tests was the following: FTA-Abs IgM: 95.5%, ID-PaGIA and ELISA IgM: 94%, and TPHA 75%. The positive and negative predictive values of ID-PaGIA were 100 and 89.5%, respectively. Compared with other treponemal tests ID-PaGIA has excellent sensitivity and specificity.

  12. Malignant syphilis (Leus maligna in a HIV infected patient

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    Prasad P

    2001-01-01

    Full Text Available A 40-year-old promiscuous man presented with nodulo ulcerative lesions all over the body and a healing genital ulcer. Blood VDRL was reactive in 64 dilutions and HIV (Elisa was positive. Patient was diagnosed to have malignant syphilis (leas inaligna and was given appropriate treatment. Lesions healed with hypopigmented macules suggestive of ′Icukoderma colli′.

  13. [Pregnancies complicated by maternal syphilis and fetal death].

    Science.gov (United States)

    do Nascimento, Maria Isabel; Cunha, Alfredo de Almeida; Guimarães, Elisângela Victor; Alvarez, Felipe Silva; Oliveira, Sandra Regina Dos Santos Muri; Villas Bôas, Eduardo Loyola

    2012-02-01

    To describe the characteristics of pregnancies complicated by maternal syphilis and fetal death. Retrospective descriptive study performed by reviewing the medical records of 48 pregnant women with maternal syphilis and fetal death outcome admitted to Hospital Geral de Nova Iguaçu, Baixada Fluminense, State of Rio de Janeiro, during the period from 2005 to 2008. Birth weight >500 g and fetal death documented by Death Certificate were the inclusion criteria. The following aspects were analyzed: sociodemographic factors, reproductive history, aspects of the current pregnancy, prenatal care, Venereal Disease Research Laboratory (VDRL) testing, and other gestational conditions, in addition to syphilis. The fetal deaths were classified as maternal, placental or fetal. Percentage, mean, standard deviation (SD), maximum and minimum values were reported. The mean maternal age was 22.7 years (SD=0.9 years), and at least 50% of the patients had low educational level. At hospital admission, 68.8% of the subjects were in the third trimester, with a mean gestational age of 29.2 weeks (SD=0.5), and more than 50% were in labor. The vast majority of fetal deaths (93%) occurred before maternal hospitalization. Among the patients who received prenatal care (54.2%), 30.8% had no VDRL test, 30.8 and 15.4% had a reactive and non-reactive result, respectively, and none had more than one prenatal VDRL test. At the time of childbirth, most of the mothers (95.8%) carried out VDRL testing. Overall, the VDRL titers varied from 1:1 to 1:512, with predominant values >1:4 (91.7%). In 23% of cases other clinical conditions related to fetal death, in addition to syphilis, were found. The infection was the main clinically identified cause of fetal death in this patient series. Fetal death occurred during the preterm period and in the presence of high titers of maternal infection, suggesting recent syphilis infection.

  14. Risk of HIV or second syphilis infection in Danish men with newly acquired syphilis in the period 2000-2010

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Katzenstein, Terese Lea; Gerstoft, Jan

    2013-01-01

    in men diagnosed with one of these sexually transmitted diseases indicate a high frequency of unsafe sex in the Danish MSM population. As one-third of the HIV-infected persons diagnosed with syphilis had high viral loads, our data support initiation of antiretroviral therapy in all HIV-infected MSM...

  15. Utility of immunochromatographic assay as a rapid point of care test for screening of antenatal syphilis

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    Bineeta Kashyap

    2015-01-01

    Full Text Available Background and Objectives: Syphilis is one of the most common preventable causes of adverse effects during pregnancy. Antenatal screening prevents the delay between diagnosis and treatment there by reducing the risk of congenital syphilis. The objective of this study was to evaluate the utility of an immunochromatographic assay as a point of care test for antenatal screening of syphilis. Materials and Methods: Sera of 200 antenatal mothers were evaluated for serodiagnosis of syphilis by the venereal disease research laboratory (VDRL, Treponema pallidum hemagglutination assay (TPHA and SD BIOLINE Syphilis 3.0 test. The performance of SD BIOLINE Syphilis 3.0 test was compared with VDRL as screening assay and TPHA as a confirmatory test. Results: The antenatal prevalence of syphilis was found to be 2% by both VDRL and TPHA. The sensitivity, specificity, positive predictive value, and the negative predictive value of SD BIOLINE Syphilis 3.0 test were 75%, 100%, 100%, and 99.45%, respectively. Conclusions: Antenatal screening and treatment of maternal syphilis are cost-effective health interventions even under the low prevalence of infection. SD BIOLINE Syphilis 3.0 test, although having less sensitivity than the existing testing strategy, can have a tremendous impact on the disease burden if used prudently for the screening of antenatal mothers in peripheral health settings.

  16. Utility of immunochromatographic assay as a rapid point of care test for screening of antenatal syphilis.

    Science.gov (United States)

    Kashyap, Bineeta; Sagar, Tanu; Kaur, Iqbal R

    2015-01-01

    Syphilis is one of the most common preventable causes of adverse effects during pregnancy. Antenatal screening prevents the delay between diagnosis and treatment there by reducing the risk of congenital syphilis. The objective of this study was to evaluate the utility of an immunochromatographic assay as a point of care test for antenatal screening of syphilis. Sera of 200 antenatal mothers were evaluated for serodiagnosis of syphilis by the venereal disease research laboratory (VDRL), Treponema pallidum hemagglutination assay (TPHA) and SD BIOLINE Syphilis 3.0 test. The performance of SD BIOLINE Syphilis 3.0 test was compared with VDRL as screening assay and TPHA as a confirmatory test. The antenatal prevalence of syphilis was found to be 2% by both VDRL and TPHA. The sensitivity, specificity, positive predictive value, and the negative predictive value of SD BIOLINE Syphilis 3.0 test were 75%, 100%, 100%, and 99.45%, respectively. Antenatal screening and treatment of maternal syphilis are cost-effective health interventions even under the low prevalence of infection. SD BIOLINE Syphilis 3.0 test, although having less sensitivity than the existing testing strategy, can have a tremendous impact on the disease burden if used prudently for the screening of antenatal mothers in peripheral health settings.

  17. The Global Epidemiology of Syphilis in the Past Century - A Systematic Review Based on Antenatal Syphilis Prevalence.

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    Chris Richard Kenyon

    2016-05-01

    Full Text Available How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance.1 A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA, United Kingdom (UK and Zimbabwe. The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2 National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3 Linear regression was used to test for an association between ASP in 1990-1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence. WHO world regions were included as potential explanatory variables.In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3-5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990-1999 and 2008 than in the other world

  18. Evaluation of SD BIOLINE Syphilis 3.0 for rapid diagnosis of syphilis: Report from a regional sexually transmitted infection reference laboratory in North India

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    Bhanu Mehra

    2016-01-01

    Conclusion: Keeping in view the high sensitivity and specificity of SD BIOLINE Syphilis 3.0, we conclude that the test can be used as a tool for rapid on-site diagnosis of syphilis and as an alternative to TPHA for detection of antibodies to Treponema pallidum.

  19. Evaluation of SD BIOLINE Syphilis 3.0 for Rapid Diagnosis of Syphilis: Report from a Regional Sexually Transmitted Infection Reference Laboratory in North India.

    Science.gov (United States)

    Mehra, Bhanu; Bhattar, Sonali; Saxena, Shikhar; Rawat, Deepti; Bhalla, Preena

    2016-01-01

    Serology is considered the mainstay of syphilis diagnosis. The limitations of the traditional serological methods and the advent and availability of novel immunochromatographic assays have led to the widespread application of rapid point-of-care procedures as screening tools for syphilis. However, these tests have not been extensively evaluated. This study was designed to evaluate the performance of a rapid syphilis diagnostic test known as SD BIOLINE Syphilis 3.0 (SD Biostandard Diagnostics Private Limited, Gurgaon, Haryana, India). A panel comprising of 50 venereal disease research laboratory reactive and 50 nonreactive sera was tested using SD BIOLINE Syphilis 3.0. The performance of the test was evaluated using IMMUTREP Treponema pallidum hemagglutination assay (TPHA) (OMEGA Diagnostics Limited, Scotland, United Kingdom) as the reference standard and sensitivity, specificity, and negative and positive predictive values were calculated. The sensitivity, specificity, and positive and negative predictive values of SD BIOLINE Syphilis 3.0 were 92.86% (confidence interval of 95%: 80.52-98.50%), 98.28% (90.76-99.96%), 97.50% (86.84-99.94%), and 95.00% (86.08-98.96%), respectively, compared to TPHA as the gold standard. Keeping in view the high sensitivity and specificity of SD BIOLINE Syphilis 3.0, we conclude that the test can be used as a tool for rapid on-site diagnosis of syphilis and as an alternative to TPHA for detection of antibodies to Treponema pallidum.

  20. Seroprevalence of syphilis in patients attending a tertiary care hospital in Southern India

    Institute of Scientific and Technical Information of China (English)

    Sadia Khan; GodfredAntony Menezes; Rahul Dhodapkar; Belgode Narasimha Harish

    2014-01-01

    To report our experience with two tests, anti-cardiolipin antibody test [venereal disease reasearch laboratory (VDRL) test] and specific treponemal test (Treponema pallidum hemagglutination assay), used for screening antenatal, high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008. Methods: A total of 14639 samples received from various patient groups including antenatal cases, patients attending sexually transmitted disease (STD) clinic, blood donors and HIV positive patients were screened. Results: Among the 14639 samples collected, 103 were positive by VDRL test. Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay. The cumulative seroprevalence over two years was found to be 0.61% in this study. The syphilis seroprevalence reduced from 0.88% in 2006 to 0.40% in 2008. Among the various sub-populations studied, patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%. The seroprevalence decreased significantly from 4.00% in 2006 to 1.39% in 2008. Conclusions: Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence. These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.

  1. Seroprevalence of syphilis in patients attending a tertiary care hospital in Southern India

    Institute of Scientific and Technical Information of China (English)

    Sadia; Khan; Godfred; Antony; Menezes; Rahul; Dhodapkar; Belgode; Narasimha; Harish

    2014-01-01

    Objective:To report our experience with two tests,anti-cardiolipin antibody test[venereal disease reasearch laboratory(VDRL) test]and specific treponemal test(Treponema pallidum hemagglutination assay),used for screening antenatal,high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008.Methods:A total of 14639 samples received from various patient groups including antenatal cases,patients attending sexually transmitted disease(STD) clinic,blood donors and HIV positive patients were screened.Results:Among the 14639 samples collected,103 were positive by VDRL test.Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay.The cumulative seroprevalence over two years was found to be 0.61%in this study.The syphilis seroprevalence reduced from 0.88%in 2006 to 0.40%in 2008.Among the various sub-populations studied,patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%.The seroprevalence decreased significantly from 4.00%in 2006 to1.39%in 2008.Conclusions:Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence.These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.

  2. Undetectable hepatitis C virus RNA during syphilis infection in two HIV/HCV-co-infected patients

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Knudsen, Andreas; Krarup, Henrik Bygum;

    2014-01-01

    BACKGROUND: Treponema pallidum, the causative agent of syphilis, elicits a vigorous immune response in the infected host. This study sought to describe the impact of syphilis infection on hepatitis C virus (HCV) RNA levels in patients with HIV and chronic HCV infection. METHODS: Patients...... with chronic HIV/HCV and syphilis co-infection were identified by their treating physicians from 1 October 2010 to 31 December 2013. Stored plasma samples obtained before, during, and after syphilis infection were analysed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF......-α), interferon gamma (IFN-γ), and IFN-γ-inducible protein 10 kDa (IP-10). RESULTS: Undetectable HCV RNA at the time of early latent syphilis infection was observed in 2 patients with HIV and chronic HCV infection. After treatment of the syphilis infection, HCV RNA levels increased again in patient 1, whereas...

  3. High prevalence of syphilis among demobilized child soldiers in Eastern Congo: a cross-sectional study

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    Lutala Prosper

    2011-09-01

    Full Text Available Abstract Background Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined the prevalence of syphilis among young demobilized soldiers. Methods Screening of syphilis using the rapid plasma reagin test and the Treponema pallidum hemagglutination assay was conducted in three transit sites of soldier reintegration in 2005. The Fisher Exact probability test was used to compare results. Results The prevalence of syphilis was found to be 3.4%, with almost equal distribution in respect to sex, location. Conclusion Syphilis continues to be highly prevalent in demobilized child soldiers in Eastern Congo. Syphilis screening tests are recommended.

  4. A longitudinal evaluation of Treponema pallidum PCR testing in early syphilis

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    Shields Matt

    2012-12-01

    Full Text Available Abstract Background Syphilis is a growing public health problem among men who have sex with men (MSM globally. Rapid and accurate detection of syphilis is vital to ensure patients and their contacts receive timely treatment and reduce ongoing transmission. Methods We evaluated a PCR assay for the diagnosis of Treponema pallidum using swabs of suspected early syphilis lesions in longitudinally assessed MSM. Results We tested 260 MSM for T pallidum by PCR on 288 occasions: 77 (26.7% had early syphilis that was serologically confirmed at baseline or within six weeks, and 211 (73.3% remained seronegative for syphilis. Of 55 men with primary syphilis, 49 were PCR positive, giving a sensitivity of 89.1% (95% CI: 77.8%-95.9% and a specificity of 99.1% (95% CI: 96.5%-99.9%. Of 22 men with secondary syphilis, 11 were PCR positive, giving a sensitivity of 50% (95% CI: 28.2%-71.8% and a specificity of 100% (95% CI: 66.4%-71.8%. Of the 77 syphilis cases, 43 (56% were HIV positive and the sensitivity and specificity of the PCR test did not vary by HIV status. The PCR test was able to detect up to five (10% primary infections that were initially seronegative, including one HIV positive man with delayed seroconversion to syphilis (72 to 140 days and one HIV positive man who did not seroconvert to syphilis over 14 months follow-up. Both men had been treated for syphilis within a week of the PCR test. Conclusions T pallidum PCR is a potentially powerful tool for the early diagnosis of primary syphilis, particularly where a serological response has yet to develop.

  5. Prevalence and Characteristics of Pregnant Syphilis among Women Attending Antenatal Clinics in Shenzhen (China) in 2003

    Institute of Scientific and Technical Information of China (English)

    Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)

    2004-01-01

    Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother

  6. Dr. Arthur Conan Doyle and the case of congenital syphilis.

    Science.gov (United States)

    Silverstein, Arthur M; Ruggere, Christine

    2006-01-01

    In 1894, Dr. Arthur Conan Doyle wrote "The Third Generation," a short story involving the transmission of congenital syphilis from generation to generation. Analysts of his writings have interpreted the pathogenetic mechanism involved in modern terms: infection of mother by father and then transplacental infection of the fetus. However, a review of the contemporary literature and the history of the concepts of congenital and "hereditary" syphilis demonstrates that the late 19th-century understanding of the process involved a Lamarckian transmission of paternal infection, via the sperm at the moment of conception. It was undoubtedly this concept that Doyle learned in medical school in the late 1870s and that provided the background to his story.

  7. Lack of effectiveness of ofloxacin against experimental syphilis in rabbits.

    Science.gov (United States)

    Une, T; Nakajima, R; Otani, T; Katami, K; Osada, Y; Otani, M

    1987-09-01

    Ofloxacin, a new pyridone-carboxylic acid derivative, was evaluated in experimental syphilis in rabbits in comparison with penicillin G. Experimental syphilis was established by intradermal injection of Treponema pallidum subsp. pallidum Nichols. Ten days after infection, the dermal lesions were characterized by syphilitic papula accompanied with central necrosis. These animals were subsequently treated either with ofloxacin twice a day at an oral dose of 10 mg/kg or with penicillin G once a day at an intramuscular dose of 10,000 U/kg for 21 consecutive days. In penicillin G-treated animals, the dermal lesions became smaller as early as day 3 of treatment and almost disappeared during the therapy. In marked contrast to remarkable efficacy of penicillin G was further development of the lesions in ofloxacin-treated animals, showing no difference in pathological manifestations as compared to untreated animals. The results of nontreponemal serologic test correlated well with the response of animals to treatment.

  8. Syphilis in Colonial Morocco - The Case of Bousbir

    Directory of Open Access Journals (Sweden)

    Fouad Laboudi

    2016-03-01

    Full Text Available Syphilis is a venereal disease. Morocco has witnessed syphilis since the fifteenth century and the treatment of this disease remained archaic until the Protectorate was established.With the establishment of the colonial system in Morocco, the phenomenon of prostitution spread. Protectorate authorities designated a particular place in Casablanca for such activity that developed: Bousbir district. The authorities’ efforts failed to regulate and organize such activity because of the development of clandestine prostitution in relation to urban growth and the increase of employed, poor and downgraded urban population, especially among women who practice prostitution, and due to lack of a real social policy of the Protectorate concerning the policy of land-use planning or control that were a priority. 

  9. La syphilis congenitale revelee par une fracture spontanee

    Directory of Open Access Journals (Sweden)

    Mounia Lakhdar Idrissi

    2011-11-01

    Full Text Available Alors qu�elle est actuellement oubliee dans les pays developpes, la syphilis congenitale se voit encore chez nous faute du depistage antenatal. Ses formes cliniques sont polymorphes et orientent a tord vers d�autres pathologies surtout en periode neonatale. Le diagnostic n�est donc pas toujours facile. La revelation d�une syphilis congenitale par une fracture spontanee est exceptionnellement decrite. Nous rapportons dans ce travail le cas d�un nourrisson de 2 mois ramene en consultation pour limitation douloureuse des mouvements du bras droit. Le diagnostic est evoque sur les donnees radiologiques et confirme par la serologie syphilitique. Le traitement a repose essentiellement sur l�administration de la penicilline G avec une bonne evolution clinique.

  10. Peliosis and gummatous syphilis of the liver: A case report

    Institute of Scientific and Technical Information of China (English)

    Jun-Fa Chen; Wei-Xia Chen; Hong-Ying Zhang; Wen-Yan Zhang

    2008-01-01

    Peliosis hepatis is a rare benign vascular disorder of the liver that may be associated with malignancy, infection and drugs. The imaging manifestation of this disorder is often variable and nonspecific making its diagnosis difficult. We describe a rare case of peliosis hepatis and gummatous syphilis of the liver with emphasis on CT findings. Image characteristics of our patient included pseudotumoral appearance of peliosis hepatis, isodensity to the adjacent liver parenchyma on unenhanced and dual-phase scanning. To our knowledge, peliosis hepatis associated with syphilis and unique enhancement pattern has not been reported. Considering the imaging features of peliosis hepatis, it should be considered in the differential diagnosis of atypical focal hepatic lesion.

  11. Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients

    Directory of Open Access Journals (Sweden)

    Velia Ramírez-Amador

    2013-01-01

    Full Text Available Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003–2011 are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL, and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21–59 years with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80% cases. Mucous patch was the most common oral manifestation (17, 85.5%, followed by shallow ulcers (2, 10% and macular lesions (1, 5%. Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients.

  12. Characterization of Sera with Discordant Results from Reverse Sequence Screening for Syphilis

    Directory of Open Access Journals (Sweden)

    Kyunghoon Lee

    2013-01-01

    Full Text Available Reverse sequence screening for syphilis (RSSS (screening with treponemal tests, followed by confirmation with nontreponemal tests has been increasingly adopted. CDC recommends confirmation of discordant results (reactive EIA/CIA and nonreactive nontreponemal test with Treponema pallidum particle agglutination assay (TP-PA. We characterized sera with discordant results from RSSS with Architect Syphilis TP CIA. Among 15,713 screening tests using Architect Syphilis TP at Seoul National University Gangnam Center between October 2010 and May 2011, 260 (1.7% showed reactive results. Rapid plasma reagin (RPR and TP-PA were performed on 153 available sera among them. On sera with discordant results between Architect Syphilis TP and TP-PA, INNO-LIA Syphilis Score and FTA-ABS were performed. Among 153 sera, RPR was nonreactive in 126 (82.4%. Among them, TP-PA was positive in 103 (81.7%, indeterminate (± in 7 (5.6%, and negative in 16 (12.7%. Out of 16 CIA(+/RPR(−/TP-PA(− sera, INNO-LIA Syphilis Score and/or FTA-ABS were negative on 14 sera. Out of 7 CIA(+/RPR(−/TP-PA(± sera, INNO-LIA Syphilis Score and FTA-ABS were positive/reactive in 6 sera. RSSS with confirmation by TP-PA on sera with discordant results between Architect Syphilis TP and RPR effectively delineated those discordant results and could be successfully adopted for routine checkup for syphilis.

  13. Knowledge, behaviors, and attitudes of HIV-infected men about syphilis.

    Science.gov (United States)

    Valdes, A; Cazanave, C; Dabis, F; Neau, D; Lacoste, D; Gaborieau, V; Farbos, S; Dworkin, M S

    2017-09-21

    To explore knowledge on syphilis, sexual behaviors, and attitudes in men living with HIV in southwestern France. In the ANRS CO3 Aquitaine Cohort of people living with HIV (PLHIV), a self-administered questionnaire was proposed to all male PLHIV attending one of the seven participating clinics between September 22 and October 24, 2014. The 15 questions explored patient knowledge about syphilis disease, attitudes, and behaviors during sexual intercourse. Among 302 patients surveyed, 101 reported at least one episode of syphilis. A history of syphilis was associated with awareness that syphilis was on the rise in men who have sex with men (MSM) in the Aquitaine region (46% vs. 22%, Poral sex was low in both patients with (37%) and without (20%) a history of syphilis (P=0.0045). Patients with a history of syphilis more often used recreational drugs (RR 1.6; P=0.0028). Among 160 patients who had sexual intercourse with a man in the past 12 months, 23% reported using condoms for oral intercourse and 80% reported using condoms for anal intercourse. Sixty-two per cent of MSM declared being ready to change their practice if informed about the rise in syphilis. This survey revealed important information gaps in PLHIV about syphilis and related behavior. The reported receptiveness of this population to behavioral change may help inform educational interventions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Case Report: Neuropathic Arthropathy of the Hip as a Sequela of Undiagnosed Tertiary Syphilis

    National Research Council Canada - National Science Library

    Viens, Nicholas A; Watters, Tyler Steven; Vinson, Emily N; Brigman, Brian E

    2010-01-01

    .... Neuropathic arthropathy can be associated with tabes dorsalis, a unique manifestation of late, tertiary neurosyphilis that may arise in individuals with untreated syphilis many years after initial...

  15. Primary chancre in the rectum: A report of rare case of syphilis

    Directory of Open Access Journals (Sweden)

    Zheng Shu

    2014-12-01

    Full Text Available Rectal syphilis is rare and it is easily diagnosed as rectal cancer. We report a case of a 32-year-old male patient complained of intermittent blood stool for 2 months. The patient was initially diagnosed suffering from rectal cancer based on clinical findings, Computed Tomography (CT and sigmoidoscopy examination, but rectal biopsy specimens and lymph node biopsy revealed no cancer cells. After knowing that he had a history of homosexuality, rectal syphilis was diagnosed because of positive syphilis-related indices. CT imaging of rectal syphilis was retrospectively evaluated and it may play a role in directing the adequate diagnosis with subsequent effective treatment of such patient population.

  16. Characterization of sera with discordant results from reverse sequence screening for syphilis.

    Science.gov (United States)

    Lee, Kyunghoon; Park, Hyewon; Roh, Eun Youn; Shin, Sue; Park, Kyoung Un; Park, Myoung Hee; Song, Eun Young

    2013-01-01

    Reverse sequence screening for syphilis (RSSS) (screening with treponemal tests, followed by confirmation with nontreponemal tests) has been increasingly adopted. CDC recommends confirmation of discordant results (reactive EIA/CIA and nonreactive nontreponemal test) with Treponema pallidum particle agglutination assay (TP-PA). We characterized sera with discordant results from RSSS with Architect Syphilis TP CIA. Among 15,713 screening tests using Architect Syphilis TP at Seoul National University Gangnam Center between October 2010 and May 2011, 260 (1.7%) showed reactive results. Rapid plasma reagin (RPR) and TP-PA were performed on 153 available sera among them. On sera with discordant results between Architect Syphilis TP and TP-PA, INNO-LIA Syphilis Score and FTA-ABS were performed. Among 153 sera, RPR was nonreactive in 126 (82.4%). Among them, TP-PA was positive in 103 (81.7%), indeterminate (±) in 7 (5.6%), and negative in 16 (12.7%). Out of 16 CIA(+)/RPR(-)/TP-PA(-) sera, INNO-LIA Syphilis Score and/or FTA-ABS were negative on 14 sera. Out of 7 CIA(+)/RPR(-)/TP-PA(±) sera, INNO-LIA Syphilis Score and FTA-ABS were positive/reactive in 6 sera. RSSS with confirmation by TP-PA on sera with discordant results between Architect Syphilis TP and RPR effectively delineated those discordant results and could be successfully adopted for routine checkup for syphilis.

  17. [Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network].

    Science.gov (United States)

    Tinajeros, Freddy; Ares, Lucila Rey; Elías, Vanessa; Reveiz, Ludovic; Sánchez, Franz; Mejía, Martha; Hernández, Rosalinda; Revollo, Rita

    2017-05-25

    Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

  18. Short-time, high-dosage penicillin infusion therapy of syphilis: an alternative to recommended regimens?

    DEFF Research Database (Denmark)

    Lomholt, Hans; Poulsen, Asmus; Brandrup, Flemming;

    2003-01-01

    The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G intraven......The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G...

  19. Yellowish dots in the retina: a finding of ocular syphilis?

    Directory of Open Access Journals (Sweden)

    Renan Albert Mendonça Rodrigues

    2014-10-01

    Full Text Available Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 11 men (91.6%, 19 eyes, median presentation age of 38.1 years, and panuveitis as the main clinical manifestation (seven patients, 58.3%, being bilateral in four. Ten patients were taking oral prednisone (83.3%. Serum panels performed by the Venereal Disease Research Laboratory (VDRL showed positive results in eight patients (66.7%, whereas VDRL cerebrospinal fluid (CSF tests were negative in seven of nine collected (77.8%. However, serum FTA-Abs was positive in 100% of patients, and eight patients (66.7% had HIV infection. The best corrected visual acuity (BCVA presented after treatment improved in 10 eyes (55.6%, did not change in seven eyes (38.9%, and worsened in one eye (5.6%. Although not yet acknowledged in the literature as a typical manifestation of ocular syphilis, these are very common findings in clinical practice. We believe that preretinal dots are due to perivasculitis secondary to treponema infection. It is important recognize them and remember that syphilis can present in several forms, including the one presented in this study.

  20. Epidemiology Of Genital Ulcers And Prevalence Of Seropositivity For Syphilis

    Directory of Open Access Journals (Sweden)

    Hazra B. R

    1997-01-01

    Full Text Available The study assesses the prevalence of seropositivity for syphilis amongst cases presenting with genital ulcer to STD Clinic, Medical College, Calcutta during July 1994 to January 1995, and their epidemiological characteristics. Of the 157 cases studied, 142 (90.9% were males and 15 (9.1% were females. Prevalence of seropositivity for syphilis was in 22.93% cases of genital ulcers. In the age distribution of males, 9% were below 21 years, 33.8% between 21-25 years and 23.9% between 26-30 years. In females, the highest proportion (33.3% was in the age range 16-20 years. While all the female patients were Hindus, 87.3% of males were Hindus and 12.7% were Muslims. Large Majority (70% of the cases were literate. Amongst male patients, unskilled labourers constituted the highest proportion (35.2%, and majority in females (53.3% were from middle income group and 16.6% from high income group. 90.1% of males were unmarried single against 87.9% in females. The type of family for both male and female patients was overwhelmingly nuclear (86.6% to 87.3% and 2.8% of the males and 13.3% of the females were orphans. Amongst the seropositive patients, primary syphilis was present in 71.4% males and 62.5% females and the figures for secondary syphilis were 28.6% in males and 30.6% in females, 42% males and 26.7% females had knowledge about source of infection. While 85.9% males got infection from prostitutes, 66.7% females got it from clients. In females, 20% had been infected by friends and neighbours and 13.3% by casual contact.

  1. Syphilis, sex and psychiatry, 1789-1925: Part 1.

    Science.gov (United States)

    Kaplan, Robert M

    2010-02-01

    Syphilis has changed the course of history, shaped the path of medicine and had more influence on psychiatry than any other illness. This paper, part one of a two-part series, investigates the historical, social and cultural aspects of the interaction of syphilis and psychiatry. Syphilis did not manifest as a psychiatric illness until the French Revolution. At the time, the Pinel School was focussing on the environment and moral therapy. Bayle, who made the first discovery of the cause of a psychiatric disease - chronic arachnoiditis - paid the price for his discovery by being driven from psychiatry. The 19th century led to the rise of a new medical polymath: the syphilologist - a specialist in every aspect of a disease that showed a remarkable capacity to affect every organ and tissue in the body and produce symptoms resembling other illnesses. The field was dominated by Frenchmen, Philippe Ricord and Alfred Fournier, and Englishman Jonathan Hutchinson. A middle-class illness, neurosyphilis struck at the heart of the class interests - property. This reeked havoc with the family business or finances, causing considerable distress to their relatives. General paresis of the insane became associated in the public eye with creative, intellectual or philosophical activity. It affected a long list of artists, writers and musicians, including Oscar Wilde, Robert Schumann, Baudelaire, Schubert and Ivan the Terrible. While the features of syphilis were delineated, confirmation remained elusive and neurosyphilis continued to hide its secrets. It remained the grand cause that defined psychiatry and it was not until the middle of the 20th century that it ceased to play a part in the daily life of doctors in psychiatric wards.

  2. Curse on two generations: a history of congenital syphilis.

    Science.gov (United States)

    Obladen, Michael

    2013-01-01

    Before the microbiologic era, venereal diseases were poorly distinguished. Congenital syphilis was believed to be transmitted during conception by the father's sperm, during delivery in the birth canal, or from infected milk or breasts. The most frequent maternofetal transmission was not considered because the mother's primary infection remained undiagnosed. The concept of treating infants with mercury transmitted by nurses' milk prompted the founding of a specialized infant hospital in Vaugirard in 1780: lactating syphilitic women received mercury orally and by rubbing it into the skin. Their own infant and a second infected infant from the foundling hospital were believed to be cured by their milk. Underwood described snuffles in 1789 and Bertin periosteal bone disease in 1810. Tardive congenital lues with keratitis, deafness, and notched upper incisors were described by Hutchinson in 1863. Feeding remained difficult, as wet nursing transmitted syphilis to the nurse and other infants. Specialized institutions tried goat or donkey milk. A debate between contagionists assuming exclusively maternal infection and hereditists assuming germinal transmission by the father's sperm continued throughout the 19th century. Schaudinn and Hoffmann identified Spirochaeta pallida in 1905. When Ehrlich discovered the efficacy of salvarsan in 1910, Noeggerath treated infants with the new drug, pioneering the injection into scalp veins. In 1943, Lentz and Ingraham established penicillin treatment for congenital syphilis. Whereas this drug effectively prevented maternofetal transmission, treating infants remained difficult due to the Jarisch-Herxheimer reaction.

  3. Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.

    Science.gov (United States)

    Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue

    2014-01-01

    Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.

  4. Congenital syphilis in neonates with nonreactive nontreponemal test results.

    Science.gov (United States)

    Wozniak, P S; Cantey, J B; Zeray, F; Leos, N K; Sheffield, J S; Wendel, G D; Sánchez, P J

    2017-07-06

    Infants whose mothers had syphilis during pregnancy were studied to determine how often exposed newborns with normal physical examinations and nonreactive nontreponemal serologic tests had abnormal laboratory or radiographic studies. Retrospective analysis of prospectively collected data from infants born to mothers with syphilis and had a normal examination and a nonreactive nontreponemal test. Some infants had IgM immunoblotting, PCR testing or rabbit infectivity testing (RIT) performed. From 1984 to 2002, 115 infants had a nonreactive serum Venereal Disease Research Laboratory (VDRL)/rapid plasma reagin (RPR) test and a normal physical examination at birth. Among 87 infants born to mothers who had untreated syphilis, 4 had a positive serum IgM immunoblot or PCR test, but none had spirochetes recovered by RIT. Two infants had anemia, one had an elevated serum alanine aminotransferase concentration and one with Down's syndrome had direct hyperbilirubinemia. Among 14 infants born to mothers treated laboratory or radiographic tests, although 1 of 11 had a reactive serum IgM immunoblot. Among 14 infants born to mothers treated ⩾4 weeks before delivery, none had abnormal laboratory or radiographic tests. Newborns with normal physical examination and nonreactive nontreponemal test results are unlikely to have abnormalities detected on conventional laboratory and radiographic testing.Journal of Perinatology advance online publication, 6 July 2017; doi:10.1038/jp.2017.103.

  5. Syphilis and HIV infection among prisoners in Maputo, Mozambique.

    Science.gov (United States)

    Vaz, R G; Gloyd, S; Folgosa, E; Kreiss, J

    1995-01-01

    A cross-sectional study was carried out among 1284 male and 54 female prisoners to assess the prevalence of and risk factors for sexually transmitted diseases (STD) in 4 correctional institutions of Maputo, Mozambique. Among the men, 32% reported a history of prostitute contact and 41% reported a history of STD. Only 9% reported having ever used condoms. Seventy (5.5%) men reported having had sexual intercourse while in prison, in all but one instance this involved sex with another man. There was no reported intravenous drug use. One hundred and four (7.8%) inmates had positive serological tests for syphilis and 8 (0.6%) had antibodies to HIV. Among men, syphilis was associated with a history of genital ulcer [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.4, 6.4] and uncircumcised status (OR = 1.5, 95% CI = 1.0, 2.5). This study demonstrates that syphilis is common among inmates in Maputo and that risk behaviours for STD transmission exist within Maputo prisons. There is a need for STD screening and treatment programmes within prisons in Mozambique and the introduction of educational interventions, including condom promotion.

  6. 出国劳务人员咽梅毒感染个案报道%A case report on pharyngeal Syphilis of abroad labor

    Institute of Scientific and Technical Information of China (English)

    王俊贤

    2011-01-01

    目的 研究梅毒传播途径及易感人群,减少梅毒感染率.方法对1例不明原因咽痛的出国劳务人员进行梅毒相关试验:甲苯胺红不加热血清验TRU ST);梅毒螺旋体血凝试验(TPPA);口腔粘膜刮片暗视野螺旋体检查,以及流行病学调查.结果TRUST试验1/8滴度阳性,1/16滴度阴性;TPPA试验阳性;暗视野螺旋体检查阳性.确诊该患者感染梅毒,且出现咽梅毒症状.流行病学调查表明梅毒感染者为出国劳务人员;同性恋者,且有口交行为.结论梅毒是一种性传播疾病,临床症状多见于生殖器,偶尔可通过口交感染咽梅毒.因此,耳鼻咽喉科医生在诊疗患者时应加强对此类疾病的注意,避免因误诊而延误治疗.%Objective To study the transmission way and susceptible of syphilis, and to reduce its infection. Methods A series of experiments about syphilis , TRUST, TPPA, and syphilis spirochete check by oral mucosal smears under dark-field microscopy were adopted, Meamevhile, the epidemiological investigation was conducted. Results TRUST 1/8+.1/16-, TPPA + , syphilis spirochete found in oral mucosal smears. Diagnosis was pharyngeal Syphilis, and the male was a gay who had oral sex during his labor abroad period. Conclusions Syphilis is a sexually transmitted disease, often found in reproductive organ , seldom in pharynx by oral sex .So the doctors ^specially the otolaryngology doctors should pay attention to pharyngeal syphilis, avoiding to misdiagnosis.

  7. The clinical and radiological observation of congenital syphilis

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Byung Sik; Chung, Ung Ki [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    1983-03-15

    Congenital syphilis is transmitted through the placenta by the infected mother after 16 weeks of gestation. Since the incidence of syphilis is again on the increase, syphilis remains at the present time a public problem of major and increasing proportions. Recently, congenital syphilis has different formas of presentation. The authors observed clinically and radiologically 27 cases of congenital syphilis in the neonates and infants treated at the pediatric ward of Chonnam National University Hospital from Jan. 1977 to Mar. 1982. The results are as follows: 1. The number of observed patients was 27 cases, 22 cases in male, 5 cases in female. 2. Onset of first clinical symptoms and signs was within the 4th week life in 14 cases (52%), 1-2 months in 6 cases (22%), 2-3 months in 4 cases (15%), 3-4 months in 3 cases (11%). All cases was within 6 months. 3. The order of the frequency of common clinical manifestations was hepatomegaly (96%), splenomegaly (78%), skin lesion (63%), anemia (63%), nasal snuffle (56%). 4. Of 11 cases with known birth weight, 10 cases were low birth weight. 5. The serologic test (VDRL slide test) of 27 tested caes revealed reactive response in 26 cases, non-reactive response in 1 case, and that of syphilitic mothers except one revealed reactive in 23 cases, non- reactive in 3 cases. 6. Roentgenographic syphilitic bony changes were detected in 26 cases (96%), of 27 studied cases, osteochondritis was present in 24 cases (89%), periostitis in 21 case (78%), osteomyelitis in 11 cases (41%). 7. The most common sites affected were as follows. Radius and ulna were the most frequently affected, the next were in order of tibia and fibula. Considering osteochondiritis only, the distal end of radius and ulna (78% respectively) and proximal end of tibra (67%) were the most frequently affected sites, the proximal end of femur (33%) was least frequently affected site. 8. On chest films of 27 case, osseous changes (mainly periostitis) of clavicle were noted

  8. Syphilis test availability and uptake at medical facilities in southern China

    Science.gov (United States)

    Tucker, Joseph D; Wang, Cheng; Shen, Song-Ying; Chen, Xiang-Sheng; Yang, Bin; Peeling, Rosanna

    2011-01-01

    Abstract Objective To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China. Methods Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004–2008 were studied. Findings In 2008, 54 196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4–25), services at the township level (OR: 33; 95% CI: 10–100) and services with ≤ 1000 deliveries per year (OR: 1.002; 95% CI: 1.001–1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis. Conclusion Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority. PMID:22084525

  9. Laboratory evaluation of the Chembio Dual Path Platform HIV-Syphilis Assay

    Directory of Open Access Journals (Sweden)

    Mireille B. Kalou

    2016-02-01

    Full Text Available Background: Use of rapid diagnostic tests for HIV and syphilis has increased remarkably in the last decade. As new rapid diagnostic tests become available, there is a continuous need to assess their performance and operational characteristics prior to use in clinical settings.Objectives: In this study, we evaluated the performance of the Chembio Dual Path Platform (DPP® HIV–Syphilis Assay to accurately diagnose HIV, syphilis, and HIV/syphilis co-infection.Method: In 2013, 990 serum samples from the Georgia Public Health Laboratory in Atlanta, Georgia, United States were characterised for HIV and syphilis and used to evaluate the platform. HIV reference testing combined third-generation Enzyme Immunoassay and Western Blot, whereas reference testing for syphilis was conducted by the Treponema pallidum passive particle agglutination method and the TrepSure assay. We assessed the sensitivity and specificity of the DPP assay on this panel by comparing results with the HIV and syphilis reference testing algorithms.Results: For HIV, sensitivity was 99.8% and specificity was 98.4%; for syphilis, sensitivity was 98.8% and specificity was 99.4%. Of the 348 co-infected sera, 344 (98.9% were detected accurately by the DPP assay, but 11 specimens had false-positive results (9 HIV and 2 syphilis due to weak reactivity.Conclusion: In this evaluation, the Chembio DPP HIV–Syphilis Assay had high sensitivity and specificity for detecting both HIV and treponemal antibodies. Our results indicate that this assay could have a significant impact on the simultaneous screening of HIV and syphilis using a single test device for high-risk populations or pregnant women needing timely care and treatment.

  10. Making Sense of Pain: Delusions, Syphilis, and Somatic Pain in London County Council Asylums, c. 1900

    Directory of Open Access Journals (Sweden)

    Louise Hide

    2012-12-01

    Full Text Available During the late nineteenth century, a high percentage of male deaths in asylums was attributed to various forms of tertiary syphilis, most notably General Paralysis of the Insane (GPI and tabes dorsalis. It was not unusual for patients to present symptoms of both conditions, the latter of which could be agonizingly painful. Some patients also suffered from persecutory delusions, believing that electricity was running through them or that their limbs were gnawed by lions and wolves at night. Drawing on a theory advanced by a number of key alienists and pathologists of the period, I suggest that these delusions were misinterpretations of felt sensations and, as such, illusions rather than delusions. Despite the well-known problems around using these historical sources, I contend that recorded delusions in asylum case notes can be treated as narratives of pain that provide invaluable insights into patients' subjective experiences.

  11. Determinants Associated with Syphilis among the Youth in Health Centre Wamena City, Jayawijaya Regency

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    Oliphina Rumbekwan

    2016-08-01

    Full Text Available Abstract Sexually transmitted infections (STI cases in province of Papua in 2013 were 1,213 cases, then in 2014 the number of visits to STI services were 19 945 cases with the number of STI patients of 10,995 cases and the number of syphilis patients was 2,150 cases, while cases of syphilis in adolescent at the health center Wamena City District Jayawijaya in 2015 were 91 cases. The method used in this research is quantitative correlation type with cross sectional study. The population in this study was all teenagers who visited the health center Jayawijaya Wamena town, with 578 teenagers. The sampling technique used was purposive sampling, obtained a sample of 236 respondents. The data collection is done by distributing questionnaires to the respondents. Analysis of the data in this study is analysis of univariate and bivariate. The results showed a correlation between free association with syphilis in adolescence (p-value = 0.000, there is a relationship between the use of condoms with syphilis in adolescence (p-value = 0.000, there is no relationship between early sex education with disease syphilis in adolescence (p-value = 0.151, there is no relationship between the supervision of parents with syphilis in adolescence (p-value = 0.265, there is a relationship between personal hygiene with syphilis in adolescence (p-value = 0.001 , there is no relationship between the mass media with syphilis in adolescence (p-value = 0.569.

  12. Unusual case of cervical syphilis with Piringer-Kuchinka-like lymphadenitis.

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    Moreno-Sánchez, Manuel; González-García, Raúl; García, Carlos Moreno; Monje, Florencio

    2014-12-01

    Syphilis rarely presents with cervical lymphadenopathy. We describe a patient with a cervical mass associated with weight loss, asthenia, and night sweats. The mass was excised and histological examination suggested Piringer-Kuchinka lymphadenitis, which is usually present in cervical toxoplasmosis. To the best of our knowledge, Piringer-Kuchinka lymphadenitis has not previously been reported in cervical syphilis.

  13. Acute periostitis in early acquired syphilis simulating shin splints in a jogger.

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    Meier, J L; Mollet, E

    1986-01-01

    Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.

  14. Syphilis in Men Who Have Sex With Men: A Warning Sign for HIV Infection.

    Science.gov (United States)

    Gállego-Lezáun, C; Arrizabalaga Asenjo, M; González-Moreno, J; Ferullo, I; Teslev, A; Fernández-Vaca, V; Payeras Cifre, A

    2015-11-01

    To describe the clinical and epidemiological characteristics of syphilis in men who have sex with men (MSM) in an area of Mallorca, Spain. We performed a retrospective analysis of syphilis cases in MSM seen at a hospital in Mallorca between January 2005 and June 2013. Fifty-five cases of syphilis were recorded in MSM during the study period (34.3% of all cases diagnosed), and 74.5% of these patients had human immunodeficiency virus (HIV) coinfection. The two diseases had been diagnosed simultaneously in 70.7% of this population. Patients with HIV coinfection had a median CD4 count of 456cells/μL (range, 29-979 cells/μL). Syphilis was diagnosed clinically in 49.1% of cases and by screening in the remaining 50.9%. The most common form of syphilis was late latent or indeterminate syphilis (41.9% of cases). In the group of men with syphilis, MSM had a higher risk of HIV infection. A majority of MSM with syphilis had HIV coinfection. HIV screening is therefore essential in this population and could even result in early diagnosis. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  15. Don’t Forget What You Can’t See: A Case of Ocular Syphilis

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    Lee, Monica I.; Lee, Annie W.C.; Sumsion, Sean M.; Gorchynski, Julie A.

    2016-01-01

    This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss. PMID:27429702

  16. Don’t Forget What You Can’t See: A Case of Ocular Syphilis

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    Monica I. Lee

    2016-06-01

    Full Text Available This case describes an emergency department (ED presentation of ocular syphilis in a human immunodeficiency virus (HIV infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM. This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss.[West J Emerg Med. 2016;17(4:473-476.

  17. What underpins the decline in syphilis in Southern and Eastern Africa? An exploratory ecological analysis

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    Chris Richard Kenyon

    2014-12-01

    Conclusions: AIDS mortality may have played an important role in the decline in syphilis in this region. Consequently, with AIDS deaths declining in Sub-Saharan Africa, vigilant surveillance of syphilis prevalence will be necessary to detect a potential re-emergence, as has occurred in high-income countries, and to render a timely public health response.

  18. The clinical significance comparison of a latex agglutination based syphilis screening test at low antibody titer.

    Science.gov (United States)

    Wang, Hua-Cheng; Chen, Cha; Wang, Li-Na; Long, Yi-Fei; Zhang, Wei-Zheng; Li, You-Qiang; Xiao, Qian; Yuan, Hui

    2013-01-01

    The rapid increase of syphilis underscores a tremendous need to carefully evaluate many new serological tests for syphilis and choose efficient and economical strategies for syphilis screening, especially in the case of primary infection with low antibody titer. Between 2011 and 2012, 73 patients' sera samples were included in this retrospective study. They were either TRUST or TPPA reactive, either LA (latex agglutination) based auto3 TP or CLIA (chemiluminescence assay) based Architect Syphilis TP assay reactive. The contradictory weak response samples were further examined by FTA-Abs method. TPPA could not give reactive results in samples with antibody concentration less than 10 mIU. Auto3 TP reagent shows good linearity at low antibody titers and was more sensitive than TPPA, while the former does not show significant superiority compared to the Architect Syphilis TP assay at low antibody titer, except that it is suitable for adaptation on diverse automated chemistry analyzers.

  19. Latent Syphilis: Immunoglobulins Reactive in Immunofluorescence and Other Serological Tests

    Science.gov (United States)

    Julian, A. J.; Logan, L. C.; Norins, L. C.; Scotti, A. T.

    1971-01-01

    Study of sera from 69 patients with untreated or inadequately treated latent syphilis revealed that immunoglobulin (Ig)G antibodies made up the bulk of the fluorescent treponemal antibody-absorption (FTA-ABS)-test reactivity found in the sera. IgM and IgA antibodies also contributed in some cases. Venereal Disease Research Laboratory slide-test reactivity was found in both 19 and 7S serum fractions, whereas Treponema pallidum immobilization-test reactivity was found mainly in the 7S fraction. PMID:16558017

  20. Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal

    Science.gov (United States)

    Kakchapati, Sampurna; Singh, Dipendra Raman; Rawal, Bir Bahadhur; Lim, Apiradee

    2017-01-01

    Purpose Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. Materials and methods The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. Results A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. Conclusion HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.

  1. Laboratory Diagnosis of Syphilis: A Survey to Examine the Range of Tests Used in Canada

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    Raymond SW. Tsang

    2011-01-01

    Full Text Available Laboratory diagnosis of syphilis has undergone major changes in the past decade with the introduction of immunoassays and recombinant Treponema pallidum antigens as screening tools for syphilis infection. To address this change in laboratory practice, a national syphilis laboratory working group was established with members from the Public Health Agency of Canada, provincial public health laboratories across the country as well as sexually transmitted infection researchers, clinicians and epidemiologists. This working group aims to examine how the use of newer immunoassays will affect syphilis diagnosis, surveillance and disease management. To provide a baseline for this work, an e-mail survey was conducted in the fall of 2009 to determine current laboratory practices for syphilis diagnosis in Canada. The most commonly used tests were rapid plasma reagin, enzyme immunoassay, T pallidum passive particle agglutination, venereal disease research laboratory, fluorescent treponemal antibody absorption, line immunoassay and polymerase chain reaction with 92%, 36%, 32%, 20%, 12%, 12% and 12% of the responding laboratories reporting using these tests, respectively. The ultimate goal of this working group will be to update laboratory guidelines for the diagnosis of syphilis, and to identify syphilis surveillance and research priorities in Canada.

  2. Laboratory diagnosis of syphilis: A survey to examine the range of tests used in Canada.

    Science.gov (United States)

    Tsang, Raymond Sw; Radons, Sandra Michelle; Morshed, Muhammad

    2011-01-01

    Laboratory diagnosis of syphilis has undergone major changes in the past decade with the introduction of immunoassays and recombinant Treponema pallidum antigens as screening tools for syphilis infection. To address this change in laboratory practice, a national syphilis laboratory working group was established with members from the Public Health Agency of Canada, provincial public health laboratories across the country as well as sexually transmitted infection researchers, clinicians and epidemiologists. This working group aims to examine how the use of newer immunoassays will affect syphilis diagnosis, surveillance and disease management. To provide a baseline for this work, an e-mail survey was conducted in the fall of 2009 to determine current laboratory practices for syphilis diagnosis in Canada. The most commonly used tests were rapid plasma reagin, enzyme immunoassay, T pallidum passive particle agglutination, venereal disease research laboratory, fluorescent treponemal antibody absorption, line immunoassay and polymerase chain reaction with 92%, 36%, 32%, 20%, 12%, 12% and 12% of the responding laboratories reporting using these tests, respectively. The ultimate goal of this working group will be to update laboratory guidelines for the diagnosis of syphilis, and to identify syphilis surveillance and research priorities in Canada.

  3. [Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men].

    Science.gov (United States)

    González-Domenech, Carmen M; Antequera Martín-Portugués, Isabel; Clavijo-Frutos, Encarnación; Márquez-Solero, Manuel; Santos-González, Jesús; Palacios-Muñoz, Rosario

    2015-01-01

    to analyse epidemiological, clinical, and analytical features of HIV-infected men who have sex with men (MSM) diagnosed with syphilis in the Infectious Diseases Unit (Hospital Virgen de la Victoria, Málaga, Spain) during 2004-2013. An observational study was conducted on 196 syphilis episodes in 167 MSM infected with HIV (2004-2013). Epidemiological, clinical, and analytical data were collected. Annual syphilis incidence among HIV-MSM is calculated as the number of syphilis episodes among MSM in one year divided by the number of MSM followed up in that year. Incidence ranged from 1.2% (2007) to 7.8% (2012). There were asymptomatic episodes in 42.8% cases, and an HIV-syphilis coincident diagnosis in 28.5%. The annual incidence of syphilis has increased within HIV infected MSM. One third of the syphilis episodes were simultaneous to HIV diagnosis and near half of them were asymptomatic. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. PROFILE OF SYPHILIS PATIENTS ATTENDING THE DERMATOLOGY VENEREOLOGY OPD AT A GOVERNMENT TERTIARY HOSPITAL

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    Vasuki Shanmugam

    2017-08-01

    Full Text Available BACKGROUND Syphilis is one of the major sexually transmitted infections, which is showing a raising trend across the globe. The aim of the study is to study the prevalence of syphilis among Sexually Transmitted Infection (STI clinic attendees of a tertiary care hospital of south India. MATERIALS AND METHODS This was a cross-sectional study of one year duration conducted at STI clinic of a government tertiary hospital in South India. Patients who have been diagnosed to have syphilis were analysed with respect to demographic profile and their sexual behaviour pattern. RESULTS 40 were persons diagnosed to have syphilis among a total of 1790 STI clinic attendees. The mean age of patients with syphilis found to be 31 years. Male-to-female ratio is 7:1. 80% of patients with syphilis had higher school level and college level education. Homosexual behaviour pattern was predominant and it was found among 60% of them (p value 0.011. 62.5% of them were alcoholic. Safe sex practices were minimal in spite of knowledge about condom. CONCLUSION There was a raising trend of syphilis among STI clinic attendees during 2016. Early infectious stage of disease is more and was found more commonly among Men Having Sex with Men (MSM.

  5. Check Yourself: a social marketing campaign to increase syphilis screening in Los Angeles County.

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    Plant, Aaron; Javanbakht, Marjan; Montoya, Jorge A; Rotblatt, Harlan; O'Leary, Christopher; Kerndt, Peter R

    2014-01-01

    In 2007, the Los Angeles County Department of Public Health launched Check Yourself, a new social marketing campaign, as part of ongoing efforts to address the persistent syphilis epidemic among men who have sex with men (MSM) in the county. The goals of the campaign were to increase syphilis testing and knowledge among MSM. Check Yourself was planned with careful attention to the principles of social marketing, including formative research, market segmentation, and an emphasis on building a strong brand. A cross-sectional survey using a time-location sample was conducted in 2009 for the evaluation. The survey assessed demographics, syphilis knowledge, and recent syphilis testing as well as unaided awareness, aided awareness, and confirmed awareness, meaning that a person had both awareness of the campaign and could correctly identify that the campaign was about syphilis. The total sample size was 306. Unaided awareness for Check Yourself was 20.7%, and aided awareness was 67.5%, bringing total campaign awareness to 88.2%; confirmed awareness was 30.4%. Unaided campaign awareness was associated with syphilis knowledge and important risk behaviors for syphilis, indicating that the campaign reached an appropriate audience. Total awareness was not associated with recent syphilis testing in a multivariate model. However, MSM with confirmed awareness were more than 6 times more likely to have been recently tested. The evaluation of Check Yourself found that the campaign had a very strong brand among MSM. Although total awareness was not associated with syphilis testing, confirmed awareness, a more robust measure, was strongly associated.

  6. Prioritizing congenital syphilis control in south China: a decision analytic model to inform policy implementation.

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    Nicholas X Tan

    Full Text Available BACKGROUND: Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. METHODS AND FINDINGS: Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111 CS cases averted per 100,000 live births (58% decrease. The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160 CS cases averted per 100,000 live births (85% decrease. CONCLUSIONS: The Chinese national plan provides a strong foundation for syphilis control, but more

  7. Evaluation of preventative and control measures for congenital syphilis in State of Mato Grosso

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    Leila Regina de Oliveira

    2014-06-01

    Full Text Available Introduction Congenital syphilis is an important health problem in Brazil. This study assessed measures aimed at the prevention and control of syphilis in the State of Mato Grosso and its capital, Cuiabá. Methods A descriptive study cross-sectional and of time trends assessing the congenital syphilis was performed in Cuiabá and Mato Grosso between 2001 and 2011. We compared maternal sociodemographic characteristics and health care utilization related to cases of congenital syphilis during the periods from 2001 to 2006 and from 2007 to 2011. We assessed the temporal trends in this disease's incidence using a simple linear regression. Results Between 2001 and 2006 in Mato Grosso, 86.8% of the mothers who had live births with congenital syphilis received prenatal care, 90.6% presented with a nontreponemal test reagent at delivery, 96.2% had no information regarding a treponemal confirmatory test at delivery, and 77.6% received inadequate treatment for syphilis; additionally, 75.8% of their partners were not treated. There was a statistically significant reduction in prenatal visits (p = 0.004 and an increase in the proportion of mothers reactive to nontreponemal tests at delivery (p = 0.031 between the two periods. No other variables were found to differ significantly between the periods. In Cuiabá, we observed a similar distribution of variables. In the state and in the capital, the increasing trend of congenital syphilis was not statistically significant. Conclusions The high incidence of congenital syphilis in Mato Grosso and the low levels of health care indicators for pregnant women with syphilis suggest the need to improve the coverage and quality of prenatal care.

  8. [Syphilis in adolescent mothers in the city of Posadas, Province of Misiones].

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    Jacquier, N; Dos Santos, L; Deschutter, J D; Duarte, B; Rodriguez Fermepin, M; Martinelli, M; de Torres, R A

    1999-01-01

    During three months (April to June 1997) 1,238 consecutive pregnant women were studied at the time of delivery at the Madariaga public Hospital. Syphilis was confirmed in 26 (2.1%) women, and 15 cases (57.7%) of congenital syphilis were demonstrated in newborns one of whom was a stillborn. Of the syphilitic women 61.5% were 20 years old (average), 65.4% were single, 19.2% had a stable partner and 15.4% were married; 70% of them had finished elementary school (seven years), but despite this discrete level of instruction and that they were benefited with free health attention, 73% of them had not started or completed the pregnancy control. None of these women acted as sexual workers or were drug users; 57.7% were unemployed and the remainder worked as domestic servants or were still going to school. Menarca started at 13 (average) and the age of the first sexual activity was 15 (average). The distribution of the cases of syphilis within the city area shows four clusters that coincide with the lower income population, but not with marginal groups. The failure to submit to medical control during pregnancy among syphilitic women is directly linked with an increased risk for congenital syphilis. The specific prevalence of syphilis in women (20 years old or less) pregnant or not, shows an alarming hidden epidemic situation. An interinstitutional and communitary program, with direct interventions within the detected population clusters, is now underway in order to control syphilis. Undesired pregnancy and syphilis seem to be associated with adolescent unsafe sex conducts. A coordinated program between Public Health Service and National Misiones University is operating, visiting home by home, in order to decrease or eliminate congenital syphilis and is considered a priority health problem. Unfortunately, if sexual conducts do not undergo changes in the near future, at least by the correct use of condoms, HIV will replace syphilis.

  9. The prevalence and correlates of syphilis and HIV among homosexual and bisexual men in Shijiazhuang, China.

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    Zhang, Shao-Hui; Liu, Shu-Jun; Hu, Ling-Ling; Li, Jie-Fang; Liu, Li-Hua; Wei, Ning

    2016-02-01

    Bisexual men (men who have sex with men and women) are potential epidemiological bridges responsible for the spread of HIV and other sexually transmitted infections from men who have sex with men only to the heterosexual population. We aimed to estimate the prevalence of syphilis and HIV and the factors associated with syphilis infection among men who have sex with men and women and men who have sex with men only from Shijiazhuang, China. In 2011-2013, a cross-sectional cohort of 427 men who have sex with men was recruited by a snowball sampling method and tested for syphilis and HIV. Chi square and logistic regression were performed to identify syphilis risk factors. Among the 427 men who have sex with men, 71 (16.6%) cases were syphilis-positive and 16 cases (3.7%) were HIV-positive. The proportions of men who have sex with men and women and men who have sex with men only in the total sample were 31.4% and 68.6%, respectively. Men who have sex with men and women exhibited double the syphilis prevalence of men who have sex with men only and were more likely to practice insertive anal sex. Higher education level, being married, having more male partners, and both receptive and insertive anal sex roles were associated with syphilis among men who have sex with men and women. Residing in suburban areas, being married, being HIV positive, and an absence of desire to change sexual orientation were associated with syphilis among men who have sex with men only. Therefore, men who have sex with men and women represent an important sub-group in the syphilis epidemic and further interventions should be developed to reduce risk among different sub-sets of men who have sex with men.

  10. Clinical and epidemiological characteristics of patients with syphilis: 5 year-case study from Thailand.

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    Leeyaphan, Charussri; Jiamton, Sukhum; Prasertworonun, Nuntida; Maneeprasopchoke, Pitchaya; Omcharoen, Viboon

    2014-09-01

    Syphilis has been increasing dramatically worldwide since 2000, especially among men who have sex with men (MSM), and in those with human immunodeficiency virus (HIV) infection. However most previous reports studied about prevalence and riskfactors ofsyphilis in MSMpopulation without statistical comparison with non-MSMpopulation. The present study aimed to describe epidemiological trends, clinical manifestations, laboratory investigation, treatment, and HIV co-infection in patients diagnosed with syphilis, including statistical evaluation these data between MSMand non-MSM as well as HIV and non-HIVpopulations. This was a retrospective medical records review ofpatients diagnosed with syphilis who attended Sexual Transmitted Diseases (STD) clinic between January 2008 and December 2012. Demographic data, clinical manifestations, HIVstatus, VDRL titer; and treatment regimens were collected. Of the 922 patients that attended the STD clinic, 143 syphilis patients were recruited with an overall prevalence of 15.5%. Twenty-six patients were MSM and 31 were HIV infected patients. Prevalence rate of syphilis in MSMand HIV infected patients were 2.8% and 3.4%, respectively. Prevalence had upward trend that startedfrom 2008 and reachedpeak in 2011. When taking MSMinto account, MSMsignificantly had younger age than non-MSM Early stage ofsyphilis, VDRL titer higher than 1:32 at diagnosis, and MSMpopulation were significantly associated with HIV-positivity among syphilis patients. Regarding treatment ofsyphilis, median time to cure syphilis was 117 days (95% confidence interval = 93-141). Treatment regimen, MSM and HIVco-infection did not significantly show influence on duration to cure. Prevalence ofsyphilis has been continuously increasing. MSM with syphilis significantly associated with younger age. Moreover, early stage of syphilis, VDRL titer higher than 1:32, and MSMpopulation were significantly related with HIVinfection. Treatment regimen, MSM and HIVco-infection did not

  11. Syphilis in HIV-infected patients: predictors for serological failure and serofast state

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    R Palacios

    2012-11-01

    Full Text Available Purpose: HIV-infected patients treated for syphilis may be at increased risk for serological failure and serofast state. Our aim was to analyse serological response to treatment in HIV-infected patients diagnosed with syphilis, and factors associated with serological cure and serofast state. Methods: Open-label, no controlled study of a series of HIV-patients diagnosed with syphilis during 2004–2011. Patients were categorized by rapid plasma reagin titer (RPR into success (4-fold decrease in RPR by 12 or 24 months after treatment of early or late syphilis, serofast (success with persistently stable reactive RPR, and failure/re-infection (failure to decrease 4-fold in RPR by 12 or 24 months after treatment or sustained 4-fold increase in RPR after treatment response. Results: 141 HIV-patients were diagnosed with syphilis during the study period (104 early syphilis, 36 late or indeterminate latent syphilis. The mean age was 36.3 years, 98.5% were male, and 87.2% homosexual men. In 46 (32.6% cases, HIV and syphilis infection diagnosis were coincident (mean CD4 457/mm3 and HIV-VL 4.72 log10. Among patients with prior known HIV infection, 65 were on antiretroviral therapy (ART at syphilis diagnosis (mean CD4 469/mm3, 76.9% undetectable HIV-VL. 116 patients satisfied criteria for serological response analysis (89 early, 24 late/indeterminate. At 12 months of early syphilis treatment (89.2% penicillin there were 16 (18% failures, and at 24 months of late/indeterminate syphilis (91.7% penicillin there were 5 (18.5% failures. Overall, 36 (31.0% patients presented serofast state. Treatment failure was related with lower CD4 count (295 vs 510/mL; p=0.045 only in patients with coincident diagnosis. Serofast state was related with older age (41 vs 36 years; p=0.024, and lower CD4 count (391 vs 513/mm3; p=0.026. Conclusions: In this series of HIV-infected patients, with many patients on ART and with good immunological and virological parameters, serological

  12. RPR test for serological survey of rabbit syphilis in companion rabbits.

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    Saito, Kumiko; Tagawa, Masayo; Hasegawa, Atsuhiko

    2003-07-01

    Since the RPR (rapid plasma regain) test was found to be useful for the diagnosis of rabbit syphilis, serological survey by this test has been carried out in Japanese companion rabbits. A hundred virgin household rabbits kept alone and without signs and history of syphilis were examined by RPR test from April 2001 to March 2002, in Tokyo, Japan. The test was positive in 35 cases and negative in 65 cases. RPR negative rabbits should be selected for breeding to prevent the spread of rabbit syphilis in companion rabbits in Japan.

  13. Papulonodular secondary syphilis: a rare clinic presentation confirmed by serologic and histologic exams*

    Science.gov (United States)

    Veasey, John Verrinder; Lellis, Rute Facchini; Boin, Maria Fernanda Feitosa de Camargo; Porto, Pedro Loureiro; Chen, Jessica Chia Sin

    2016-01-01

    Syphilis is a sexually transmitted disease caused by Treponema pallidum and divided into three stages according to the duration of the disease: primary, secondary and tertiary. Secondary syphilis has diverse clinical presentations, such as papular-nodular lesions. This presentation is rare, with 15 cases reported in the literature over the past 20 years. We report a case of secondary syphilis with papular-nodular lesions in a healthy 63-year-old patient, who has presented treponema in immunohistochemical examination of the skin lesions. PMID:27192520

  14. Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals

    Science.gov (United States)

    Shilaih, Mohaned; Marzel, Alex; Braun, Dominique L.; Scherrer, Alexandra U.; Kovari, Helen; Young, Jim; Calmy, Alexandra; Darling, Katharine; Battegay, Manuel; Hoffmann, Matthias; Bernasconi, Enos; Thurnheer, Maria C.; Günthard, Huldrych F.; Kouyos, Roger D.

    2017-01-01

    Abstract After several years of steady decline, syphilis is reemerging globally as a public health hazard, especially among people living with human immunodeficiency virus (HIV). Syphilis resurgence is observed mainly in men who have sex with men (MSM), yet other transmission groups are affected too. In this manuscript, we study the factors associated with syphilis incidence in the Swiss HIV cohort study in the era of highly effective antiretrovirals. Using parametric interval censored models with fixed and time-varying covariates, we studied the immunological, behavioral, and treatment-related elements associated with syphilis incidence in 3 transmission groups: MSM, heterosexuals, and intravenous drug users. Syphilis incidence has been increasing annually since 2005, with up to 74 incident cases per 1000 person-years in 2013, with MSM being the population with the highest burden (92% of cases). While antiretroviral treatment (ART) in general did not affect syphilis incidence, nevirapine (NVP) was associated with a lower hazard of syphilis incidence (multivariable hazard ratio 0.5, 95% confidence interval 0.2–1.0). We observed that condomless sex and younger age were associated with higher syphilis incidence. Moreover, time-updated CD4, nadir CD4, and CD8 cell counts were not associated with syphilis incidence. Finally, testing frequency higher than the recommended once a year routine testing was associated with a 2-fold higher risk of acquiring syphilis. Condomless sex is the main driver of syphilis resurgence in the Swiss HIV Cohort study; ART and immune reconstitution provide no protection against syphilis. This entails targeted interventions and frequent screening of high-risk populations. There is no known effect of NVP on syphilis; therefore, further clinical, epidemiological, and microbiological investigation is necessary to validate our observation. PMID:28079818

  15. Syphilis Predicts HIV Incidence Among Men and Transgender Women Who Have Sex With Men in a Preexposure Prophylaxis Trial

    Science.gov (United States)

    Solomon, Marc M.; Mayer, Kenneth H.; Glidden, David V.; Liu, Albert Y.; McMahan, Vanessa M.; Guanira, Juan V.; Chariyalertsak, Suwat; Fernandez, Telmo; Grant, Robert M.; Bekker, Linda-Gail; Buchbinder, Susan; Casapia, Martin; Chariyalertsak, Suwat; Guanira, Juan; Kallas, Esper; Lama, Javier; Mayer, Kenneth; Montoya, Orlando; Schechter, Mauro; Veloso, Valdiléa

    2014-01-01

    Background. Syphilis infection may potentiate transmission of human immunodeficiency virus (HIV). We sought to determine the extent to which HIV acquisition was associated with syphilis infection within an HIV preexposure prophylaxis (PrEP) trial and whether emtricitabine/tenofovir (FTC/TDF) modified that association. Methods. The Preexposure Prophylaxis Initiative (iPrEx) study randomly assigned 2499 HIV-seronegative men and transgender women who have sex with men (MSM) to receive oral daily FTC/TDF or placebo. Syphilis prevalence at screening and incidence during follow-up were measured. Hazard ratios for the effect of incident syphilis on HIV acquisition were calculated. The effect of FTC/TDF on incident syphilis and HIV acquisition was assessed. Results. Of 2499 individuals, 360 (14.4%) had a positive rapid plasma reagin test at screening; 333 (92.5%) had a positive confirmatory test, which did not differ between the arms (FTC/TDF vs placebo, P = .81). The overall syphilis incidence during the trial was 7.3 cases per 100 person-years. There was no difference in syphilis incidence between the study arms (7.8 cases per 100 person-years for FTC/TDF vs 6.8 cases per 100 person-years for placebo, P = .304). HIV incidence varied by incident syphilis (2.8 cases per 100 person-years for no syphilis vs 8.0 cases per 100 person-years for incident syphilis), reflecting a hazard ratio of 2.6 (95% confidence interval, 1.6–4.4; P < .001). There was no evidence for interaction between randomization to the FTC/TDF arm and incident syphilis on HIV incidence. Conclusions. In HIV-seronegative MSM, syphilis infection was associated with HIV acquisition in this PrEP trial; a syphilis diagnosis should prompt providers to offer PrEP unless otherwise contraindicated. PMID:24928295

  16. Enhanced therapy for primary and secondary syphilis: a longitudinal retrospective analysis of cure rates and associated factors.

    Science.gov (United States)

    Tittes, Julia; Aichelburg, Maximilian C; Antoniewicz, Lukasz; Geusau, Alexandra

    2013-09-01

    For the treatment of early infectious syphilis, enhanced therapy with three dosages of benzathine penicillin G has been under consideration, particularly in the human immunodeficiency virus type 1 infected population (HIV-1). The serological outcome of 249 patients with primary and secondary syphilis treated with standard or enhanced therapy was analyzed retrospectively; 98% (139/142) achieved serological cure with a single dosage and 92% with enhanced therapy (P=0.033). In HIV-1 infected individuals, cure rates were 88% after a single dosage compared to 97% after three dosages (P=0.18). A fourfold decrease of Venereal Disease Research Laboratory (VDRL) titres was achieved within a median of 102 days after treatment initiation (SD=2; 95% CI=98-106). Patients aged over 40 years were 5.5 times (OR=5.52; 95% CI=1.43-21.32; P=0.013) and patients with low baseline VDRL titres (≤ 1:32) were 4 times (OR=4.25; 95% CI=1.21-14.87; P=0.024) more likely to experience serological failure.

  17. Single photon emission CT perfusion imaging of cerebral blood flow of early syphilis patients

    Institute of Scientific and Technical Information of China (English)

    施辛; 吴锦昌; 刘增礼; 唐军; 苏玉华

    2003-01-01

    Objective To injvestigate the cerebral blood flow of patients with early syphilis. Methods 99Tcm-ECD as brain perfusion imaging agent was used in single photon emission computed tomography (SPECT) for 32 patients with early syphilis and 15 controls. Visual analyses were made on every BSPECT image. Results The 32 patients with early syphilis had general, patchy hypoperfusion of cerebral blood flow. Fourteen of the 32 patients had 48 episodes of marked patchy hypoperfusion of rCBF. The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe (6 episodes), right frontal lobe (3), left parietal lobe (7), right parietal lobe (6), left temporal lobe (11), right temporal lobe (5), left occipital lobe (3), left basal ganglia (3), cerebellum (1), and nerve nuceus (1). No abnormality was found in the control group.Conclusions Cerebral blood flow abnormalities exist in patients with early syphilis. General patchy hypoperfusion on SPECT imaging is common.

  18. Novel Treponema pallidum Serologic Tests: A Paradigm Shift in Syphilis Screening for the 21st Century

    National Research Council Canada - National Science Library

    Arlene C. Seña; Becky L. White; P. Frederick Sparling

    2010-01-01

    .... Although most of these newer tests are not yet cleared for use in the United States by the Food and Drug Administration, their performance and ease of automation have promoted their application for syphilis screening...

  19. Analysis of syphilis incidence at the territory in Saratov region (2011-2015

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    Schnaider D.A.

    2016-09-01

    Full Text Available Aims: analysis of dynamics and pattern of syphilis incidence in 2011-2015 years in Saratov region. Materials and methods. The article provides analysis of the state statistical supervision forms from 2011-2015. Results. The analysis of the data obtained from the state statistical supervision forms during 2011-2015 years has shown the decreasing tendency of syphilis incidence. However, an unfavorable situation still remains in number of territories of Saratov region. The indicators of morbidity caused by late syphilis and neurosyphilis have increased. Conclusion. High incidence of syphilis has negative effect on the reproductive health of the general population. The fast spread of disease is generating special interest in conditions of demographic crisis.

  20. Molecular Typing of Treponema pallidum in Denmark: A Nationwide Study of Syphilis.

    Science.gov (United States)

    Salado-Rasmussen, Kirsten; Cowan, Susan; Gerstoft, Jan; Larsen, Helle Kiellberg; Hoffmann, Steen; Knudsen, Troels Bygum; Katzenstein, Terese Lea; Jensen, Jørgen Skov

    2016-02-01

    The aim of this nationwide study is to determine the strain type diversity among patients diagnosed with syphilis by PCR during a 4-year period in Denmark. Epidemiological data, including HIV status, for all patients were obtained from the Danish national syphilis registration system. Molecular strain typing was based on characterization of 3 variable treponemal genes, arp, tpr and tp0548. A total of 278 specimens from 269 patients were included. Among the fully typeable specimens (n = 197), 22 strain types were identified, with 1 type, 14d/g, accounting for 54%. The majority (93%) of the patients reported acquiring syphilis in Denmark. Among patients with concurrent HIV, 9 full strain types were identified and no difference in strain type was found by HIV status (p = 0.197). In conclusion, the majority of patients were infected in Denmark and the HIV-infected syphilis patients were diagnosed with a wide spectrum of different strain types of Treponema pallidum.

  1. Genetic diversity in Treponema pallidum: implications for pathogenesis, evolution and molecular diagnostics of syphilis and yaws.

    Science.gov (United States)

    Smajs, David; Norris, Steven J; Weinstock, George M

    2012-03-01

    Pathogenic uncultivable treponemes, similar to syphilis-causing Treponema pallidum subspecies pallidum, include T. pallidum ssp. pertenue, T. pallidum ssp. endemicum and Treponema carateum, which cause yaws, bejel and pinta, respectively. Genetic analyses of these pathogens revealed striking similarity among these bacteria and also a high degree of similarity to the rabbit pathogen, Treponema paraluiscuniculi, a treponeme not infectious to humans. Genome comparisons between pallidum and non-pallidum treponemes revealed genes with potential involvement in human infectivity, whereas comparisons between pallidum and pertenue treponemes identified genes possibly involved in the high invasivity of syphilis treponemes. Genetic variability within syphilis strains is considered as the basis of syphilis molecular epidemiology with potential to detect more virulent strains, whereas genetic variability within a single strain is related to its ability to elude the immune system of the host. Genome analyses also shed light on treponemal evolution and on chromosomal targets for molecular diagnostics of treponemal infections.

  2. A defined syphilis vaccine candidate inhibits dissemination of Treponema pallidum subspecies pallidum

    Science.gov (United States)

    Lithgow, Karen V.; Hof, Rebecca; Wetherell, Charmaine; Phillips, Drew; Houston, Simon; Cameron, Caroline E.

    2017-01-01

    Syphilis is a prominent disease in low- and middle-income countries, and a re-emerging public health threat in high-income countries. Syphilis elimination will require development of an effective vaccine that has thus far remained elusive. Here we assess the vaccine potential of Tp0751, a vascular adhesin from the causative agent of syphilis, Treponema pallidum subsp. pallidum. Tp0751-immunized animals exhibit a significantly reduced bacterial organ burden upon T. pallidum challenge compared with unimmunized animals. Introduction of lymph nodes from Tp0751-immunized, T. pallidum-challenged animals to naive animals fails to induce infection, confirming sterile protection. These findings provide evidence that Tp0751 is a promising syphilis vaccine candidate. PMID:28145405

  3. Syphilis and HIV co-infection. Epidemiology, treatment and molecular typing of Treponema pallidum.

    Science.gov (United States)

    Salado-Rasmussen, Kirsten

    2015-12-01

    The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten per cent of Danish men with syphilis acquired HIV infection within five years after they were diagnosed with syphilis during an 11-year study period. Interestingly, the risk of HIV declined during the later part of the period. Moreover, HIV-infected men had a substantial increased risk of re-infection with syphilis compared to HIV-uninfected men. As one third of the HIV-infected patients had viral loads >1,000 copies/ml, our conclusion supported the initiation of cART in more HIV-infected MSM to reduce HIV transmission. During a five-year study period, including the majority of HIV-infected patients from the Copenhagen area, we observed that syphilis was diagnosed in the primary, secondary, early and late latent stage. These patients were treated with either doxycycline or penicillin and the rate of treatment failure was similar in the two groups, indicating that doxycycline can be used as a treatment alternative - at least in an HIV-infected population. During a four-year study period, the T. pallidum strain type distribution was investigated among patients diagnosed by PCR

  4. EPIDEMIOLOGICAL AND SOCIODEMOGRAPHIC PROFILE OF CHILDREN INFECTED CONGENITAL SYPHILIS IN JEQUIÉ/BAHIA

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    Marizete Argolo Teixeira

    2015-11-01

    Full Text Available Research aimed to describe the epidemiological and demographic profile of children infected with congenital syphilis. Descriptive epidemiological character quantitative study, was developed through time-series of the years 2009 to 2013 – in Jequié, Bahia, Brazil – from the data obtained in the Information System for Notifiable Diseases. The results showed that there were 111 cases of maternal syphilis, resulting in 39 cases of congenital syphilis. Of the notified pregnant women, (74% underwent prenatal care, (92% had incomplete primary education, (84% were black and mulatto, (64% with late pregnancy diagnosis, (36% with inadequate treatment and (77% of their partners did not undergo treatment, (86% live births and (64% were female. We conclude that a there is a high number of maternal and congenital syphilis in our municipality causing a public health problem, requiring that measures of prevention, early diagnosis and adequate treatment ought to be implemented in order to prevent vertical transmission.

  5. Predictors of lack of serological response to syphilis treatment in HIV-infected subjects

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    Vincenzo Spagnuolo

    2014-11-01

    Full Text Available Introduction: The aim of this study was to determine factors associated with lack of serological response (LSR to treatment of syphilis among HIV-infected subjects. Materials and Methods: Retrospective, longitudinal study on HIV-infected subjects diagnosed and treated for syphilis and with an assessable serological response between 1 January 2004 and 15 September 2013. LSR was defined as a <4-fold decline of rapid plasma reagin (RPR titer or a failed reversion to nonreactive (if RPR ≤1:4 at diagnosis after one year since treatment. Diagnoses of syphilis were staged in early syphilis (primary, secondary and early latent or late syphilis (tertiary and late latent according to clinical examination and patient's history. Syphilis was classified in new infections [NI: positive RPR and TPHA (Treponema pallidum Haemagglutination assay titers in subjects without previous history of syphilis] or re-infections [ReI: a ≥4-fold increase of RPR titer in subjects previously successfully treated for syphilis]. Syphilis treatment was prescribed according to CDC guidelines. The crude incidence rates (IRs of LSR were calculated per 1000-person months of follow-up (PMFU as the total number of LSR episodes divided by the cumulative time contributed by all subjects (interval time since each syphilis diagnosis and the date of ascertainment of response. Results are described as median (IQR or frequency (%. Results: 565 diagnoses of syphilis with an assessable serological response in 421 patients; 458 (81% were early syphilis, 189 (33% were NI, 376 (67% were ReI. At first, diagnosis of syphilis median age was 41 (36–47 years, 419 (99.5% males, 391 (93% MSM, HIV-infected since 7.7 (3.5–12.9 years, 75 (18% HCV or HBV co-infected, 56 (13% with a previous AIDS diagnosis, 82 (19% antiretroviral treatment naïve, 102 (24% with HIV-RNA ≥50 cp/mL, CD4+=576 (437–749 cells/mm3, nadir CD4+=308 (194–406 cells/mm3. LSRs were observed in 70/565 (12.4% treated syphilis

  6. Role of the Venereal Disease Research Laboratory test in the detection of syphilis.

    Science.gov (United States)

    Diggory, P

    1983-02-01

    Of 9733 consecutive serological samples received by Portsmouth and Southampton Public Health Laboratories (PHL) and tested for syphilis, 190 (140 from men and 50 from women) gave positive results. Thirty new cases of syphilis were identified. Most sera were tested initially by both a specific antibody test (the Treponema pallidum haemaglutination (TPHA) test) and a cardiolipin test (the Venereal Disease Research Laboratory (VDRL) test). Among the 14 patients whose sera gave VDRL-positive but TPHA-negative results, 12 sera gave false-positive results. The sera of 90 patients gave TPHA-positive but VDRL-negative results; sera from only seven of these patients gave false-positive results. The VDRL test is very unlikely to identify a new case of syphilis where a TPHA test has failed to do so. The results of the survey suggest that the VDRL test should be withdrawn from initial testing for syphilis except where early primary disease is suspected.

  7. Recurrent Fever, Anemia, Arthralgia, and Genu Varum as Late Manifestations of Congenital Syphilis.

    Science.gov (United States)

    Quaresma, Liliana; Gonçalves, Juan; Estanqueiro, Paula; Salgado, Manuel

    2015-12-01

    We report an unusual case of recurrent fever, inflammatory knee pain, genu varum, persistent anemia, and high erythrocyte sedimentation rate in a 28-month-old boy as late manifestations of congenital syphilis (CS). Despite standard penicillin treatment at the end of the first month of life, it recurred later in life, more than once. In the first relapse, manifested by a likely gumma lesion, the prior penicillin treatment plus a negative venereal disease research laboratory result unduly led to exclusion of CS. A second treatment with penicillin led to complete clinical resolution. Although rare, bow legs, recurrent fever, anemia, and inflammatory arthralgias may be manifestations of late CS. Congenital syphilis should be considered throughout early childhood, especially if history of syphilis infection is present. A negative venereal disease research laboratory result does not exclude late syphilis, present in nearly 30% of these patients. The possibility of atypical symptoms of this "great masquerader" should always be borne in mind.

  8. Serological Response to Treatment of Syphilis with Doxycycline Compared with Penicillin in HIV-infected Individuals

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan;

    2016-01-01

    Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios...... (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15......%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0...

  9. Atypical presentation of syphilis in an HTLV-I infected patient

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    Carnaúba Jr Dimas

    2003-01-01

    Full Text Available We report the case of a 44 year-old female, who presented a long-lasting, clinically atypical, secondary syphilis ("malignant syphilis" in the right foot, which started six months before medical evaluation. The patient had a serological diagnosis of HTLV-I infection and syphilis two years before the onset of the skin lesions, following a blood donation. As she believed she was allergic to penicillin, she initially received sulfamethoxazole + trimethoprim, without any improvement of the clinical picture. After failure of this first treatment regimen, she was given penicillin, which promoted complete healing of the lesion. We found evidence that infection by HTLV-I is capable of modifying the clinical course of secondary syphilis.

  10. Syphilis presenting as inflammatory tumors of the liver in HIV-positive homosexual men.

    Science.gov (United States)

    Hagen, Catherine E; Kamionek, Michal; McKinsey, David S; Misdraji, Joseph

    2014-12-01

    Syphilis, a sexually transmitted infection caused by the spirochete Treponema pallidum, has seen a resurgence since 2001, particularly in men who have sex with men. Syphilis can affect the liver during the secondary stage as syphilitic hepatitis and during the tertiary stage as gummas. We describe 3 cases of syphilis in human immunodeficiency virus-positive homosexual men that presented as hepatic mass lesions clinically suspected of being malignant tumors. Histologically, 2 of the 3 cases showed a plump spindle cell proliferation, mixed inflammatory infiltrate with numerous neutrophils, and abscesses, whereas the third case showed granulomas and pericholangitis/cholangitis. Immunohistochemical staining for T. pallidum showed innumerable organisms in 2 of the cases. Pathologists must be aware of the possibility of syphilis causing hepatic inflammatory masses in human immunodeficiency virus-positive men who have sex with men in order to avoid misdiagnosis or delayed treatment.

  11. Seroprevalence of syphilis in patients attending a tertiary care hospital in Southern India

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    Sadia Khan

    2014-12-01

    Conclusions: Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence. These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.

  12. Cerebro-spinal fluid examination in early syphilis after treatment with penicillin

    Directory of Open Access Journals (Sweden)

    Talwar S

    1990-01-01

    Full Text Available In case s having early syphilis, cerebro-spinal fluid:(CSF was examined 6 months following pencillin treatment in 1173 cases of which 1 case showed some abnormality. In 1288 cases, CSF examination done at 30 months or later revealed abnormality in 3 cases. The initial diagnosis in these cases was primary syphilis in 2 cases and secondary syphilis in the remaining 2 and these cases had initially been treated with 2.4 MU of benzathine penicillin. These 4 cases were now diagnosed as cases of asymptomatic nourosyphifis and retreated with 9 MU Of procaine penicillin. AU these cases were cured following retreatment. Considering this small number (0.17%, it is considered unessential to examine CSF as a routine in early -syphilis.′ However in cases where the clinical or serological response to treatment is not satisfactory, CSF examination is advisable.

  13. Serum Levels of Interleukin-2 and- 10 in Patients with Early Syphilis

    Institute of Scientific and Technical Information of China (English)

    张秀英; 陈懿德; 庞玉森; 张景生; 严静丽

    2003-01-01

    Objective: To investigate the roles of interleukin-2 (IL-2) and interleukin-10 (IL-10) in pathogenesis of early syphilis.Methods: The serum levels of IL-2 and IL-10 in 48 patients with early syphilis were detected by ABC-ELISA.Results: (1) The level of IL-2 in the patients with early syphilis was significantly higher than that in healthy controls, while that of IL-10 was lower (P0.05), as well as between dif-ferent RPR titers (P>0.05). (3) After therapy, the level of IL-2 decreased markedly (P0.05). (4) A significant correlation was found between the serum levels of IL-2 and IL-10 (r=0.5385 P<0.05).Conclusions: Th1 up-regulation occurs in patients with early syphilis, and plays an active role in fighting against TP infection.

  14. Fibronectin tetrapeptide is target for syphilis spirochete cytadherence

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, D.D.; Baseman, J.B.; Alderete, J.F.

    1985-11-01

    The syphilis bacterium, Treponema pallidum, parasitizes host cells through recognition of fibronectin (Fn) on cell surfaces. The active site of the Fn molecule has been identified as a four-amino acid sequence, arg-gly-asp-ser (RGDS), located on each monomer of the cell-binding domain. The synthetic heptapeptide gly-arg-gly-asp-ser-pro-cys (GRGDSPC), with the active site sequence RGDS, specifically competed with SVI-labeled cell-binding domain acquisition by T. pallidum. Additionally, the same heptapeptide with the RGDS sequence diminished treponemal attachment to HEp-2 and HT1080 cell monolayers. Related heptapeptides altered in one key amino acid within the RGDS sequence failed to inhibit Fn cell-binding domain acquisition or parasitism of host cells by T. pallidum. The data support the view that T. pallidum cytadherence of host cells is through recognition of the RGDS sequence also important for eukaryotic cell-Fn binding.

  15. Secondary syphilis in cali, Colombia: new concepts in disease pathogenesis.

    Directory of Open Access Journals (Sweden)

    Adriana R Cruz

    Full Text Available Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp. Herein we describe a cohort of 57 patients (age 18-68 years with secondary syphilis (SS identified through a network of public sector primary health care providers in Cali, Colombia. To be eligible for participation, study subjects were required to have cutaneous lesions consistent with SS, a reactive Rapid Plasma Reagin test (RPR-titer > or = 1 : 4, and a confirmatory treponemal test (Fluorescent Treponemal Antibody Absorption test- FTA-ABS. Most subjects enrolled were women (64.9%, predominantly Afro-Colombian (38.6% or mestizo (56.1%, and all were of low socio-economic status. Three (5.3% subjects were newly diagnosed with HIV infection at study entry. The duration of signs and symptoms in most patients (53.6% was less than 30 days; however, some patients reported being symptomatic for several months (range 5-240 days. The typical palmar and plantar exanthem of SS was the most common dermal manifestation (63%, followed by diffuse hypo- or hyperpigmented macules and papules on the trunk, abdomen and extremities. Three patients had patchy alopecia. Whole blood (WB samples and punch biopsy material from a subset of SS patients were assayed for the presence of Tp DNA polymerase I gene (polA target by real-time qualitative and quantitative PCR methods. Twelve (46% of the 26 WB samples studied had quantifiable Tp DNA (ranging between 194.9 and 1954.2 Tp polA copies/ml blood and seven (64% were positive when WB DNA was extracted within 24 hours of collection. Tp DNA was also present in 8/12 (66% skin biopsies available for testing. Strain typing analysis was attempted in all skin and WB samples with detectable Tp DNA. Using arp repeat size analysis and tpr RFLP patterns four different strain types were identified (14d, 16d, 13d and 22a. None of the WB samples had sufficient DNA for typing. The clinical and microbiologic

  16. A nodular-ulcerative form of secondary syphilis in AIDS

    Science.gov (United States)

    Owen, Benjamin D.; Balavenkataraman, Arvind; Weinstein, Mitchell R.

    2017-01-01

    An uncommon variant in the pre-AIDS era, lues maligna is a nodular-ulcerative form of secondary syphilis. We present a case of a 41-year-old man with HIV infection who developed fever, chills, nausea, vomiting, right upper quadrant abdominal pain, weight loss, watery diarrhea, and a painless, nonpruritic rash. He had diffuse nodular-ulcerative lesions in various stages of development. He was found to have a CD4 count of 101 cells/mm3 (22%), an HIV viral load of 2,735,060 copies/mL, and a positive rapid plasma reagin at 1:64. He was started on emtricitabine, tenofovir, and dolutegravir, as well as doxycycline. He was given benzathine penicillin 2.4 million units intramuscularly and within hours developed a Jarisch-Herxheimer reaction. Skin lesions showed signs of healing, and constitutional symptoms improved 48 hours later. PMID:28127144

  17. EVALUATION OF MICRO-TPHA, VDRL AND RPR TESTS IN THE SERODIAGNOSIS OF SYPHILIS

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    Santhi

    2016-04-01

    Full Text Available Syphilis is one of the most fascinating diseases of humans. Widespread use of antibiotics now has reduced the incidence of early syphilis and recognized new cases of late syphilis have decreased. Serological tests are the basis for the diagnosis of latent syphilis. They vary in their sensitivity and specificity. While non-treponemal tests (VDRL and RPR are most frequently used as screening procedures, treponemal tests (FTA-ABS and TPHA are considered to be highly sensitive and specific. MATERIALS AND METHODS In this study 100 serum samples collected from the patients attending STD Department, King George Hospital, Visakhapatnam. Samples were subjected to VDRL, RPR and Micro-TPHA tests to evaluate the sensitivity and specificity of Micro-TPHA test in patients with various stages of syphilis and to evaluate the efficacy of Micro-TPHA to confirm the diagnosis of syphilis and to rule out biological false positive reactions or false negative reactions of VDRL tests. RESULTS Three tests (VDRL, RPR and Micro-TPHA were applied to all 100 patients. Among them 85 were VDRL reactive, 84 were RPR positive and 89 were TPHA positive. In them males were more in number, in 3 tests with respect to age, (21-30 age group patients showed predominance. Out of 100 patients, 81 sera were positive for all three tests and one serum sample was VDRL reactive, but RPR and TPHA were non-reactive. This may be a false positive reaction. The following tables showed the sensitivity and specificity of each test and also the sensitivity of each test in various stages of syphilis. CONCLUSION It is concluded as by performing TPHA test, false positive reactivity of VDRL test could be detected. Even in the cases of treated primary and secondary syphilis, TPHA was reactive. The lipoidal antigen tests primarily reflect disease activity and serial quantitative performance of these tests used to measure the treatment response.

  18. [Spatial analysis of syphilis and gonorrhea infections in a Public Health Service in Madrid].

    Science.gov (United States)

    Wijers, Irene G M; Sánchez Gómez, Amaya; Taveira Jiménez, Jose Antonio

    2017-06-21

    Sexually transmitted diseases are a significant public health problem. Within the Madrid Autonomous Region, the districts with the highest syphilis and gonorrhea incidences are part of the same Public Health Service (Servicio de Salud Pública del Área 7, SSPA 7). The objective of this study was to identify, by spatial analysis, clusters of syphilis and gonorrhea infections in this SSPA in Madrid. All confirmed syphilis and gonorrhea cases registered in SSPA 7 in Madrid were selected. Moran's I was calculated in order to identify the existence of spatial autocorrelation and a cluster analysis was performed. Clusters and cumulative incidences (CI) per health zone were mapped. The district with most cases was Centro (CI: 67.5 and 160.7 per 100.000 inhabitants for syphilis and gonorrhea, respectively) with the highest CI (120.0 and 322.6 per 100.000 inhabitants) in the Justicia health zone.91.6% of all syphilis cases and 89.6% of gonorrhea cases were among men who have sex with men (MSM). Moran's I was 0.54 and 0.55 (p=0.001) for syphilis and gonorrhea, respectively. For syphilis, a cluster was identified including the six health zones of the Centro district, with a relative risk (RR)of 6.66 (p=0.001). For gonorrhea, a cluster was found including the Centro district, three health zones of the Chamberí district and one of Latina (RR 5.05; p=0.001). Centro was the district with most cases of syphilis and gonorrhea and the most affected population were MSM. For both infections, clusters were found with an important overlap. By identifying the most vulnerable health zones and populations, these results can help to design public health measures for preventing sexually transmitted diseases.

  19. Maternal Syphilis: An Independent Risk Factor for Mother to Infant Human Immunodeficiency Virus Transmission.

    Science.gov (United States)

    Kinikar, Aarti; Gupte, Nikhil; Bhat, Jayalakshmi; Bharadwaj, Renu; Kulkarni, Vandana; Bhosale, Ramesh; McIntire, Katherine N; Mave, Vidya; Suryavanshi, Nishi; Patil, Sandesh; Bollinger, Robert; Gupta, Amita

    2017-06-01

    Syphilis is associated with increased human immunodeficiency virus acquisition and sexual transmission; we examined impact on human immunodeficiency virus mother-to-child transmission among mother-infant pairs enrolled in the India Six-Week Extended-Dose Nevirapine study. Maternal syphilis, diagnosed serologically using Venereal Disease Research Laboratory titer plus Treponema Pallidum Hemagglutination Assay, was associated with 2.5-fold greater risk.

  20. Incident syphilis infection among people who inject drugs in Tijuana, Mexico.

    Science.gov (United States)

    Pines, Heather A; Rusch, Melanie L; Vera, Alicia; Rangel, Gudelia; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2015-12-01

    Given that syphilis is associated with HIV infection among people who inject drugs (PWID), we examined syphilis incidence among PWID in Tijuana, Mexico. From 2006 to 2007, 940 PWID (142 women and 798 men) were recruited via respondent-driven sampling and followed for 18 months. At semi-annual visits, participants were tested for syphilis and completed surveys, which collected information on socio-demographics, sexual behaviours, substance use and injection behaviours. Poisson regression was used to estimate syphilis incidence rates (IRs), incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Twenty-one participants acquired syphilis during follow-up (IR = 1.57 per 100 person-years, 95% CI: 1.02-2.41). In a multivariate analysis, syphilis incidence was higher among women (IRR = 3.90, 95% CI: 1.37-11.09), HIV-positive participants (IRR = 4.60, 95% CI: 1.58-13.39) and those who reported ever exchanging sex for drugs, money, or other goods (IRR = 2.74, 95% CI: 0.97-7.76), while syphilis incidence was lower among those living in Tijuana for a longer duration (IRR = 0.95 per year, 95% CI: 0.91-1.00) and those reporting at least daily injection drug use (past 6 months) (IRR = 0.22, 95% CI: 0.09-0.54). Our findings suggest interventions that address the destabilising conditions associated with migration and integrate sexual and drug-related risk reduction strategies may help reduce syphilis incidence among PWID along the Mexico-US border.

  1. Trends and risk factors for syphilis infection in Piedmont Region, Italy, 2002-2008.

    Directory of Open Access Journals (Sweden)

    Federica Vigna-Taglianti

    2011-03-01

    Full Text Available

    Abstract:
    Background: This work aims to analyze trends of syphilis infections in the Piedmont Region (Italy between 2002 and 2008, and to evaluate risk factors for infection. Methods: Syphilis trends were described according to socio-demographic characteristics, sexual behavior, condom use, number of partners and HIV infection. Independent risk factors for syphilis among men having sex with men (MSM, men having sex with women (MSW, and women were identified through logistic regression comparing cases with 12,773 negative patients. Results: Between 2002 and 2008, 1,046 cases of syphilis were diagnosed, with peaks in 2004 and 2007. The risk of a syphilis diagnosis was independently associated with being older than 24, having a low education level, homosexual behavior, HIV self-reported infection (for MSM and MSW, number of partners (for MSW and women and non- consistent condom use (for women. Conclusions: Recent outbreaks suggest that the attention to syphilis can’t be lowered. Screening, treatment of cases and notification of partners should be reinforced and integrated with sexual health education and counselling in high-risk environments. Surveillance data must be continuously collected.

  2. Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview.

    Science.gov (United States)

    Peeling, Rosanna W.; Ye, Htun

    2004-01-01

    Syphilis is a major cause of adverse outcomes in pregnancy in developing countries. Fetal death and morbidity due to congenital syphilis are preventable if infected mothers are identified and treated appropriately by the middle of the second trimester. Most pregnant women with syphilis are asymptomatic and can only be identified through serological screening. Non-treponemal tests, such as the rapid plasma reagin (RPR) test, are sensitive, simple to perform, and inexpensive. However, they have often not been available at primary health-care settings because they required cold storage for reagents and electricity to operate a rotator. Additionally, as many as 28% of positive RPR results in pregnant women are biological false positives. Confirmatory assays are usually available only in reference laboratories. Technological advances have resulted in improved serodiagnostic tools for syphilis. New enzyme immunoassays are available for surveillance and for large-scale screening programmes. Decentralized antenatal screening with on-site confirmation is now possible since new RPR reagents that are stable at room temperature have become commercially available, as have solar-powered rotators and simple, rapid point-of-care treponemal tests that use whole blood and do not require electricity or equipment. These will be valuable tools for preventing or eliminating congenital syphilis. The development of a non-invasive rapid treponemal test that distinguishes between active and past infections remains a high priority in areas where syphilis is endemic. PMID:15356937

  3. Evaluation of the HISCL Anti-Treponema pallidum Assay as a Screening Test for Syphilis.

    Science.gov (United States)

    An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting; Tao, Chuanmin; Wang, Lanlan

    2015-07-01

    The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive samples, 704 fresh syphilis-negative samples, 48 preselected potentially interfering samples, and 30 "borderline" samples and was compared head to head with the commercially available Lumipulse G TP-N. In this study, the HISCL anti-TP assay was in perfect agreement with the applied testing algorithms with an overall agreement of 100%, comparable to that of Lumipulse G TP-N (99.63%). The sensitivity and specificity of the HISCL anti-TP assay were 100% (95% confidence interval [CI], 98.42% to 100%) and 100% (95% CI, 99.37% to 100%), respectively. Considering the excellent ease of use and automation, high throughput, and its favorable sensitivity and specificity, the HISCL anti-TP assay may represent a new choice for syphilis screening in high-volume laboratories.

  4. Community reactions to a syphilis prevention campaign for gay and bisexual men in Los Angeles County.

    Science.gov (United States)

    Nanin, Jose E; Bimbi, David S; Grov, Christian; Parsons, Jeffrey T

    2009-01-01

    "Stop the Sores" (STS), a humor-based syphilis prevention campaign, was implemented in response to increasing syphilis prevalence among gay and bisexual men in Los Angeles County. In 2004, 564 men completed surveys measuring exposure and reactions to the campaign and syphilis testing. Mean age was 39, and men of color comprised a significant proportion of the sample (46.8%). Most men reported being HIV-negative (79.3%). Overall, 7.8% of the sample reported ever having syphilis; HIV-positive men were six times more likely to report this. Over one half of the sample (58.5%) reported exposure to the campaign. Men reporting any recent unprotected anal sex were twice more likely (than those who did not) to see the campaign. Men of color were twice more likely than White men to report wanting to speak to their friends about it. Finally, 39.1% of men exposed to the campaign reported being tested for syphilis as a result. Factors related to higher likelihood to test for syphilis included HIV seropositive status, any recent unprotected anal insertive sex, recent use of methamphetamine, recent use of "poppers," and recent use of erectile dysfunction drugs. Although STS was somewhat effective, outreach efforts to particular subgroups may need to increase.

  5. Syphilis and HIV infection among displaced pregnant women in rural Mozambique.

    Science.gov (United States)

    Cossa, H A; Gloyd, S; Vaz, R G; Folgosa, E; Simbine, E; Diniz, M; Kreiss, J K

    1994-01-01

    A cross-sectional study was conducted among displaced pregnant women in Mozambique to determine the prevalence and correlates of HIV infection and syphilis. Between September 1992 and February 1993, 1728 consecutive antenatal attendees of 14 rural clinics in Zambézia were interviewed, examined, and tested for HIV and syphilis antibodies. The seroprevalence of syphilis and HIV were 12.2% and 2.9%, respectively. Reported sexual abuse was frequent (8.4%) but sex for money was uncommon. A positive MHA-TP result was significantly associated with unmarried status, history of past STD, HIV infection, and current genital ulcers, vaginal discharge, or genital warts. Significant correlates of HIV seropositivity included anal intercourse, history of past STD, and syphilis. In summary, displaced pregnant women had a high prevalence of syphilis but a relatively low HIV seroprevalence suggesting recent introduction of HIV infection in this area or slow spread of the epidemic. A syphilis screening and treatment programme is warranted to prevent perinatal transmission and to reduce the incidence of chancres as a cofactor for HIV transmission.

  6. Psychological defense mechanisms in patients with syphilis at different stages of the disease

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    Filonova A.V.

    2015-09-01

    Full Text Available Purpose: the study of psychological defense mechanisms in patients with syphilis at different stages of the disease. Material and methods. We used questionnaire Plutchik-Kellerman-Comte "life style Index". The study involved 257 people (118 women (46% and 139 men (54% aged 18 to 67 years (mean age — 23,5±8,9years. Results. In patients with primary syphilis primary mecha-protection scheme is "denying"; secondary syphilis of skin and mucus-purity membranes— "replacement"; syphilis latent early — "projection"; in patients with late syphilis — intellectualization. Thus, in patients with late forms of syphilis is dominated by more Mature mechanisms of protection (projection, rationalization. Patients with early forms use more primitive mechanisms (denial, substitution. Conclusion. The obtained data may be useful in the choice of methods of psychotherapy, the formation of patients more realistic (ADAP-tive installations for the treatment, restoration of family and other social relations, the prevention of distress and improving the quality of life of patients.

  7. Is there a difference between hare syphilis and rabbit syphilis? Cross infection experiments between rabbits and hares

    NARCIS (Netherlands)

    Lumeij, J.T.; Mikalová, L.; Smajs, D.

    2013-01-01

    Abstract Cross infection of rabbits and hares with Treponema paraluiscuniculi from rabbits and the related microorganism from hares, which was provisionally named "Treponema paraluisleporis", revealed that T. paraluiscuniculi affects rabbits clinically, but only causes seroconversion in hares withou

  8. Is there a difference between hare syphilis and rabbit syphilis? Cross infection experiments between rabbits and hares.

    Science.gov (United States)

    Lumeij, Johannes T; Mikalová, Lenka; Smajs, David

    2013-05-31

    Cross infection of rabbits and hares with Treponema paraluiscuniculi from rabbits and the related microorganism from hares, which was provisionally named "Treponema paraluisleporis", revealed that T. paraluiscuniculi affects rabbits clinically, but only causes seroconversion in hares without causing clinical disease, while "T. paraluisleporis" induces disease in both rabbits and hares. The 16S rRNA gene of "T. paraluisleporis" was sequenced (GenBank acc. no. JX899416) and compared to the sequence of T. paraluiscuniculi strain Cuniculi A. A phylogenetic tree based on the sequence alignment of 2002 bp taken from several treponemal strains was constructed. Both "T. paraluisleporis" and T. paraluiscuniculi are clustered together indicating their common origin. The close phylogenetic relatedness of both representatives supports the conclusion that subspecies or ecovar status should be given to these strains rather than species status. A more appropriate species name might be Treponema paraluisleporidarum. The genitive refers to the nominative Leporidae (family of rabbits and hares). The naturally occurring strain in rabbits would than be T. paraluisleporidarum ecovar Cuniculus and the strain from hares T. paraluisleporidarum ecovar Lepus. Since the former seems to have fewer physiological hosts, ecovar Lepus may represent an evolutionary ancestor of ecovar Cuniculus.

  9. Use of the Treponema pallidum-specific captia syphilis IgG assay in conjunction with the rapid plasma reagin to test for syphilis.

    OpenAIRE

    1997-01-01

    The Captia Syphilis IgG enzyme immunoassay (EIA) was evaluated for use in conjunction with the rapid plasma reagin test (RPR) as a method to test for syphilis. A total of 1,288 serum specimens were tested by the routine laboratory protocol of the RPR followed by microhemagluttination assay for Treponema pallidum (MHA-TP) testing of RPR-reactive sera as well as the EIA-RPR protocol in which the automated EIA followed by a manual RPR test for EIA-positive specimens is used. When using the routi...

  10. Treponema pallidum-specific antibody expression for the diagnosis of different stages of syphilis

    Institute of Scientific and Technical Information of China (English)

    SUN Ran; LAI Di-hui; REN Rong-xin; LIAN Shi; ZHANG Hai-ping

    2013-01-01

    Background Tp15,Tp17,Tp45,and Tp47 are outer-membrane proteins found in Treponema pallidum,the etiologic agent of syphilis.These proteins are potent antigens and are potential markers for the serological detection of syphilis.The present study analyzed antibodies to these protein antigens (TP-IgM and TP-IgG) in human serum and investigated the expression of these antibodies during different stages of syphilis.Methods Serum samples were collected from 69 subjects (male 45,female 24) diagnosed with syphilis and analyzed by Western blotting for the expression of IgM and IgG against the four protein antigens.Expression levels of the target antibodies were compared during the same stage of syphilis as well as between different stages of this disease.Results In subjects with primary syphilis,the positive rate of Tp45 IgM was higher than that of other TP-IgM.Tp15 IgM was detected only in subjects with tertiary syphilis.Similarly,the seroprevalence of Tp45 IgG in primary syphilis was higher than for other TP-IgG No target TP-IgM was detected in subjects with latent syphilis.In subjects with secondary syphilis,the expression level of Tp15 IgG (138.73±20.16) was higher than for other target TP-IgG In subjects with tertiary syphilis,all target TP-IgG were detected.In subjects with tertiary or latent syphilis,the expression levels of Tp45 IgG (121.33±11.04 and 110.10±40.19,respectively) were higher than those of other target TP-IgG.The expression levels of all Tp-IgM were similar before or after anti-syphilis treatment.In comparison,the expression levels of all TP-IgG decreased compared with the pre-treatment levels,and this decrease was statistically significant (both P <0.05) for Tp17 IgG and Tp47 IgG.Conclusions After Treponema pallidum infection,Tp45 IgM appeared first and Tp15 IgM occurred during later stages.The positive rates of all TP-IgG increased with the duration of this disease.Anti-syphilis treatment reduced the expression levels of Tp17 IgG and Tp47 Ig

  11. Syphilis screening among 27,150 pregnant women in South Chinese rural areas using point-of-care tests.

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    Li-Gang Yang

    Full Text Available OBJECTIVES: To determine the prevalence and correlates of syphilis among pregnant women in rural areas of South China. METHODS: Point-of-care syphilis testing was provided at 71 health facilities in less developed, rural areas of Guangdong Province. Positive samples were confirmed at a local referral center by toluidine red unheated serum tests (TRUST and Treponema pallidum particle agglutination (TPPA tests. RESULTS: Altogether 27,150 pregnant women in rural Guangdong were screened for syphilis. 106 (0.39% syphilis cases were diagnosed, of which 78 (73.6% received treatment for syphilis. Multivariate analysis revealed that older pregnant women (31-35 years old, aOR 2.7, 95% CI 0.99-7.32; older than 35 years old, aOR 5.9, 95% CI 2.13-16.34 and those with a history of adverse pregnant outcomes (aOR 3.64, 95% CI 2.30-5.76 were more likely to be infected with syphilis. CONCLUSIONS: A high prevalence of syphilis exists among pregnant women living in rural areas of South China. Enhanced integration of syphilis screening with other routine women's health services (OB GYN, family planning may be useful for controlling China's syphilis epidemic.

  12. A laboratory-based evaluation of four rapid point-of-care tests for syphilis.

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    Louise M Causer

    Full Text Available BACKGROUND: Syphilis point-of-care tests may reduce morbidity and ongoing transmission by increasing the proportion of people rapidly treated. Syphilis stage and co-infection with HIV may influence test performance. We evaluated four commercially available syphilis point-of-care devices in a head-to-head comparison using sera from laboratories in Australia. METHODS: Point-of-care tests were evaluated using sera stored at Sydney and Melbourne laboratories. Sensitivity and specificity were calculated by standard methods, comparing point-of-care results to treponemal immunoassay (IA reference test results. Additional analyses by clinical syphilis stage, HIV status, and non-treponemal antibody titre were performed. Non-overlapping 95% confidence intervals (CI were considered statistically significant differences in estimates. RESULTS: In total 1203 specimens were tested (736 IA-reactive, 467 IA-nonreactive. Point-of-care test sensitivities were: Determine 97.3%(95%CI:95.8-98.3, Onsite 92.5%(90.3-94.3, DPP 89.8%(87.3-91.9 and Bioline 87.8%(85.1-90.0. Specificities were: Determine 96.4%(94.1-97.8, Onsite 92.5%(90.3-94.3, DPP 98.3%(96.5-99.2, and Bioline 98.5%(96.8-99.3. Sensitivity of the Determine test was 100% for primary and 100% for secondary syphilis. The three other tests had reduced sensitivity among primary (80.4-90.2% compared to secondary syphilis (94.3-98.6%. No significant differences in sensitivity were observed by HIV status. Test sensitivities were significantly higher among high-RPR titre (RPR ≥ 8 (range: 94.6-99.5% than RPR non-reactive infections (range: 76.3-92.9%. CONCLUSIONS: The Determine test had the highest sensitivity overall. All tests were most sensitive among high-RPR titre infections. Point-of-care tests have a role in syphilis control programs however in developed countries with established laboratory infrastructures, the lower sensitivities of some tests observed in primary syphilis suggest these would need to be

  13. HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon.

    Science.gov (United States)

    Benzaken, Adele Schwartz; Sabidó, Meritxell; Brito, Ivo; Bermúdez, Ximena Pamela Díaz; Benzaken, Nina Schwartz; Galbán, Enrique; Peeling, Rosanna W; Mabey, David

    2017-06-05

    Contextual factors shape the risk of acquiring human immunodeficiency virus (HIV) and syphilis. We estimated the prevalence of both infections among indigenous people in nine indigenous health districts of the Brazilian Amazon and examined the context of community vulnerability to acquiring these infections. We trained 509 health care workers to screen sexually active populations in the community for syphilis and HIV using rapid testing (RT). We then assessed the prevalence of HIV and syphilis using RT. A multivariable analysis was used to identify factors associated with syphilis infection (sociodemographic, condom use, intrusion, population mobility, and violence). Of the 45,967 indigenous people tested, the mean age was 22.5 years (standard deviation: 9.2), and 56.5% were female. Overall, for HIV, the prevalence was 0.13% (57/43,221), and for syphilis, the prevalence was 1.82% (745/40,934). The prevalence in men, women, and pregnant women for HIV was 0.16%, 0.11%, and 0.07%, respectively, and for syphilis, it was 2.23%, 1.51%, and 1.52%, respectively. The district Vale do Javari had the highest prevalence of both infections (HIV: 3.38%, syphilis: 1.39%). This district also had the highest population mobility and intrusion and the lowest availability of prenatal services. Syphilis infection was independently associated with age (odds ratio [OR] 1.04, 95% confidence interval [CI]: 1.03-1.05), male sex (OR 1.32, 95% CI: 1.14-1.52), and mobility (moderate: OR: 7.46, 95% CI: 2.69-20.67; high: OR 7.09, 95% CI: 3.79-13.26). The large-scale integration of RT in remote areas increased case detection among pregnant women, especially for syphilis, in districts with higher vulnerability. Mobility is an important risk factor, especially in districts with higher vulnerability. Contextually appropriate approaches that address this factor could contribute to the long-term success of HIV and syphilis control programs.

  14. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

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    Bruce R Schackman

    2007-05-01

    Full Text Available BACKGROUND: New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. METHODS AND FINDINGS: A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care, rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care, and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. CONCLUSIONS: In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A

  15. Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries.

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    Melanie M Taylor

    Full Text Available Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis.Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis.Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases.Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment of maternal syphilis

  16. Risk factors for syphilis in women: case-control study.

    Science.gov (United States)

    Macêdo, Vilma Costa de; Lira, Pedro Israel Cabral de; Frias, Paulo Germano de; Romaguera, Luciana Maria Delgado; Caires, Silvana de Fátima Ferreira; Ximenes, Ricardo Arraes de Alencar

    2017-08-17

    To determine the sociodemographic, behavioral, and health care factors related to the occurrence of syphilis in women treated at public maternity hospitals. This is a case-control study (239 cases and 322 controls) with women admitted to seven maternity hospitals in the municipality of Recife, Brazil, from July 2013 to July 2014. Eligible women were recruited after the result of the VDRL (Venereal Disease Research Laboratory) under any titration. The selection of cases and controls was based on the result of the serology for syphilis using ELISA (enzyme-linked immunosorbent assay). The independent variables were grouped into: sociodemographic, behavioral, clinical and obstetric history, and health care in prenatal care and maternity hospital. Information was obtained by interview, during hospitalization, with the application of a questionnaire. Odds ratios and 95% confidence intervals were estimated using logistic regression to identify the predicting factors of the variable to be explained. The logistic regression analysis identified as determinant factors for gestational syphilis: education level of incomplete basic education or illiterate (OR = 2.02), lack of access to telephone (OR = 2.4), catholic religion (OR = 1.70 ), four or more pregnancies (OR = 2.2), three or more sexual partners in the last year (OR = 3.1), use of illicit drugs before the age of 18 (OR = 3.0), and use of illicit drugs by the current partner (OR = 1.7). Only one to three prenatal appointments (OR = 3.5) and a previous history of sexually transmitted infection (OR = 9.7) were also identified as determinant factors. Sociodemographic, behavioral, and health care factors are associated with the occurrence of syphilis in women and should be taken into account in the elaboration of universal strategies aimed at the prevention and control of syphilis, but with a focus on situations of greater vulnerability. Determinar os fatores sociodemográficos, comportamentais e de assistência à sa

  17. Selected aspects of the living situation of persons suffering from syphilis - Poznan study.

    Science.gov (United States)

    Rzepa, Teresa; Żaba, Ryszard; Jakubowicz, Oliwia; Szramka-Pawlak, Beata

    2012-01-01

    In the last years, a considerable increase in syphilis incidence was observed in Poland. This is a condition with serious health and psychosocial consequences. The research demonstrates that one of the events which significantly modify the course of human life is the somatic disease experience; hence, it was decided to examine selected aspects of the living situation of persons suffering from syphilis, which refer to the social position held by these persons. Materials for the research were collected based on the anonymous authors' survey composed of 16 questions. The research lasted for two years and covered a group of 42 syphilitic patients (35 males and 7 females). The mean age of male patients was 35.7 and of female patients 37.0 years. Among the participants, 8 persons had been subjected to treatment for a few years, 11 for about a year, and 22 persons had recently become ill. Patients assessed the attitude toward themselves mostly as invariable, followed by unstable; 45.2% of subjects considered their position in the family as average and 42.9% as high; 28.6% of patients assessed their occupational position as average and the same number admitted to be currently out of work. Most frequently, unemployed were patients who had been affected by the disease for several years (62.5%), whereas their social position was assessed either as high (47.6%) or average (45.2%). Irrespective of the duration of the disease, patients (during hospitalization) usually met a lot of people. It has been proven that most of the syphilitic patients do not have negative attitude toward themselves and do not assess their social position as inferior, regardless of the duration of the disease. Such a picture of the living situation may be a manifestation of the compensation for the negative mental state, activation of other defense mechanisms or proper strategy of coping with the stressor. The generally optimistic image of the studied group of syphilitic patients may constitute a warning

  18. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers’ Perspectives on Testing, Training and Quality Assurance

    Science.gov (United States)

    Ansbro, Éimhín M.; Gill, Michelle M.; Reynolds, Joanna; Shelley, Katharine D.; Strasser, Susan; Sripipatana, Tabitha; Ncube, Alexander Tshaka; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W.; Mabey, David

    2015-01-01

    Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW) acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH) adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We illustrate that new

  19. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

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    Éimhín M Ansbro

    Full Text Available Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We

  20. [Establishment of an algorithm for serological testing of syphilis identification].

    Science.gov (United States)

    Karaca, Yilmaz; Cöplü, Nilay; Gözalan, Ayşegül; Oncül, Ozgür; Akin, Levent; Esen, Berrin

    2010-01-01

    Serological methods are widely used for the laboratory diagnosis of syphilis or for screening purposes. The aim of this study was to determine an algorithm for the application of laboratory tests that will provide accurate diagnosis of syphilis in a cheap, fast and practical way. A total of 162 serum samples were evaluated by the following tests: VDRL (Venereal Disease Research Laboratory; Omega Diagnostic, UK), TPHA (Treponema pallidum Hemagglutination Test; Omega Diagnostic, UK), ELISA IgG + IgM (Enzyme Linked Immunosorbent Assay; DiaPro Diagnostic Bioprobes, Italy), FTA-ABS (Fluorescent Treponemal Antibody-Absorption; IgG, Euroimmun, Germany) and WB (Western Blot; IgG Euroimmun, Germany). When the gold standard was considered as FTA-ABS test, the sensitivity, specificity, positive and negative predictive values for VDRL were 77.1%, 100% 100% an 80.6%; for TPHA were 92.8%, 98.7%, 98.7% and 92.9%, for ELISA 98.8%, 98.7%, 98.8% and 98.7%, and for WB 98.8%, 100%, 100% and 98.7%, respectively. When the results of screening with VDRL together with TPHA were compared with FTA-ABS, it was observed that if both VDRL and TPHA results were positive, then there was 100% concordance between the tests. However, when both of the test results were negative, 1.3% of them yielded positive result with FTA-ABS. If either one of VDRL or TPHA results were positive (n = 24), 95.8% (n = 23) was positive with FTA-ABS. Therefore, inconsistent results obtained by VDRL and TPHA requires verification by another method. When ELISA or WB tests were used, the borderline results need verification, however, positive or negative results would be reported. The determination of an algorithm for laboratory tests also depend on the number of patients, cost, cost per positive patient and workload of the laboratory. Thus, ELISA could be selected when the number of cases is high and the results should be reported unless they are suspicious. When the number of cases is low, VDRL/TPHA should be selected

  1. Maternal and paternal factors associated with congenital syphilis in Shenzhen, China: a prospective cohort study.

    Science.gov (United States)

    Qin, J-B; Feng, T-J; Yang, T-B; Hong, F-C; Lan, L-N; Zhang, C-L

    2014-02-01

    Maternal and paternal factors create considerable obstacles to the elimination of congenital syphilis (CS). A clear understanding of maternal and paternal factors is important in order to define interventions in every community. This study aimed to investigate the maternal and paternal factors associated with CS. A prospective cohort study was conducted from April 25, 2007 to October 31, 2012 at the Shenzhen Center for Chronic Disease Control and Prevention (SCCDC) in China. We screened 279,334 pregnant women and identified 838 women with syphilis. Finally, a total of 360 women with syphilis were included for analysis. At the end of follow-up, 34 infants [9.4 %, 95 % confidence interval (CI): 6.8-12.9 %] were diagnosed with CS. Following adjustment for confounders, maternal history of syphilis [adjusted risk ratio (aRR) = 0.21], prenatal care (aRR = 0.12), and complete treatment (aRR = 0.22) reduced the risk of infants being infected. Every two-fold increase of titer of non-treponemal antibodies (aRR = 1.88), early stage of syphilis (aRR = 9.59), a shorter length of time between the end of the first treatment to childbirth (aRR = 5.39), and every week of delay in treatment (aRR = 2.25) for maternal syphilis as well as paternal history of cocaine use (aRR = 6.28) and positive (aRR = 3.30) or unknown (aRR = 2.79) status of syphilis increased the risk of infants being infected. CS also increased the risk (aRR = 8.02) of neonatal death. Maternal and paternal factors constituted two separate profiles associated with CS. To become more effective, future strategies for the prevention of CS should be targeted to each profile.

  2. Syphilis in HIV-infected mothers and infants: results from the NICHD/HPTN 040 study.

    Science.gov (United States)

    Yeganeh, Nava; Watts, Heather D; Camarca, Margaret; Soares, Gabriel; Joao, Esau; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa; Ceriotto, Mariana; Machado, Daisy Maria; Grinzstejn, Beatriz; Grinsztejn, Beatriz; Veloso, Valdilea G; Morgado, Mariza G; Bryson, Yvonne; Mofenson, Lynne M; Nielsen-Saines, Karin

    2015-03-01

    Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low- and middle-income countries where both diseases are common. We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. This analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants. Approximately, 10% of women (n=171) enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% infants (n=24) were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared with HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (adjusted odds ratio [AOR] 2.5, 95% CI: 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI: 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI: 1.3-3.4), with 88% of HIV infections being acquired in utero. As compared with HIV-infected or HIV-exposed infants, co-infected infants were significantly more likely to be born to mothers with venereal disease research laboratory titers≥1:16 (AOR 3, 95% CI: 1.1-8.2) and higher viral loads (AOR 1.5, 95% CI: 1.1-1.9). Of 6 newborns with symptomatic syphilis, 2 expired shortly after birth, and 2 were HIV-infected. Syphilis continues to be a common co-infection in HIV-infected women and can facilitate in utero transmission of HIV to infants. Most infants are asymptomatic at birth, but those with symptoms have high mortality rates.

  3. 梅毒少见的临床表现%Rare clinical manifestations of syphilis

    Institute of Scientific and Technical Information of China (English)

    蒲新露; 季必华

    2013-01-01

    Due to non-standardized administration of antibiotics,changes in homosexual behavior,human immunodeficiency virus co-infection,missed diagnosis of syphilis during pregnancy,and non-administration of benzathine benzylpenicillin for syphilis treatment in the first and last three months of pregnancy,many uncommon or rare manifestations haven been observed in syphilitic patients with the involvement of skin,mucous membrane,bone,joints,cardiovascular system,nervous system,alimentary system and respiratory system,which increases difficulties in the diagnosis and treatment of syphilis.This paper presents atypical syphilis cases reported at home and abroad in recent years,in hope to enhance clinicians' understanding of syphilis,so as to facilitate early diagnosis of syphilis and reduce systemic damages caused by syphilis.%由于抗生素的不规范使用,同性恋人群性行为的变化,合并HIV感染,孕期梅毒未发现及孕期前后3个月内未给予苄星青霉素治疗等因素,均可导致梅毒感染者发生皮肤黏膜、骨关节、心血管系统、神经系统、消化系统及呼吸系统少见或不典型病变,给诊断及治疗带来困难.概述近年来报道的梅毒少见临床表现,为临床医生提供更广泛的思路,及早发现及诊断梅毒,减少梅毒引起的系统性损害.

  4. Syphilis in HIV-Infected Mothers and Infants: Results from the NICHD/HPTN 040 Study

    Science.gov (United States)

    Yeganeh, Nava; Watts, Heather D.; Camarca, Margaret; Soares, Gabriel; Joao, Esau; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa; Ceriotto, Mariana; Machado, Daisy Maria; Veloso, Valdilea G.; Grinzstejn, Beatriz; Morgado, Mariza G; Bryson, Yvonne; Mofenson, Lynne M.; Nielsen-Saines, Karin

    2014-01-01

    Background Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low and middle income countries where both diseases are common. Methods We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. The present analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants. Results Approximately 10% (n=171) of women enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% (n=24) infants were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared to HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (AOR 2.5, 95% CI 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI 1.3-3.4), with 88% of HIV infections being acquired in-utero. As compared to HIV infected or HIV exposed infants, co-infected infants were significantly more likely to be born to mothers with VDRL titers ≥1:16 (AOR 3, 95% CI 1.1-8.2) and higher viral loads (AOR 1.5 95% CI 1.1-1.9). Of 6 newborns with symptomatic syphilis, 2 expired shortly after birth, and 2 were HIV-infected. Conclusion Syphilis continues to be a common co-infection in HIV-infected women and can facilitate in utero transmission of HIV to infants. Most infants are asymptomatic at birth, but those with symptoms have high mortality rates. PMID:25742089

  5. A spatial analysis of county-level variation in syphilis and gonorrhea in Guangdong Province, China.

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    Nicholas X Tan

    Full Text Available BACKGROUND: Sexually transmitted infections (STI have made a resurgence in many rapidly developing regions of southern China, but there is little understanding of the social changes that contribute to this spatial distribution of STI. This study examines county-level socio-demographic characteristics associated with syphilis and gonorrhea in Guangdong Province. METHODS/PRINCIPAL FINDINGS: This study uses linear regression and spatial lag regression to determine county-level (n = 97 socio-demographic characteristics associated with a greater burden of syphilis, gonorrhea, and a combined syphilis/gonorrhea index. Data were obtained from the 2005 China Population Census and published public health data. A range of socio-demographic variables including gross domestic product, the Gender Empowerment Measure, standard of living, education level, migrant population and employment are examined. Reported syphilis and gonorrhea cases are disproportionately clustered in the Pearl River Delta, the central region of Guangdong Province. A higher fraction of employed men among the adult population, higher fraction of divorced men among the adult population, and higher standard of living (based on water availability and people per room are significantly associated with higher STI cases across all three models. Gross domestic product and gender inequality measures are not significant predictors of reported STI in these models. CONCLUSIONS/SIGNIFICANCE: Although many ecological studies of STIs have found poverty to be associated with higher reported STI, this analysis found a greater number of reported syphilis cases in counties with a higher standard of living. Spatially targeted syphilis screening measures in regions with a higher standard of living may facilitate successful control efforts. This analysis also reinforces the importance of changing male sexual behaviors as part of a comprehensive response to syphilis control in China.

  6. Prevalence of syphilis, human immunodeficiency virus, hepatitis B virus, and human T-lymphotropic virus infections and coinfections during prenatal screening in an urban Northeastern Brazilian population

    Directory of Open Access Journals (Sweden)

    Adriana Avila Moura

    2015-10-01

    Conclusions: Syphilis was twice as prevalent among pregnant women in Maceió, compared to the national average, and coinfections with syphilis/HIV and HTLV/HBV were significantly associated among these pregnant women.

  7. Prioritizing Congenital Syphilis Control in South China: A Decision Analytic Model to Inform Policy Implementation

    Science.gov (United States)

    Tan, Nicholas X.; Rydzak, Chara; Yang, Li-Gang; Vickerman, Peter; Yang, Bin; Peeling, Rosanna W.; Hawkes, Sarah; Chen, Xiang-Sheng; Tucker, Joseph D.

    2013-01-01

    Background Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS) cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. Methods and Findings Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111) CS cases averted per 100,000 live births (58% decrease). The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160) CS cases averted per 100,000 live births (85% decrease). Conclusions The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures

  8. 梅毒的诊断%The Diagnosis of Syphilis

    Institute of Scientific and Technical Information of China (English)

    陈丽

    2015-01-01

    梅毒(syphilis)是由梅毒螺旋体(treponema pallidum,TP)感染人体引起的慢性、系统性性传播疾病.梅毒主要通过性接触和血液传播.螺旋体从皮肤或黏膜侵入,在这些部位可见梅毒的早期表现.感染梅毒螺旋体后表现复杂多样,准确判断方能正确、有效地治疗患者.文中介绍了梅毒的诊断标准,并就血清固定、前带现象、梅毒血清试验生物学假阳性、神经梅毒的判断、梅毒孕妇所生婴儿的诊断等问题进行了进一步探讨.

  9. CRITERIA FOR LABORATORY DIAGNOSIS OF VARIOUS FORMS EARLY CONGENITAL SYPHILIS

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    G. P. Martynova

    2014-01-01

    Full Text Available The results of clinical and laboratory (blood count and serological monitoring of 156 children with various forms of early congenital syphilis in the initial period and the dynamics on the background of specific therapy. Violations in haemogram characterized hypochromic anemia, thrombocytopenia, leukocytosis, neytrofillezom stab shift with a sharP increase in ESR, which prevailed among the most children with the disease over polisimptomnym and significantly exceeded the level of the norm even after specific therapy. For serological examination in 84.62 % cases registered positive results in microprecipitation reaction (RMR to 56.52% — IgM, and 97.83% — IgG reaction Enzymeimmuno assay (EIA and 100 % — Treponema pallidum hemagglutination assay (ТРHА. On the background of specific therapy indicated positive results in the growth of bladder cancer (85.19 %, in the formulation of IgM EIA (72.22 % and IgG (100%, thus, recorded a decline titer positivity serological RMR 2 times , IgM EIA reaction 12 times with simultaneous increase IgG positivity 4 times and 2 times in the ТРHА in the formulation of these reactions in the dynamics.

  10. Screening by VDRL test to detect hidden cases of syphilis.

    Science.gov (United States)

    Gupta, N; Gautam, V; Sehgal, R; Gill, P S; Arora, D R

    2003-01-01

    A total of 59,450 sera from January 1996 to December 2000 were subjected to VDRL testing. Overall VDRL positivity rate was 3.2% and downward trend was observed in the recent years, 1999 and 2000. Majority of the samples were from Gynaecology department, out of which 1.57% were VDRL positive. Out of 30,045 samples from antenatal females, 517(1.47%) were positive, while 304(1.8%) were positive out of 16,980 samples obtained from couples. Out of 304 samples from couples found positive, 17.4% wives had titre >R16; 27.9% wives had titre R1 to R8, out of which 15.3% husbands had titre of >R16. Also, 166 wives with nonreactive VDRL had 19.3% husbands with titre > R16. Thus, couple VDRL test plays an important role in detection of hidden cases of syphilis in the community and early detection and treatment of such cases will further reduce the perinatal morbidity and mortality.

  11. Screening by VDRL test to detect hidden cases of syphilis

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    Gupta N

    2003-01-01

    Full Text Available A total of 59,450 sera from January 1996 to December 2000 were subjected to VDRL testing. Overall VDRL positivity rate was 3.2% and downward trend was observed in the recent years, 1999 and 2000. Majority of the samples were from Gynaecology department, out of which 1.57% were VDRL positive. Out of 30,045 samples from antenatal females, 517(1.47% were positive, while 304(1.8% were positive out of 16,980 samples obtained from couples. Out of 304 samples from couples found positive, 17.4% wives had titre >R16; 27.9% wives had titre R1 to R8, out of which 15.3% husbands had titre of >R16. Also, 166 wives with nonreactive VDRL had 19.3% husbands with titre > R16. Thus, couple VDRL test plays an important role in detection of hidden cases of syphilis in the community and early detection and treatment of such cases will further reduce the perinatal morbidity and mortality.

  12. Rising trends of syphilis in a tertiary care center in North India

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    Sunil Sethi

    2015-01-01

    Full Text Available Background and Objectives: Syphilis is a classical sexually transmitted disease (STD, caused by Treponema pallidum subsp. pallidum. In this retrospective study, we analyzed trends of syphilis prevalence in patient groups attending our tertiary care center. Materials and Methods: The data was obtained by reviewing laboratory records of the STD laboratory from January 1, 2006 to December 31, 2011. Cases positive by both Venereal Disease Research Laboratory (VDRL and Treponema pallidum particle agglutination (TPPA tests were analyzed for seroprevalence of syphilis in different groups, and to analyze the rising or falling trends, if any. Results: A total of 28,920 serum samples were received in the 6-year study period for VDRL testing, of which 972 (3.4% were found to be reactive. Of these, 1722 sera were also submitted for TPPA testing, 374 (21.7% of which were positive. A total of 375 samples were submitted for both tests, indicating biological false positivity of 0.27%. A rising trend, though not statistically significant, was observed in pregnant women, drug users and patients from wards/out-patient departments, while a statistically significant rise in prevalence of syphilis was found in HIV-positive individuals. A falling trend (not statistically significant was observed in STD clinic attendees. Conclusion: An increasing trend of syphilis was observed during the study period when all groups were analyzed together, especially in HIV-seropositive individuals, which calls for continued and sustained efforts for case detection, treatment, and preventive measures to contain the disease.

  13. Hair and Scalp Manifestations in Secondary Syphilis: Epidemiology, Clinical Features and Trichoscopy.

    Science.gov (United States)

    Piraccini, Bianca Maria; Broccoli, Alessandro; Starace, Michela; Gaspari, Valeria; D'Antuono, Antonietta; Dika, Emi; Patrizi, Annalisa

    2015-01-01

    Syphilitic alopecia (SA) is mainly described in single case reports, and there are only a few epidemiological studies. To investigate the clinical and dermoscopic features of SA in patients with secondary syphilis and to record its actual prevalence. All patients with a diagnosis of secondary syphilis were clinically and trichoscopically evaluated in search of hair and scalp alterations. Five of 12 patients (41.6%) diagnosed with secondary syphilis had SA. The 'moth-eaten' pattern was detected in 4 patients (80% of cases): 1 had 'essential' SA, whereas 3 patients had 'symptomatic' SA. The 'diffuse' SA pattern was found in 1 patient. Trichoscopy of the 'moth-eaten' areas showed that alopecia is mainly due to a reduction in the number of terminal hairs. One patient with secondary syphilis showed trichodynia that regressed completely after antibiotic therapy. The small number of patients included and the fact that none of our patients accepted to be biopsied in an affected area. Since SA appears to be present much more frequently than reported in the literature, when secondary syphilis is suspected, the patient should be examined for the presence of signs compatible with SA and the scalp should be examined by dermoscopy.

  14. Rising trends of syphilis in a tertiary care center in North India.

    Science.gov (United States)

    Sethi, Sunil; Mewara, Abhishek; Hallur, Vinaykumar; Prasad, Amber; Sharma, Kusum; Raj, Atul

    2015-01-01

    Syphilis is a classical sexually transmitted disease (STD), caused by Treponema pallidum subsp. pallidum. In this retrospective study, we analyzed trends of syphilis prevalence in patient groups attending our tertiary care center. The data was obtained by reviewing laboratory records of the STD laboratory from January 1, 2006 to December 31, 2011. Cases positive by both Venereal Disease Research Laboratory (VDRL) and Treponema pallidum particle agglutination (TPPA) tests were analyzed for seroprevalence of syphilis in different groups, and to analyze the rising or falling trends, if any. A total of 28,920 serum samples were received in the 6-year study period for VDRL testing, of which 972 (3.4%) were found to be reactive. Of these, 1722 sera were also submitted for TPPA testing, 374 (21.7%) of which were positive. A total of 375 samples were submitted for both tests, indicating biological false positivity of 0.27%. A rising trend, though not statistically significant, was observed in pregnant women, drug users and patients from wards/out-patient departments, while a statistically significant rise in prevalence of syphilis was found in HIV-positive individuals. A falling trend (not statistically significant) was observed in STD clinic attendees. An increasing trend of syphilis was observed during the study period when all groups were analyzed together, especially in HIV-seropositive individuals, which calls for continued and sustained efforts for case detection, treatment, and preventive measures to contain the disease.

  15. Serological Response to Treatment of Syphilis with Doxycycline Compared with Penicillin in HIV-infected Individuals.

    Science.gov (United States)

    Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan; Jensen, Jørgen Skov; Benfield, Thomas; Gerstoft, Jan; Katzenstein, Terese Lea

    2016-08-23

    Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0.006). In conclusion, this study provides evidence for the use of doxycycline as a treatment option when treating a HIV-infected population for syphilis.

  16. UNILATERAL OPTIC NEURITIS AND CENTRAL RETINAL VASCULITIS DUE TO OCULAR SYPHILIS.

    Science.gov (United States)

    Khan, Murtaza S; Kuruppu, Dulanji K; Popli, Tanav A; Moorthy, Ramana S; Mackay, Devin D

    2017-08-14

    Report a case of concurrent unilateral optic neuritis and central retinal artery occlusion as the presenting signs of syphilis. A case report of a 22-year-old man with progressive unilateral vision loss. With no known previous history of syphilis, genital lesions, or other extraocular manifestations, the patient presented with pain with eye movements and decreased color vision. His vision dramatically worsened after a course of oral steroids. Examination was remarkable for severe right optic disk edema with a macular cherry-red spot and mild posterior uveitis. Magnetic resonance imaging of the orbits with contrast revealed enhancement and enlargement of the distal right optic nerve. Fluorescein angiography demonstrated delayed filling of the right central retinal artery, suggestive of impending central retinal artery occlusion. Syphilis serologies were positive from the serum, and cerebrospinal fluid Venereal Disease Research Laboratory test was reactive, consistent with neurosyphilis. Oral steroids were discontinued and vision improved with 2 weeks of intravenous penicillin. This unusual case highlights one of the possible initial presentations of syphilis: unilateral optic neuritis and central retinal artery vasculitis with mild posterior uveitis. The worsening of vision after administration of oral steroids also highlights a potential complication of oral steroid use in the absence of a known etiology of vision loss. A thorough history and examination may be helpful in identifying risk factors for infectious causes, including syphilis, and should prompt additional evaluation.

  17. [Congenital syphilis incidence disparities in Colombia 2005 to 2011: an ecological study].

    Science.gov (United States)

    Alzate-Granados, Juan P; Sánchez-Bello, Nubia F; Amaya-Arias, Ana C; Peralta-Pizza, Fernando; Eslava-Schmalbach, Javier

    2012-10-01

    Syphilis is a systemic, infecto-contagious, sexually-transmitted disease caused by the spirochete bacterium Treponema pallidum. Interventions reducing congenital syphilis incidence represent two of the Millennium Development Goals (MDG). Diagnostic and treatment methods are available for managing congenital syphilis; even so, variations occur in seroprevalence and the number of annual cases worldwide, so the situation continues to be worrying. This study was aimed at describing disparities per department regarding congenital syphilis incidence in Colombia from 2005 to 2011. Colombian Institute of Health (Instituto Nacional de Salud-INS) surveillance system records and Colombian Statistics Department (Departamento Administrativo Nacional de Estadística-DANE) records of live births (LB) and basic unsatisfied needs (BUN) from 2005 to 2011 were analyzed. Results Overall incidence in Colombia rose from 2.15 cases per 1,000 LB in 2005, (1,550 cases) to 3.28 cases per 1,000 LB in 2011 (2,078 cases), thereby moving further away from the MDG (0.5 per 1,000 LB). The growing number of cases of congenital syphilis indicates that this continues being a priority problem for public health and that the Overall Healthcare-related Social Security System (OHSSS) has not been able to resolve it, in spite of increased coverage and the resources which this entity has received during the last few years. Such situation demands a re-evaluation of the OHSSS's real impact on public healthcare results.

  18. Qualitative and quantitative aspects of the serological diagnosis of early syphilis.

    Science.gov (United States)

    McMillan, A; Young, H

    2008-09-01

    The aim of the present study was to evaluate the use of various serological tests in the diagnosis of early syphilis. The Murex enzyme immunoassay (EIA) test was used for screening; the Venereal Diseases Research Laboratory (VDRL) test, the Treponema pallidum particle agglutination assay (TPPA) and the Mercia antitreponemal IgM EIA were used in all the patients with a positive screening test and in those with suspected syphilis or in known contacts. In 89 cases of primary syphilis, the Murex EIA screening test was positive in 67 (75%) patients, the Mercia IgM EIA in 80 (90%) cases, the VDRL in 60 (67%) cases and the TPPA in 85 (96%) cases. All the tests were positive in 68 patients with secondary syphilis. In 72 cases of early latent syphilis, the Murex EIA screening test was positive in 68 (94%) patients, the Mercia IgM EIA in 50 (69%) cases, the VDRL in 61 (85%) cases and the TPPA in 68 (94%) cases. The Mercia IgM EIA was the only test positive in four (6%) of these cases; these four patients were known contacts. Antibody titres in the VDRL and TPPA increased as the infection progressed.

  19. Is routine antenatal screening for syphilis in Nigeria still justified clinically and economically?

    Science.gov (United States)

    Bukar, Mohammed; Audu, Bala M; Takai, Usman I; Ajayi, Bamidele B; Kullima, Abubakar A

    2009-10-01

    To determine the seroprevalence and cost effectiveness of antenatal syphilis screening at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria. A retrospective chart analysis of venereal disease research laboratory (VDRL) results among pregnant women at the UMTH, Maiduguri, Nigeria, during a 10-year period (from 1st January 1999 to 31st December 2008) was undertaken. A total of 18,712 women registered for antenatal care during the study period. Of these, 18,101 had serological screening for syphilis. Only 12 of the 18,101 screened were seropositive by VDRL, 9 (75%) were confirmed by Treponema pallidum hemagglutination assay (TPHA), giving a seroprevalence rate of 0.05%. Three (25%) were biological false-positive. The peak age-specific incidence of 0.02% was in the 20-24 year-age group. There was zero prevalence in the age groups 15-19 and >40 years. There was no case of congenital syphilis seen. The cost for VDRL testing per patient in UMTH is US$2. The total amount of money spent on VDRL tests over the study period was US$37,424. The seroprevalence rate of syphilis is extremely low in this study. This calls for a review of the policy of routine antenatal serology screening for syphilis in Maiduguri, Nigeria.

  20. Rising trends of syphilis in a tertiary care center in North India

    Science.gov (United States)

    Sethi, Sunil; Mewara, Abhishek; Hallur, Vinaykumar; Prasad, Amber; Sharma, Kusum; Raj, Atul

    2015-01-01

    Background and Objectives: Syphilis is a classical sexually transmitted disease (STD), caused by Treponema pallidum subsp. pallidum. In this retrospective study, we analyzed trends of syphilis prevalence in patient groups attending our tertiary care center. Materials and Methods: The data was obtained by reviewing laboratory records of the STD laboratory from January 1, 2006 to December 31, 2011. Cases positive by both Venereal Disease Research Laboratory (VDRL) and Treponema pallidum particle agglutination (TPPA) tests were analyzed for seroprevalence of syphilis in different groups, and to analyze the rising or falling trends, if any. Results: A total of 28,920 serum samples were received in the 6-year study period for VDRL testing, of which 972 (3.4%) were found to be reactive. Of these, 1722 sera were also submitted for TPPA testing, 374 (21.7%) of which were positive. A total of 375 samples were submitted for both tests, indicating biological false positivity of 0.27%. A rising trend, though not statistically significant, was observed in pregnant women, drug users and patients from wards/out-patient departments, while a statistically significant rise in prevalence of syphilis was found in HIV-positive individuals. A falling trend (not statistically significant) was observed in STD clinic attendees. Conclusion: An increasing trend of syphilis was observed during the study period when all groups were analyzed together, especially in HIV-seropositive individuals, which calls for continued and sustained efforts for case detection, treatment, and preventive measures to contain the disease. PMID:26692604

  1. Prevalence and Incidence of Syphilis among Volunteer Blood Donors in Israel

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    Leibovici Vera

    2014-01-01

    Full Text Available Data of 1,290,222 volunteer blood donors, in a 5-year period, was analyzed for prevalence and incidence of syphilis. Subsequent testing of donations positive in Treponema pallidum hemagglutination assay included Venereal Disease Research Laboratory and fluorescent Treponemal antibody absorption. Stepwise logistic regression model was used to identify positive syphilis serology. Prevalence of syphilis was 47 : 100,000, similar in men and women and increased significantly with age (P<0.001. Native Israelis had the lowest prevalence rate of syphilis (21 : 100,000, while a significantly higher prevalence was found among immigrants from Africa, Eastern Europe, and South America (odds ratios of 19.0, 10.8, and 7.3, resp., P<0.001 for each. About 33.2% of the seropositive donors had evidence of recent infection, and 66.8% had past infections. Incidence rate reached 8 : 100,000 person-years. Coinfection with HIV, HCV, and HBV was calculated as 8%, 1.88%, and 0.37% for positive donations, respectively. The data support the need to continue screening blood donors in Israel for syphilis and employ preventive measures to populations at risk, in order to improve public health, blood safety, and quality. A subsequent study to assess blood donors’ knowledge, attitude, and behavior is planned. In times of global migration this information may be useful to blood services worldwide.

  2. Immune Evasion and Recognition of the Syphilis Spirochete in Blood and Skin of Secondary Syphilis Patients: Two Immunologically Distinct Compartments

    Science.gov (United States)

    Cruz, Adriana R.; Ramirez, Lady G.; Zuluaga, Ana V.; Pillay, Allan; Abreu, Christine; Valencia, Carlos A.; La Vake, Carson; Cervantes, Jorge L.; Dunham-Ems, Star; Cartun, Richard; Mavilio, Domenico; Radolf, Justin D.; Salazar, Juan C.

    2012-01-01

    Background The clinical syndrome associated with secondary syphilis (SS) reflects the propensity of Treponema pallidum (Tp) to escape immune recognition while simultaneously inducing inflammation. Methods To better understand the duality of immune evasion and immune recognition in human syphilis, herein we used a combination of flow cytometry, immunohistochemistry (IHC), and transcriptional profiling to study the immune response in the blood and skin of 27 HIV(-) SS patients in relation to spirochetal burdens. Ex vivo opsonophagocytosis assays using human syphilitic sera (HSS) were performed to model spirochete-monocyte/macrophage interactions in vivo. Results Despite the presence of low-level spirochetemia, as well as immunophenotypic changes suggestive of monocyte activation, we did not detect systemic cytokine production. SS subjects had substantial decreases in circulating DCs and in IFNγ-producing and cytotoxic NK-cells, along with an emergent CD56−/CD16+ NK-cell subset in blood. Skin lesions, which had visible Tp by IHC and substantial amounts of Tp-DNA, had large numbers of macrophages (CD68+), a relative increase in CD8+ T-cells over CD4+ T-cells and were enriched for CD56+ NK-cells. Skin lesions contained transcripts for cytokines (IFN-γ, TNF-α), chemokines (CCL2, CXCL10), macrophage and DC activation markers (CD40, CD86), Fc-mediated phagocytosis receptors (FcγRI, FcγR3), IFN-β and effector molecules associated with CD8 and NK-cell cytotoxic responses. While HSS promoted uptake of Tp in conjunction with monocyte activation, most spirochetes were not internalized. Conclusions Our findings support the importance of macrophage driven opsonophagocytosis and cell mediated immunity in treponemal clearance, while suggesting that the balance between phagocytic uptake and evasion is influenced by the relative burdens of bacteria in blood and skin and the presence of Tp subpopulations with differential capacities for binding opsonic antibodies. They also

  3. Syphilis and HIV-1 co-infection: influence on CD4 T cell count, HIV-1 viral load and treatment response

    DEFF Research Database (Denmark)

    Kofoed, Kristian; Gerstoft, Jan; Mathiesen, Lars Reinhardt

    2006-01-01

    OBJECTIVES: To assess the effect of human immunodeficiency virus (HIV)-1 and syphilis coinfection on HIV-ribonucleic acid (RNA) viral load, CD4 cell count, and the response in rapid plasmin reagin (RPR) to treatment of the syphilis infection. STUDY DESIGN: Cases of syphilis diagnosed during 1 yea...

  4. [HIV and syphilis coinfection in pregnancy and vertical HIV transmission: a study based on epidemiological surveillance data].

    Science.gov (United States)

    Acosta, Lisiane M W; Gonçalves, Tonantzin Ribeiro; Barcellos, Nêmora Tregnago

    2016-12-01

    To estimate the rate of HIV and syphilis coinfection among pregnant women living in Porto Alegre, Brazil, as well as the association of coinfection with vertical HIV transmission and socioeconomic variables. This analytical retrospective cross-sectional study employed data from the regular epidemiological surveillance system for the period from 2010 to 2013. Data were obtained regarding pregnant women with HIV and exposed children, syphilis in pregnancy, and congenital syphilis. The study population included 1 500 HIV-positive women with deliveries from 2010 to 2013. Of these, 155 (10.3%) were also infected with syphilis, corresponding to an HIV and syphilis coinfection rate of 10.2% (± 1.5%). The coinfected group had lower education levels, higher prevalence of black women, and greater HIV exposure related to drug use by the woman or a partner. Coinfected women had more delayed HIV diagnosis (for example, during childbirth) and greater prevalence of lacking prenatal care (44%). Crude analysis showed an association between vertical HIV transmission and HIV and syphilis co-infection (PR = 2.1; 95%CI: 1.21-3.74; P = 0.01) that persisted in the adjusted analysis. A profile of increased vulnerability was identified among pregnant women with HIV and syphilis coinfection. A positive impact of the treatment to reduce congenital syphilis and eliminate vertical transmission of HIV depends on enhanced access to qualified health care.

  5. Perception of nurses on the adhesion of partners of pregnant women with syphilis to the treatment

    Directory of Open Access Journals (Sweden)

    Mayanne Santana Nóbrega de Figueiredo

    2015-07-01

    Full Text Available Objective: to investigate the perception of nurses of the Family Health Strategy on the factors that influence adhesion to treatment of sexual partners of pregnant women with syphilis. Methods: it is a qualitative research, made with 10 nurses. To collect data, a semi-structured interview was used. The data were submitted to thematic analysis. Results: the following categories were identified: the approach of the nurses to partners of pregnant women with syphilis; barriers that influence on the adhesion to the treatment; strategies and actions of adhesion of the partners in the treatment; perception of the nurse concerning the responsibility of assistance and effectiveness of the treatment. Conclusion: it was identified that nurses have a wide perception of aspects relating to adhesion to the treatment, but need better scientific and practical basis to perform effectively activities on the management of sexual partners with syphilis.

  6. Quantitative measurement of cerebral blood flow on patients with early syphilis

    Institute of Scientific and Technical Information of China (English)

    ZHONG Ji-Jun; WU Jin-Chang; YANG Yi; TANG Jun; LIU Zeng-Li; SHI Xin

    2005-01-01

    To study quantitative change of cerebral blood flow (CBF) on patients with early syphilis, we have established a method on absolute measurement of rCBF by using SPECT with Ethyl Cysteinate Dimmer (ECD) as imaging agent, and the method was applied to measure rCBF on patients with early syphilis. The rCBF values measured by this method are highly consistent with the values measured by other classical methods such as SPECT (123I-IMP) and PET (15O-H2O). The rCBF values for early syphilis patients and the normal control show some statistical differences.A routine quantitative absolute measurement of rCBF featured with simple procedures is therefore on the way of maturation.

  7. Facebook-augmented partner notification in a cluster of syphilis cases in Milwaukee.

    Science.gov (United States)

    Hunter, Paul; Oyervides, Otilio; Grande, Katarina M; Prater, Daphne; Vann, Vannessa; Reitl, Irmine; Biedrzycki, Paul A

    2014-01-01

    Public health professionals face many challenges in infectious disease cluster case identification and partner notification (PN), especially in populations using social media as a primary communication venue. We present a method using Facebook and social network diagram illustration to identify, link, and notify individuals in a cluster of syphilis cases in young black men who have sex with men (MSM). Use of Facebook was crucial in identifying two of 55 individuals with syphilis, and the cooperation of socially connected individuals with traditional PN methods yielded a high number of contacts per case. Integration of PN services for HIV and sexually transmitted diseases, as well as collaboration between the city and state information systems, assisted in the cluster investigation. Given that rates of syphilis and HIV infection are increasing significantly in young African American MSM, the use of social media can provide an additional avenue to facilitate case identification and notification.

  8. Sensitivity and specificity of point-of-care rapid combination syphilis-HIV-HCV tests.

    Directory of Open Access Journals (Sweden)

    Kristen L Hess

    Full Text Available New rapid point-of-care (POC tests are being developed that would offer the opportunity to increase screening and treatment of several infections, including syphilis. This study evaluated three of these new rapid POC tests at a site in Southern California.Participants were recruited from a testing center in Long Beach, California. A whole blood specimen was used to evaluate the performance of the Dual Path Platform (DPP Syphilis Screen & Confirm, DPP HIV-Syphilis, and DPP HIV-HCV-Syphilis rapid tests. The gold-standard comparisons were Treponema pallidum passive particle agglutination (TPPA, rapid plasma reagin (RPR, HCV enzyme immunoassay (EIA, and HIV-1/2 EIA.A total of 948 whole blood specimens were analyzed in this study. The sensitivity of the HIV tests ranged from 95.7-100% and the specificity was 99.7-100%. The sensitivity and specificity of the HCV test were 91.8% and 99.3%, respectively. The treponemal-test sensitivity when compared to TPPA ranged from 44.0-52.7% and specificity was 98.7-99.6%. The non-treponemal test sensitivity and specificity when compared to RPR was 47.8% and 98.9%, respectively. The sensitivity of the Screen & Confirm test improved to 90.0% when cases who were both treponemal and nontreponemal positive were compared to TPPA+/RPR ≥ 1 ∶ 8.The HIV and HCV on the multi-infection tests showed good performance, but the treponemal and nontreponemal tests had low sensitivity. These results could be due to a low prevalence of active syphilis in the sample population because the sensitivity improved when the gold standard was limited to those more likely to be active cases. Further evaluation of the new syphilis POC tests is required before implementation into testing programs.

  9. Clinical prediction and diagnosis of neurosyphilis in HIV-infected patients with early Syphilis.

    Science.gov (United States)

    Dumaresq, Jeannot; Langevin, Stéphanie; Gagnon, Simon; Serhir, Bouchra; Deligne, Benoît; Tremblay, Cécile; Tsang, Raymond S W; Fortin, Claude; Coutlée, François; Roger, Michel

    2013-12-01

    The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the Treponema pallidum particle agglutination (TPPA) assay, the fluorescent treponemal antibody absorption (FTA-ABS) assay, and the line immunoassay INNO-LIA Syphilis, for the diagnosis of NS from cerebrospinal fluid (CSF) samples of these patients. NS was defined by a reactive CSF-VDRL test result and/or a CSF white blood cell (WBC) count of >20 cells/μl. Thirty of the 122 patients (24.6%) had early NS. Headache, visual symptoms, a CD4 cell count of HIV-1 RNA count of ≥50 copies/ml, were associated with NS in multivariate analysis (P = diagnosis of NS, the PCR, FTA-ABS, TPPA, and INNO-LIA assays had sensitivities of 58%, 100%, 68%, and 100%, specificities of 67%, 12%, 49%, and 13%, and negative predictive values of 85%, 100%, 84%, and 100%, respectively. Visual disturbances, headache, uncontrolled HIV-1 viremia, and a CD4 cell count of HIV-infected patients with early syphilis, while blood serum RPR titers were not; therefore, RPR titers should not be used as the sole criterion for deciding whether to perform an LP in early syphilis. When applied to CSF samples, the INNO-LIA Syphilis assay easily helped rule out NS.

  10. The development and validation of dried blood spots for external quality assurance of syphilis serology

    Directory of Open Access Journals (Sweden)

    Smit Pieter W

    2013-02-01

    Full Text Available Abstract Background Syphilis causes up to 1,500,000 congenital syphilis cases annually. These could be prevented if all pregnant women were screened, and those with syphilis treated with a single dose of penicillin before 28 weeks gestation. In recent years, rapid point-of-care tests have allowed greater access to syphilis screening, especially in rural or remote areas, but the lack of quality assurance of rapid testing has been a concern. We determined the feasibility of using dried blood spots (DBS as specimens for quality assurance of syphilis serological assays. Methods We developed DBS extraction protocols for use with Treponema pallidum particle agglutination assay (TPPA, Treponema pallidum haemagglutination assay (TPHA and an enzyme immunoassay (EIA and compared the results with those using matching plasma samples from the same patient. Results Since DBS samples showed poor performance with TPHA and EIA (TPHA sensitivity was 50.5% (95% confidence interval: 39.9–61.2% and EIA specificity was 50.4% (95% CI: 43.7–57.1%, only the DBS TPPA was used in the final evaluation. DBS TPPA showed an sensitivity of 95.5% (95% CI: 91.3–98.0% and a specificity of 99.0% (95% CI: 98.1–99.5% compared to TPPA using plasma samples as a reference. Conclusion DBS samples can be recommended for use with TPPA, and may be of value for external quality assurance of point-of-care syphilis testing.

  11. Syphilis seroprevalence among patients attending a sexually transmitted disease clinic in West Bengal, India.

    Science.gov (United States)

    Maity, Susmita; Bhunia, Somesh Chandra; Biswas, Subrata; Saha, Malay Kumar

    2011-01-01

    Syphilis is a sexually transmitted disease (STD) and is a major public health concern in India. The trend of syphilis infection was studied in attendees aged 15-49 years in an STD clinic in West Bengal from 2004 to 2008. Blood samples were collected from 250 consecutive patients per year (a total of 1,250 samples over 5 years); the patients attended the STD clinic for 12 weeks (October-December) each year, and the serostatus of syphilis was determined qualitatively with the Venereal Disease Research Laboratory (VDRL) test using serum samples. A quantitative VDRL test was then performed at a dilution of 1:8 using serum samples that yielded positive results in the qualitative VDRL test. Finally, serum samples that yielded positive results in the quantitative VDRL test were also subjected to the Treponema pallidum hemagglutination assay (TPHA). The serum samples that yielded positive results in both the tests were considered syphilis seropositive. All seropositive serum samples from the quantitative VDRL test were also found to be positive results in TPHA. The total seropositivity for syphilis in the STD patients was 8.2% (women, 8.9%; men, 7.7%). Review of the data from 5 consecutive years showed a statistically significant (χ(2) = 9.968, df = 4, P < 0.05) decrease in syphilis positivity from 10.8% (2004) to 3.6% (2008). The results of the study also revealed that the highest seroprevalence was in the 20-24 age group (16.3%), and the lowest seroprevalence was in the 45-49 age group (3.3%). The study indicates the effectiveness of current interventions with a need to focus further on reducing the burden in the 20-24 age group.

  12. Bayes' theorem-based assessment of VDRL syphilis screening miss rates.

    Science.gov (United States)

    Muic, V; Ljubicic, M; Vodopija, I

    1999-01-01

    Interlaboratory differences (and conflicting practices) in syphilis screening strategies (serial versus parallel test combinations) prompted us to determine an estimate of the diagnostic miss rate in the detection of (1) infected persons and (2) infected but untreated persons potentially affected by late active syphilis. We set out to establish the most efficient syphilis screening strategy for two routine tests (VDRL and Treponema pallidum hemagglutination assay [TPHA]) with regard to our tested public health population (average VDRL+ TPHA+ and VDRL- TPHA+ reactor ages being 59.9 years and 50.5 years, respectively. Retrospective analysis covered the results of a routine parallel VDRL and TPHA testing on 24,863 persons done in four public health laboratories. Nosologic sensitivity of the VDRL test (18.32%) was determined using the TPHA test as reference. The percentage of VDRL nonreactors among infected persons (TPHA reactors) was considered as the VDRL false negative rate (81.68%). We estimated the proportion of persons infected but untreated with potential late active syphilis using our own Bayes theorem-based procedure. The Bayes theorem-based estimate showed a significantly higher value for persons at risk of active late syphilis than the number of suspected cases obtained using the classical approach (25.1% versus 18.32%, or 83 persons versus 61 of the 330 infected). In screening an older population, the VDRL test alone (or as the first of a series with TPHA as a confirmation test) may produce a diagnostic miss rate higher than the syphilis detection rate. Another miss in such a population is detected by the Bayes theorem-based method.

  13. Study of distribution and factors affecting syphilis epidemic among inner-city minorities of Baltimore.

    Science.gov (United States)

    Williams, P B; Ekundayo, O

    2001-11-01

    Disparities in health and medical conditions among ethnic and racial groups have been repeatedly documented. These inequalities, which have been noted in the recent past, include health outcomes such as quality of life and mortality, process, accessibility and appropriateness of care, and the prevalence of certain degenerative conditions and infectious diseases. Syphilis, a sexually transmitted disease (STD) which seemed to have disappeared or had been controlled over the years, has now re-emerged as a major public health problem in many rural, urban and suburban communities. Progression of the current rate of syphilis, which erupted in Baltimore during the later part of 1994, has continued unabated, most especially among the ethnic minorities, despite efforts of the Baltimore City Health Department and Maryland Department of Health and Mental Hygiene to control the epidemic. With the current incidence rates of 270 per 100 000 live births for congenital syphilis and 99.3 per 100 000 population for primary, secondary and latent syphilis (96% of the cases being in the non-white population), Baltimore becomes the city with the highest number of syphilis cases in the nation, surpassing the national average of 2.6 cases per 100 000 population. This study, which utilizes a combination of retrospective and questionnaire-oriented approach, was designed to assess factors that influenced the high incidence of syphilis among Baltimore inner-city dwellers between 1994 and 1998. Data for the study included syphilis reports from private physicians, the Baltimore City Health Department, STD clinics, the Center for Disease Control (CDC), and ethnographic interviews. Factors favoring the distribution and infectivity of the disease among the inner-city dwellers include greater poverty, high level of communication gaps between providers and a cross-section of minority inner-city dwellers, exchange of sex for crack cocaine, lower educational background, and inadequate and

  14. Early Congenital Syphilis: Recognising Symptoms of an Increasingly Prevalent Disease.

    Science.gov (United States)

    Patel, Nupur U; Oussedik, Elias; Landis, Erin T; Strowd, Lindsay C

    2017-08-01

    Congenital syphilis (CS) is an infectious disease resulting from transplacental transmission of Treponema pallidum spirochetes from an infected mother to fetus during pregnancy. While uncommon, CS has shown an increased incidence in Canada and the United States since 2001 and 2012, respectively. We present the case of a 5-week-old female infant with blistering rash on the palms and soles. The infant displayed decreased movement of the left upper extremity, clinically consistent with Parrot pseudoparalysis. Cutaneous involvement was limited to few tan crusted papules on the palms and soles. Mother reported a "false-positive" result of rapid plasma reagin (RPR) testing at 31 weeks. Cerebrospinal fluid studies of the infant resulted with positive Venereal Disease Research Laboratory (VRDL) test and positive microhemagglutination assay (MHA-TP). Histopathology of a crusted papule revealed a lichenoid infiltrate composed of lymphocytes, histiocytes, and plasma cells. Immunohistochemical staining for T pallidum was negative. The patient completed treatment with a 10-day course of intravenous penicillin. While CS is largely considered a historic entity, it has been increasing in incidence in the United States since 2012 and in Canada since the early 2000s. Diagnosis of CS can be difficult as infants may be asymptomatic or present with nonspecific signs. This case highlights the presentation of minimal cutaneous involvement as well as skeletal involvement after birth. RPR testing may result in false negatives or indeterminate results, further complicating diagnosis. Given these difficulties in screening and the increasing incidence of CS, clinicians may need to refamiliarise themselves with its clinical findings.

  15. Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015.

    Science.gov (United States)

    Abara, Winston E; Hess, Kristen L; Neblett Fanfair, Robyn; Bernstein, Kyle T; Paz-Bailey, Gabriela

    2016-01-01

    Globally, men who have sex with men (MSM) are disproportionately burdened with syphilis. This review describes the published literature on trends in syphilis infections among MSM in the US and Western Europe from 1998, the period with the fewest syphilis infections in both geographical areas, onwards. We also describe disparities in syphilis trends among various sub-populations of MSM. We searched electronic databases (Medline, Embase, Global Health, PsychInfo, CAB Abstracts, CINAHL, Sociological Abstracts, Web of Science, Cochrane Library, and LILACS) for peer-reviewed journal articles that were published between January 2004 and June 2015 and reported on syphilis cases among MSM at multiple time points from 1998 onwards. Ten articles (12 syphilis trend studies/reports) from the US and eight articles (12 syphilis trend studies/reports) from Western Europe were identified and included in this review. Taken together, our findings indicate an increase in the numbers and rates (per 100,000) of syphilis infections among MSM in the US and Western Europe since 1998. Disparities in the syphilis trends among MSM were also noted, with greater increases observed among HIV-positive MSM than HIV-negative MSM in both the US and Western Europe. In the US, racial minority MSM and MSM between 20 and 29 years accounted for the greatest increases in syphilis infections over time whereas White MSM accounted for most syphilis infections over time in Western Europe. Multiple strategies, including strengthening and targeting current syphilis screening and testing programs, and the prompt treatment of syphilis cases are warranted to address the increase in syphilis infections among all MSM in the US and Western Europe, but particularly among HIV-infected MSM, racial minority MSM, and young MSM in the US.

  16. Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

    Science.gov (United States)

    Jansen, Klaus; Schmidt, Axel J; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

    2016-10-27

    In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections.

  17. Clinical Study on 29 Cases of Syphilis in Neonates%新生儿梅毒29例临床研究

    Institute of Scientific and Technical Information of China (English)

    张健; 陆峰; 何敏

    2013-01-01

    Objective :To explore the diagnosis of syphilis in neonates and prevention and treatment of points .Methods :A retrospective analysis of 29 cases of syphilis in newborn children with clinical information ,analysis of clinical charac-teristics in children with summarizing the experiences of diagnosis and treatment .Results:In children with different clin-ical manifestations of syphilis in neonates ,atypical ,no specific performance diagnosis must rely on auxiliary examina-tion ;after the vast majority of parents of children with syphilis ,due in part to no symptoms or symptoms is not obvi-ous ,not regular treatment in time ,and hide the history ,make diagnosis difficult ;preferred in the treatment of penicillin , penicillin treatment using azithromycin .Conclusion:Especially in premature infants after birth ,on symptoms and multi-ple organ dysfunction in children with existing diseases cannot be explained ,should have serum Rotary body RPR and TPHA syphilis examination in a timely manner and long bone X-ray .Preferred in the treatment of penicillin ,agie insen-sitive given adriamycin .Early diagnosis ,treatment ,prognosis is better ,but some children may result in death or leave sequelae .While actively STD prevention and advocacy work ,reducing the incidence of congenital syphilis .%目的:探讨新生儿梅毒的诊断及防治要点。方法:回顾性分析29例新生儿梅毒患儿的临床资料,分析患儿的临床特点,总结诊治经验。结果:新生儿梅毒患儿临床表现各异,不典型,无特异性表现,确诊要靠辅助检查;绝大部分患儿父母感染梅毒后,部分由于无症状或症状不明显,未及时正规治疗,且存在隐瞒病史,导致诊断困难;治疗上首选青霉素,对青霉素治疗无效的选用阿奇霉素。结论:新生儿出生后特别是一些早产儿,症状上有多器官功能损害而又不能以现有疾病解释的患儿,应及时做血清梅毒螺旋体RPR、TPHA检

  18. Towards elimination of parent-to-child transmission of syphilis in India: a rapid situation review to inform national strategy.

    Science.gov (United States)

    Srinivas, Vani; Turlapati, Prasad Ln; Bhola, Anil K; Singh, Aman K; Rajan, Shobini; Gupta, Radha S; Khaparde, Sunil D

    2015-01-01

    In February 2015, India's National AIDS Control Organisation, Ministry of Health and Family Welfare, launched a national strategy towards elimination of parent-to-child transmission (E-PTCT) of syphilis, with a goal to reduce the incidence of congenital syphilis to 0.3 cases per 1000 live births by 2017. As part of the development of the national strategy, a rapid situation analysis was undertaken to ascertain the current practices, challenges and barriers for E-PTCT of syphilis in India. The analysis was conducted during February and March 2014 in five states selected from five different regions of India. Key informant interviews were conducted with key stakeholders at facility, state and district level. Content analysis was used to identify the themes. Key barriers identified for E-PTCT of syphilis were: low priority for antenatal syphilis testing among providers, limited access to testing, untrained human resources, shortage of test kits and benzathine penicillin, nonadherence to the national protocol for syphilis testing, and poor recording and reporting of antenatal syphilis data. The analysis also identified opportunities for functional integration of E-PTCT within existing maternal and child health programmes. Health-care providers and programme managers expressed a need for training in the programme for E-PTCT of syphilis. The situation analysis identified that, for successful implementation of E-PTCT of syphilis, it is essential that state and district programme managers adopt this initiative; coordinate the programme; plan for an adequate budget in their programme implementation plan; ensure an uninterrupted supply of standardized diagnostics kits and drugs at all levels of health care; and adhere to E-PTCT guidelines when implementing the programme.

  19. Prevalence of Syphilis and associated factors in homeless people of Sao Paulo, Brazil, using a Rapid Test

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    Valdir Monteiro Pinto

    2014-06-01

    Full Text Available Introduction: Homeless people are a vulnerable group to sexually transmitted diseases (STD with high prevalence of syphilis and hepatitis. Objectives: To estimate the prevalence of syphilis infection and its association with risky behaviors for STDs in a sample of homeless people, and to assess the feasibility of the use of rapid syphilis test (RST in this population. Methods: Cross-sectional study, in a convenience sample of homeless people assisted in social support services of São Paulo, between 2006 and 2007. A structured questionnaire was applied and RST was performed. In addition, a blood sample for syphilis detection was also collected. The sensitivity and specificity of the RST was estimated using conventional laboratory diagnosis (VDRL + TPHA as reference. Results: 1,405 volunteers were included in the study. The prevalence rate of syphilis was 7.0%, and was associated with homosexual practices (ORadj 4.9; 95%CI 2.6 - 9.4, prior history of STD (ORadj 2.6; 95%CI 1.7 - 4.0 and with self-referred non-white race (ORadj 1.9; 95%CI 1.1 - 3.4. The sensitivity and specificity of the RST for syphilis were, respectively, 81.4 and 92.1%. Conclusion: The high prevalence of syphilis infection among homeless people shows the need for actions for its control and the utilization of RST that can be considered an efficient strategy due to its sensitivity and specificity. Public Health policymakers must strengthen actions for syphilis control, with screening tests for syphilis and early treatment, decreasing morbidity with the improvement of sexual and reproductive health of the population in general and especially the most vulnerable.

  20. Risk factors for syphilis infection among pregnant women: results of a case‐control study in Shenzhen, China

    Science.gov (United States)

    Zhou, Hua; Chen, Xiang‐Sheng; Hong, Fu‐Chang; Pan, Peng; Yang, Fan; Cai, Yu‐Mao; Yin, Yue‐Ping; Peeling, Rosanna W; Mabey, David

    2007-01-01

    Background China has been experiencing a rapidly growing syphilis epidemic since the early 1990s, with the reported incidence of congenital syphilis increasing from 0.01 cases per 100 000 live births in 1991 to 19.7 cases per 100 000 live births in 2005. Detailed studies of risk factors for syphilis in pregnant women are needed to inform new preventive interventions. Objective To investigate factors associated with recent syphilis infection among pregnant women and recommend strategies for improved preventive interventions in the community. Methods A case–control study was conducted among women attending antenatal clinics in Shenzhen City, South China. Cases were antenatal clinic women testing positive for early syphilis, based on laboratory results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. Results 129 cases and 345 controls were recruited. Syphilis was significantly associated with unmarried status, less education, multiple sex partners, travel of sex partner in the past 12 months, a history of induced abortion, and previous sexually transmitted infections. Overall, there were no differences between syphilis‐positive and negative women in household registration status (hukou), living district and duration in Shenzhen, monthly income, and age at first sex. Conclusions Many demographic and behavioural risk factors are associated with syphilis among pregnant women. In the government congenital syphilis control programme, comprehensive preventive interventions should be provided in all clinical settings in addition to the current procedures for syphilis screening among antenatal women. PMID:17675391

  1. Prevalence of syphilis infection in different tiers of female sex workers in China: implications for surveillance and interventions

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    Chen Xiang-Sheng

    2012-04-01

    Full Text Available Abstract Background Syphilis has made a dramatic resurgence in China during the past two decades and become the third most prevalent notifiable infectious disease in China. Female sex workers (FSWs have become one of key populations for the epidemic. In order to investigate syphilis infection among different tiers of FSWs, a cross-sectional study was conducted in 8 sites in China. Methods Serum specimens (n = 7,118 were collected to test for syphilis and questionnaire interviews were conducted to obtain socio-demographic and behavioral information among FSWs recruited from different types of venues. FSWs were categorized into three tiers (high-, middle- and low-tier FSWs based on the venues where they solicited clients. Serum specimens were screened with enzyme-linked immunosorbent assay (ELISA for treponemal antibody followed by confirmation with non-treponemal toluidine red unheated serum test (TRUST for positive ELISA specimens to determine syphilis infection. A logistic regression model was used to determine factors associated with syphilis infection. Results Overall syphilis prevalence was 5.0% (95%CI, 4.5-5.5%. Low-tier FSWs had the highest prevalence (9.7%; 95%CI, 8.3-11.1%, followed by middle-tier (4.3%; 95%CI, 3.6-5.0%, P P Conclusions This multi-site survey showed a high prevalence of syphilis infection among FSWs and substantial disparities in syphilis prevalence by the tier of FSWs. The difference in syphilis prevalence is substantial between different tiers of FSWs, with the highest rate among low-tier FSWs. Thus, current surveillance and intervention activities, which have low coverage in low-tier FSWs in China, should be further examined.

  2. Cost and clinical utility of repeated syphilis screening in the third trimester in a high-risk population.

    Science.gov (United States)

    Shiber, Linda; Todia, William J

    2014-03-01

    We sought to determine the clinical utility and cost of repeating syphilis testing in the third trimester of pregnancy in a high-risk urban population. A retrospective cohort analysis was performed for patients delivering from January 1993 through December 2009 with at least 1 venereal disease research laboratory (VDRL) test sent during pregnancy. Chart review was performed for patients with confirmed syphilis to determine the temporal relationship of syphilis diagnosis to the pregnancy. For patients who seroconverted during pregnancy (no antecedent history or treatment for syphilis), newborn charts were reviewed. The costs of treating seropositive neonates and the costs of implementing additional third-trimester syphilis screening were then compared. In the 17-year cohort, 58,569 deliveries were available for analysis. In all, 113 new cases of syphilis occurred (192.9/100,000 deliveries). There were 17 detected seroconversions; 10 were not rescreened in the third trimester and tested positive at delivery. These 10 patients may have benefitted from implementing uniform VDRL testing at 28-32 weeks' gestation. All newborns were asymptomatic with a negative workup and received empiric penicillin therapy. Based on 2011 hospital charges, the cost of evaluating and treating a neonate for syphilis is $11,079. Implementing an additional VDRL screen at 28-32 weeks' gestation for each pregnant patient during the 17 years studied would cost $1,991,346. An 18-fold increase in syphilis prevalence (3500/100,000 [3.5%] deliveries) would be required for the cost of implementation of universal early third-trimester screening to be equal to the potential health care charges saved by detecting maternal seroconversion and obviating the need for neonatal therapy. In this high-risk population, additional syphilis screening in the third trimester is costly and is not clinically helpful in detecting maternal seroconversion. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Outreach syphilis testing services by different health providers to female sex workers in southern China.

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    Xiang-Sheng Chen

    Full Text Available Health providers have played important roles on delivering prevention and care services to control syphilis in China. The current study was aimed to evaluate the performance of different health providers in providing outreach syphilis testing services to female sex workers (FSWs. The current study carried out during April to August 2009 in Liuzhou was aimed to investigate the services delivered by two different types of clinics in China. A total of 1,808 FSWs recruited from sex work venues were included in the study. Prevalence of positive syphilis test (6.4% among FSWs accessed by the local center for disease control outreach teams (CDC teams was significantly lower than that (9.3% among FSWs accessed by the local reproductive health hospital outreach teams (RHH teams. As compared with CDC teams, RHH teams had more FSWs to be successfully referred to the designated STD clinics for further syphilis confirmation and intervention (85.7% vs. 26.7%, P<0.001. These findings indicate that RHH teams may be more efficient than CDC teams to provide outreach-based services to FSWs. Participation of the reproductive health providers or other medical facilities in outreach services to FSWs should be considered in developing intervention programs in China.

  4. Outreach Syphilis Testing Services by Different Health Providers to Female Sex Workers in Southern China

    Science.gov (United States)

    Chen, Xiang-Sheng; Yin, Yue-Ping; Liu, Guo-Gu; Wei, Wan-Hui; Wang, Hong-Chun; Yu, Yuan-Lin; Mabey, David C.; Peeling, Rosanna W.

    2013-01-01

    Health providers have played important roles on delivering prevention and care services to control syphilis in China. The current study was aimed to evaluate the performance of different health providers in providing outreach syphilis testing services to female sex workers (FSWs). The current study carried out during April to August 2009 in Liuzhou was aimed to investigate the services delivered by two different types of clinics in China. A total of 1,808 FSWs recruited from sex work venues were included in the study. Prevalence of positive syphilis test (6.4%) among FSWs accessed by the local center for disease control outreach teams (CDC teams) was significantly lower than that (9.3%) among FSWs accessed by the local reproductive health hospital outreach teams (RHH teams). As compared with CDC teams, RHH teams had more FSWs to be successfully referred to the designated STD clinics for further syphilis confirmation and intervention (85.7% vs. 26.7%, P<0.001). These findings indicate that RHH teams may be more efficient than CDC teams to provide outreach-based services to FSWs. Participation of the reproductive health providers or other medical facilities in outreach services to FSWs should be considered in developing intervention programs in China. PMID:23637755

  5. Prevalence of HIV and syphilis in pregnant women in Leon, Nicaragua

    NARCIS (Netherlands)

    Hoekstra, Carlijn E L; Riedijk, Martiene; Matute, Armando J; Hak, Eelko; Delgado, Edgar; Alonso, Rosa E; Benavides, Maria D; van Loon, Anton M; Hoepelman, Ilja M

    2006-01-01

    The objective of this study was to determine the prevalence of HIV and syphilis and to identify risk factors among pregnant women visiting antenatal clinics in León, Nicaragua. During February to April 2004, blood samples from pregnant women were collected after written consent had been obtained. Th

  6. Educational intervention in Primary Care for the prevention of congenital syphilis 1

    Science.gov (United States)

    Lazarini, Flaviane Mello; Barbosa, Dulce Aparecida

    2017-01-01

    ABSTRACT Objectives: to evaluate the efficiency of educational interventions related to the knowledge of health care professionals of Primary Care and to verify the impact on the vertical transmission rates of congenital syphilis. Method: a quasi-experimental study conducted in the city of Londrina, Paraná, between 2013 and 2015. An educational intervention on diagnosis, treatment and notification was carried out with 102 professionals with knowledge measurement before and after the intervention. Incidence and mortality data from congenital syphilis were taken from the system for notifiable diseases (SINAN) and the Mortality Information System (SIM). Excel tabulation and statistical analysis was done in the Statistical Package for Social Sciences, version 2.1. A descriptive and inferential analysis was performed. Results: the mean number of correct responses increased from 53% to 74.3% after the intervention (p < 0.01). The adherence to professional training was 92.6%. There was a significant reduction in the vertical transmission rate of syphilis from 75% in 2013 to 40.2% in 2015. In 2014 and 2015 there were no records of infant mortality from this condition. Conclusion: the educational intervention significantly increased the knowledge of health professionals about syphilis and collaborated to reduce the rate of vertical transmission of the disease. PMID:28146181

  7. Diagnostic dilemma of the single screening test used in the diagnosis of syphilis in Nepal.

    Science.gov (United States)

    Dumre, S P; Shakya, G; Acharya, D; Malla, S; Adhikari, N

    2011-12-01

    Syphilis screening by the nontreponemal rapid plasma reagin (RPR) test is not usually followed up by specific treponemal tests in most of the resource poor healthcare settings of Nepal. We analyzed serum specimens of 504 suspected syphilis cases at the immunology department of the national reference laboratory in Nepal during 2007-2009 using RPR test and Treponema pallidum hemagglutination assay (TPHA). In overall, 35.7% were positive by both methods (combination) while 13.1% were RPR positive and TPHA negative, 8.7% were positive by TPHA only and 42.5% were negative by both methods. Among the RPR reactive (n = 246), 73.2% were positive by TPHA. Non-specific agglutination in RPR testing was relatively higher (26.8%) compared to TPHA (19.6%). Although TPHA was found more specific than RPR test, either of the single tests produced inaccurate diagnosis. Since the single RPR testing for syphilis may yield false positive results, specific treponemal test should be routinely used as confirmatory test to rule out false RPR positive cases. More attention needs to be paid on formulation of strict policy on the implementation of the existing guidelines throughout the country to prevent misdiagnosis in syphilis with the use of single RPR test.

  8. Discordant results from reverse sequence syphilis screening--five laboratories, United States, 2006-2010.

    Science.gov (United States)

    2011-02-11

    CDC recommends syphilis serologic screening with a nontreponemal test, such as the rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) test, to identify persons with possible untreated infection; this screening is followed by confirmation using one of several treponemal tests. Recently, the availability of automatable treponemal enzyme and chemiluminescence immunoassays (EIA/CIA) has led some laboratories to adopt a reverse sequence of screening in which a treponemal EIA/CIA is performed first, followed by testing of reactive sera with a nontreponemal test. To better understand the performance of reverse sequence screening for syphilis, CDC analyzed data from five laboratories that used reverse sequence screening during 2006-2010. This report describes the results of that analysis, which indicated that among sera reactive on initial screening with a treponemal EIA/CIA, 56.7% had a nonreactive RPR test. Among these discordant sera, 31.6% also were nonreactive by treponemal testing using Treponema pallidum particle agglutination (TP-PA) or fluorescent treponemal antibody absorbed (FTA-ABS) tests. Among discordant sera, the rate of nonreactive confirmatory treponemal tests was 2.9 times higher in a population with low prevalence of syphilis, suggesting that the low-prevalence population had a higher percentage of false-positive test results. Although CDC continues to recommend the traditional algorithm with reactive nontreponemal tests confirmed by treponemal testing, in this report CDC offers additional recommendations if reverse sequence syphilis screening is used.

  9. Reactivity of microhemagglutination, fluorescent treponemal antibody absorption, and venereal disease research laboratory tests in primary syphilis.

    Science.gov (United States)

    Dyckman, J D; Storms, S; Huber, T W

    1980-10-01

    Seroreactivity in 130 cases of primary syphilis was 91.5% by fluorescent treponemal antibody absorption test, 82.3% by microhemagglutination (MHA-TP test), and 68.5% by the Venereal Disease Reseach Laboratory (VDRL) test. The MHA TP test generally became reactive earlier than the VDRL test and confirmed all reactive and most weakly reactive VDRL results.

  10. SCREENING ASSAYS TO FIND OUT LATE LATENT SYPHILIS CASES - WHICH IS THE BEST ONE?

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    Dr. Dzintars Ozoliņš

    2009-07-01

    Full Text Available The serological methods for diagnosis of syphilis are classified into non-specific (non-treponemal such as Rapid Plasma Reagin (RPR, and specific (treponemal such as Treponema pallidum hemagglutination test (TPHA and Enzyme-linked immunosorbent assay IgG, IgM (ELISA IgG, IgM tests. The aim of this retrospective study was to estimate and compare the sensitivity and specificity of RPR, TPHA and Syphilis ELISA IgG, IgM. The study was conducted on 18 799 clinically healthy persons who had visited the Outpatient clinic of Ministry of the Interior Clinical Centre, Latvia during 2 years period from August 2006 to November 2007. Patients were screened to find out possible late latent syphilis cases by using RPR, TPHA and ELISA IgG, IgM assays. The results showed the highest sensitivity indices of ELISA IgG, IgM and TPHA methods, and the lowest for the RPR test. Highest specificity indices were observed by using ELISA IgG, IgM method followed by TPHA method with lower values and RPR method showing the lowest specificity. To conclude, ELISA IgG, IgM and TPHA methods should be used for screening late latent syphilis cases and ELISA IgG, IgM for diagnosis confirmation. RPR is not recommended for screening purposes.

  11. Characteristics of gonorrhea and syphilis cases among the Roma ethnic group in Belgrade, Serbia.

    Science.gov (United States)

    Bjekić, Milan; Vlajinac, Hristina; Šipetić-Grujičić, Sandra

    2016-01-01

    The Roma ethnic group is the largest and most marginalized minority in Europe, believed to be vulnerable to sexually transmitted infections. The purpose of the study was to investigate frequency and characteristics of gonorrhea and syphilis among the Roma population in Belgrade. Data from the City Institute for Skin and Venereal Diseases to which all gonorrhea and syphilis cases are referred were analyzed. During the period of 2010-2014 sexually transmitted infections were more frequent among Roma than in rest of Belgrade population. Average percentages of Roma among all reported subjects with syphilis and those with gonorrhea were 9.6% and 13.5%, respectively, while the percentage of Roma in the total Belgrade population was about 1.6%. Roma with syphilis and gonorrhea were more frequently men (75%), most frequently aged 20-29 years (43.4%), never married (64.5%), with elementary school or less (59.2%), unemployed (80.3%), and heterosexual (89.5%). Among Roma 10.5% were sex workers and 68.4% did not know the source of their infection. Significant differences between Roma cases and other cases in Belgrade in all characteristics observed were in agreement with differences between Roma population and the total population of Serbia. The present study confirmed the vulnerability of the Roma population to sexually transmitted infections. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  12. [Trend analysis of acquired syphilis in Mexico from 2003 to 2013].

    Science.gov (United States)

    Herrera-Ortiz, Antonia; Uribe-Salas, Felipe J; Olamendi-Portugal, Ma Leonidez; García-Cisneros, Santa; Conde-Glez, Carlos Jesús; Sánchez-Alemán, Miguel A

    2015-01-01

    To identify the population group in which syphilis increase was concentrated. The information was collected from the Mexico health statistical yearbooks. The information disaggregated by sex, age group and state during the period 2003 to 2013 was used to form different databases. Linear regression analysis with confidence interval at 95% was used to evaluate changes over time in different population groups. An increase of 0.67 cases per 100,000 population (95%CI 0.30-1.04) in men was detected from 2010. The increase was concentrated in each group of 20-24 and 25-44. The highest incidence of acquired syphilis was reported in the last two years: 2012 and 2013. The last year reported a 1.85 times higher incidence than reported in 2003. Aguascalientes, Distrito Federal, Durango, Mexico, Oaxaca, Puebla, Quintana Roo, Yucatan and Zacatecas reported that syphilis increased during the study period. Acquired syphilis may be reemerging in our country among young men; this increase is not uniform across the country, it is necessary to focus intervention measures for this sexually transmitted infection.

  13. Detailed Knowledge of the Tuskegee Syphilis Study: Who Knows What? A Framework for Health Promotion Strategies

    Science.gov (United States)

    Green, B. Lee; Li, Lin; Morris, J. Fontain; Gluzman, Rima; Davis, Jenna L.; Wang, Min Qi; Katz, Ralph V.

    2011-01-01

    This report explores the level of detailed knowledge about the Tuskegee Syphilis Study (TSS) among 848 Blacks and Whites in three U.S. cities across an array of demographic variables. The Tuskegee Legacy Project (TLP) Questionnaire was used, which was designed to explore the willingness of minorities to participate in biomedical studies. A…

  14. Neurosyphilis is unlikely in patients with late latent syphilis and a negative blood VDRL-test.

    Science.gov (United States)

    Wöhrl, Stefan; Geusau, Alexandra

    2006-01-01

    Patients with latent syphilis or syphilis of unknown duration should be evaluated for tertiary disease and neurosyphilis. The aim of this retrospective study was to determine relevant serological parameters for the identification of those individuals with syphilis who are most likely to have neurosyphilis and who therefore require lumbar puncture. After excluding repeated estimates and patients whose blood syphilis serology had either been negative or not been determined within 3 months of lumbar puncture, 265 out of 710 cerebrospinal fluids from 1988 to 2004 were analysed. In each of those patients the earliest available pairs of serum and cerebrospinal fluid samples were evaluated. The diagnosis of neurosyphilis was based on criteria according to established guidelines. Forty-three of 265 patients (16.2%; 5 women, 38 men; mean age 47+/-16 years) had neurosyphilis. Seven of 72 (9.7%) of those testing HIV-positive, fulfilled the criteria of neurosyphilis. Not a single patient with neurosyphilis tested Venereal Disease Research Laboratory test (VDRL)-negative in peripheral blood, an effect which was highly significant (p VDRL titre was significantly higher in patients with neurosyphilis than in those without (1:32 vs. 1:0; p VDRL. Therefore, lumbar puncture is not recommended in these patients.

  15. [Skin and mucosal erosions revealing secondary syphilis with otologic and eye disorders].

    Science.gov (United States)

    Guedes de Carvalho, D; Bouleau, J; Pichenot, M; Dive, S; Duthoit, L; Auxenfants, E; Carpentier, O

    2016-11-01

    The clinical polymorphism of syphilis leads to diagnostic issues. We report a case of secondary syphilis revealed by skin and mucosal erosions, and responsible for sensorineural hearing loss and asymptomatic papillitis. A 55-year-old man presented oral and peri-anal erosions as the initial symptoms of secondary syphilis. He reported hypoacusis and a pure-tone audiogram revealed bilateral sensorineural hearing loss. Ophthalmological investigation revealed isolated right papillitis and superior temporal scotoma with blind-spot enlargement. TPHA-VDRL serology was strongly positive for plasma (TPHA 1/10,240 and VDRL 1/64) but doubtful for cerebrospinal fluid. For his hearing and eye disorders, considered as related to neurosyphilis, the patient received a 14-day course of intravenous penicillin G, associated with systemic corticosteroids with gradual reduction over a period of fifteen weeks. The patient's skin and mucosal erosions resolved, as did his papillitis. His hearing loss remained stable. Serological monitoring at three months showed a sixteen-fold decrease in VDRL titre. The re-emergence of syphilis has led to increasing incidence of related ophthalmological and otological disorders. This report highlights the first-line role of the dermatologist in systematic diagnosis and in screening for associated involvement. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Screening for Syphilis Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2004 U. S. Preventive Services Task Force statement about screening for syphilis in pregnancy. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits of screening, the harms of screening, and the harms of treatment o

  17. Syphilis, gonorrhoea, leprosy and yaws in the Indonesian Archipelago, 1500-1950

    NARCIS (Netherlands)

    Boomgaard, P.

    2007-01-01

    This paper dexamines the history of sexually transmitted diseases in Southeast Asia and explores the origins of venereal disease, specifically syphilis and gonorrhoea, in the region. The arrival of new diseases that accompanied Europeans from about 1500, is a subject that scholars have largely ignor

  18. Characteristics of gonorrhea and syphilis cases among the Roma ethnic group in Belgrade, Serbia

    Directory of Open Access Journals (Sweden)

    Milan Bjekić

    Full Text Available Abstract Background The Roma ethnic group is the largest and most marginalized minority in Europe, believed to be vulnerable to sexually transmitted infections. Aim The purpose of the study was to investigate frequency and characteristics of gonorrhea and syphilis among the Roma population in Belgrade. Methods Data from the City Institute for Skin and Venereal Diseases to which all gonorrhea and syphilis cases are referred were analyzed. Results During the period of 2010–2014 sexually transmitted infections were more frequent among Roma than in rest of Belgrade population. Average percentages of Roma among all reported subjects with syphilis and those with gonorrhea were 9.6% and 13.5%, respectively, while the percentage of Roma in the total Belgrade population was about 1.6%. Roma with syphilis and gonorrhea were more frequently men (75%, most frequently aged 20–29 years (43.4%, never married (64.5%, with elementary school or less (59.2%, unemployed (80.3%, and heterosexual (89.5%. Among Roma 10.5% were sex workers and 68.4% did not know the source of their infection. Significant differences between Roma cases and other cases in Belgrade in all characteristics observed were in agreement with differences between Roma population and the total population of Serbia. Conclusion The present study confirmed the vulnerability of the Roma population to sexually transmitted infections.

  19. A Novel Quantum Dots-Based Point of Care Test for Syphilis

    Science.gov (United States)

    Yang, Hao; Li, Ding; He, Rong; Guo, Qin; Wang, Kan; Zhang, Xueqing; Huang, Peng; Cui, Daxiang

    2010-05-01

    One-step lateral flow test is recommended as the first line screening of syphilis for primary healthcare settings in developing countries. However, it generally shows low sensitivity. We describe here the development of a novel fluorescent POC (Point Of Care) test method to be used for screening for syphilis. The method was designed to combine the rapidness of lateral flow test and sensitiveness of fluorescent method. 50 syphilis-positive specimens and 50 healthy specimens conformed by Treponema pallidum particle agglutination (TPPA) were tested with Quantum Dot-labeled and colloidal gold-labeled lateral flow test strips, respectively. The results showed that both sensitivity and specificity of the quantum dots-based method reached up to 100% (95% confidence interval [CI], 91-100%), while those of the colloidal gold-based method were 82% (95% CI, 68-91%) and 100% (95% CI, 91-100%), respectively. In addition, the naked-eye detection limit of quantum dot-based method could achieve 2 ng/ml of anti-TP47 polyclonal antibodies purified by affinity chromatography with TP47 antigen, which was tenfold higher than that of colloidal gold-based method. In conclusion, the quantum dots were found to be suitable for labels of lateral flow test strip. Its ease of use, sensitiveness and low cost make it well-suited for population-based on-the-site syphilis screening.

  20. HIV and syphilis testing preferences among men who have sex with men in South China: a qualitative analysis to inform sexual health services.

    Science.gov (United States)

    Bien, Cedric H; Muessig, Kathryn E; Lee, Ramon; Lo, Elaine J; Yang, Li Gang; Yang, Bin; Peeling, Rosanna W; Tucker, Joseph D

    2015-01-01

    Health services for men who have sex with men (MSM) are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences. MSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0. 35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants' decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes) compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities. Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues) settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research could further evaluate HIV/syphilis testing

  1. HIV and syphilis testing preferences among men who have sex with men in South China: a qualitative analysis to inform sexual health services.

    Directory of Open Access Journals (Sweden)

    Cedric H Bien

    Full Text Available Health services for men who have sex with men (MSM are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD testing programs among MSM, we collected descriptive data on MSM testing practices and preferences.MSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0.35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants' decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities.Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research could further evaluate HIV/syphilis

  2. HIV and Syphilis Testing Preferences among Men Who Have Sex with Men in South China: A Qualitative Analysis to Inform Sexual Health Services

    Science.gov (United States)

    Lee, Ramon; Lo, Elaine J.; Yang, Li Gang; Yang, Bin; Peeling, Rosanna W.; Tucker, Joseph D.

    2015-01-01

    Background Health services for men who have sex with men (MSM) are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences. Methods MSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0. Results 35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants’ decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes) compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities. Conclusion Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues) settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research

  3. Mother to Child Transmission of Syphilis in Pregnancy%妊娠梅毒的母婴传播

    Institute of Scientific and Technical Information of China (English)

    李新; 谭德友(通讯作者); 董巨浪; 卢伟; 陈志城

    2014-01-01

    The article was the pathogen, the transmission way, route of transmission of syphilis in pregnancy, incidence, infection rate, pregnancies, neonatal congenital syphilis syphilis diagnosis standard diagnostic criteria and principles of management and prevention .%文章就妊娠梅毒的病原体、传染方式、传播途径、发病率、感染率、妊娠者梅毒诊断标准、新生儿先天性梅毒诊断标准、处理原则及预防进行述及。

  4. 评价螺旋体乳胶快速反应实验检测梅毒血清的特异性和敏感性%Sensitivity and specificity of Diesse syphilis fast test in testing syphilis serum

    Institute of Scientific and Technical Information of China (English)

    晋红中; 王家璧; 王晓蜂; 邵燕玲; 何志新; 刘跃华; 洪少林

    2003-01-01

    Objective: To assess sensitivity and specificity of Diesse syphilis fast test(DSFT) in routine use, and compare it with rapid plasma reagin circle card test(RPR test), Treponema pallidum particle agglutination assay(TPHA), fluorescent treponemal antibody absorption test(FTA-ABS test). Methods: DSFT, RPR, TPHA, FTA-ABS were used to detect 500 cases of syphilis and normal senam. Results :Using FTA-ABS as gold standard, the sensitivity and specificity of DSFT were 98.6% (204/207), and 93.2%(273/293) ,respectirely(X2= 1.04, P > 0.05. Using TPHA as gold standard, the sensitivity and specifity of DSFT were 100% (223/223),99.6% (273/277), respectively(x2 = 0.04, P > 0.05). Condusion: The Diesse syphilis fast test in routine use has high sensitivity and specificity in testing syphilis.

  5. Syphilis and human experimentation from World War II to the present: a historical perspective and reflections on ethics.

    Science.gov (United States)

    Cuerda-Galindo, E; Sierra-Valenti, X; González-López, E; López-Muñoz, F

    2014-11-01

    Even after the Nuremberg code was published, research on syphilis often continued to fall far short of ethical standards. We review post-World War II research on this disease, focusing on the work carried out in Guatemala and Tuskegee. Over a thousand adults were deliberately inoculated with infectious material for syphilis, chancroid, and gonorrhea between 1946 and 1948 in Guatemala, and thousands of serologies were performed in individuals belonging to indigenous populations or sheltered in orphanages. The Tuskegee syphilis study, conducted by the US Public Health Service, took place between 1932 and 1972 with the aim of following the natural history of the disease when left untreated. The subjects belonged to a rural black population and the study was not halted when effective treatment for syphilis became available in 1945.

  6. Co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors in Kathmandu, Nepal

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    Ashish Chandra Shrestha

    2012-02-01

    Full Text Available Background: HIV, HBV, Syphilis and HCV share common modes of transmission. Objective: The study was aimed to determine the co-infection rate of HIV, HBV and Syphilis among HCV seropositive identified blood donors. Methods: The study was conducted on blood samples screened as HCV seropositive at Nepal Red Cross Society, Central Blood Transfusion Service, Kathmandu, Nepal. HCV seropositive samples were further tested for HIV, HBV and Syphilis. Results: Eight co-infections were observed in 139 HCV seropositives with total co-infection rate of 5.75% (95% CI = 2.52-11.03. Conclusion: Co-infection of HIV, HBV and Syphilis with HCV is prevalent in the healthy looking blood donors of Kathmandu, Nepal.

  7. 梅毒母婴传播的研究进展%Mother-to-child transmission of syphilis

    Institute of Scientific and Technical Information of China (English)

    王建; 龚向东; 吴敏智; 赵亮

    2016-01-01

    母婴传播是梅毒传播的重要途径,妊娠任何时期都可能发生梅毒的母婴传播.梅毒的母婴传播可以导致许多不良的妊娠后果,严重影响母婴健康,是一项严重的公共卫生和社会问题.梅毒的母婴传播与孕妇梅毒的分期、妊娠时期及是否治疗有关,特别是早期梅毒的母婴传播风险较高.随着梅毒发病率的增长,梅毒母婴传播的防控变得愈加重要,妊娠期梅毒的筛查和早期治疗可有效的阻断梅毒母婴传播.因此,了解梅毒母婴传播的流行病学、传播途径与传播风险及其影响因素等无疑会对其防控提供一个较好的指导途径.%Mother-to-child transmission (MTCT) is a major route of transmission of syphilis,and may occur at any time during pregnancy.MTCT of syphilis can lead to many adverse pregnancy outcomes,seriously affects maternal and infant health,and has been a severe public health and social problem.The risk of MTCT of syphilis is associated with stage of syphilis in pregnancy,stage of pregnancy,receiving or not receiving treatment,and is especially high in patients with early syphilis.With the growth of incidence of syphilis,the prevention for MTCT of syphilis has been becoming more and more important.Screening for and early treatment of syphilis in pregnancy can effectively block MTCT of syphilis.To learn the epidemiology,route,risk,and associated factors of MTCT of syphilis will undoubtedly facilitate the development of strategies for syphilis prevention and control.

  8. Magnitude of HIV and syphilis seroprevalence among pregnant women in Gondar, Northwest Ethiopia: a cross-sectional study

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    Melku M

    2015-06-01

    Full Text Available Mulugeta Melku,1 Asmarie Kebede,2 Zelalem Addis3 1Department of Hematology and Immuohematology, School of Biomedical and Laboratory Sciences, 2Department of Nursing, University of Gondar Teaching Hospital, 3Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Human immunodeficiency virus (HIV and syphilis are major public health problems in sub-Saharan Africa, causing numerous adverse pregnancy outcomes. The aim of study was to assess the magnitude of HIV and syphilis seroprevalence among pregnant women at University of Gondar Teaching Hospital. Method: The study was conducted between March and May, 2012. Sociodemographic data were collected through face-to-face interview. HIV1/2 was tested following current national HIV1/2 testing algorithm. Syphilis infection was also tested using the rapid plasm reagin test for screening and Treponema pallidum hemagglutination as a confirmatory test. Both bivariate and multivariate analysis were used to identify factors associated with HIV and syphilis seroprevalence from selected sociodemographic variables. Results: Of 300 women, 31 (10.33%, eleven (3.7%, and three (1% were seroreactive for HIV, syphilis, and HIV–syphilis coinfection, respectively. High seroprevalence of HIV was found in women ages 25–30 years (13.4%, and women whose husbands attended primary school (19.7%. Syphilis was high in women occupationally housewives (15.2% and whose husbands were illiterate (11.5%. HIV was associated with husband illiteracy (AOR [adjusted odds ratio] of 4.13, 95% CI [confidence interval] [1.01, 16.95] and primary educational level of husbands (AOR [95% CI] =3.83 [1.50, 9.90], whereas syphilis was associated with illiteracy of husband (AOR [95% CI] =7.25 [1.74, 30.30]. Conclusion: Seroprevalence of HIV and syphilis was high. Low husband educational status was a risk factor for HIV and syphilis

  9. RPR与TPPA检测对梅毒诊断及疗效的价值分析%Value of RPR and TPPA testing for syphilis diagnosis and curative effect

    Institute of Scientific and Technical Information of China (English)

    吴劲松

    2011-01-01

    OBJECTIVE To evaluate the RPR (Rapid plasma reagin circle test) and TPPA (treponema pallidum Antibody particles agglutinate experiment) detection antibody particles of syphilis diagnosis and curative effect of value. METHODS A total of 300 cases of syphilis, 100 cases of non-syphilis patients and 50 case of normal with RPR on TPPA joint test and analysis were performed. RESULTS Among the 172 cases of syphilis of phase Ⅰ with RPR and TPPA, the positive rates were 83.1% and 100%, respectively, in the 117 cases of syphilis on the phase Ⅱ with RPR and TPPA, the positive rates were 100.0% and 100.0%, respectively, 11 cases of syphilis of preclinical with RPR and TPPA, the positive rates were 84.6% and 100.0%, respectively, 100 cases of nonsyphilis patients with the positive rates of the RPR and TPPA respectively 3.0% and 0, 50 cases of normal with RPR and TPPA positive for 0 all. CONCLUSION The RPR and TPPA syphilis diagnosis is fast and effective method on diagnosis of syphilis, TPPA, as confirmed diagnose test in the specificity and sensitivity is significantly higher than RPR, but RPR is significantly better than TPPA in clinical therapeutic effect observation.%目的 评估梅毒血浆反应素快速试验(RPR)与梅毒螺旋体明胶颗粒凝集试验(TPPA)检测对梅毒诊断和疗效的价值分析.方法 对300例梅毒患者、100例非梅毒患者以及50例正常人进行RPR与TPPA进行联合检测并进行分析.结果 172例梅毒Ⅰ期患者RPR和TPPA的阳性率分别为83.1%和100.0%,117例梅毒Ⅱ期RPR和TPPA的阳性率均为100.0%,11例潜伏期梅毒的RPR和TPPA的阳性率分别为84.6%和100.0%,100例非梅毒患者的RPR和TPPA的阳性率分别为3.0%和0;50例健康体检者的RPR和TPPA的阳性率均为0.结论 RPR和TPPA都是梅毒诊断快速有效的方法,但是TPPA作为确诊试验特异性和灵敏度均明显要高于RPR,但在对疗效观察价值上RPR则又明显好于TPPA.

  10. Pros and Cons of serological testing in syphilis diagnosis and follow up

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    Gino Ciarrocchi

    2010-03-01

    Full Text Available Since a proper diagnosis of syphilis is often difficult due to the wide variability of both clinical picture and laboratory test results, early recognition of infection caused by Treponema pallidum is crucial for a timely and effective treatment. In most cases, definitive diagnosis relies upon serological testing. A screening ELISA test, coupled with a quantitative RPR test and specific IgM antibodies detection, is currently regarded as the basic diagnostic procedure. In addition, a quantitative particle agglutination TP-PA test, FTA-abs IgG test and, eventually, a western-blot IgG and IgM test, allow to achieve a whole serological pattern for each patient at the time of first diagnosis. In this study, a group of serum samples (n=107 and cerebro-spinal fluid (n=3 were retrospectively analyzed using the above mentioned tests. A population of 19 patients whose clinical picture was unremarkable for syphilis, showed border-line values at screening and negative results on confirmation tests. Thirty-three out of 91 luetic patients were diagnosed as primary or early secondary syphilis, 36 as latent syphilis, 3 as neurosyphilis, and 3 were neonates with passive specific immunization. Quantitative RPR test and detection of specific IgM antibodies exhibited extremely high values in all 33 primary syphilis patients; a whole positive luetic pattern was also obtained by confirmation tests. Searching for IgM antibodies, a capture elisa test compared with a single device rapid elisa test showed an overall concordance of 98.1%. In luetic patients other than primary syphilis, quantitative RPR test and detection of specific IgM antibodies provided less relevant values and a low prevalence pattern, whereas TP-PA and FTA-abs tests showed persistent positives results. In the follow up of 19 initially treated patients, quantitative RPR values and specific IgM antibodies index showed a slow, progressive decrease until negative. Conclusion: a comprehensive initial

  11. Oral manifestations of syphilis Manifestações orais da sífilis

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    Jair Carneiro Leão

    2006-04-01

    Full Text Available The past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in Eastern Europe, particularly the UK, and in the US. Although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. Significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carcinoma are associated with tertiary disease. Since the prevalence of infective syphilis in heterosexuals has been increasing, there has now been a gradual rise in the number of children born with congenital syphilis. Consequently, the congenital disease gives rise to dental anomalies as well as bone, skin, and neurological anomalies of the face. The aim of this report is to review syphilis-related oral lesions, as well as to summarize the relations between human immunodeficiency virus (HIV and syphilis.A última década tem mostrado um aumento importante na prevalência de sífilis infecciosa nos países desenvolvidos e epidemias surgiram na Europa ocidental, particularmente no Reino Unido, bem como nos EUA. Embora as manifestações orais da sífilis sejam mais freqüentes na fase secundária da doença, todos os estágios podem apresentar lesões orais. A fase terciária da doença está associada a lesões orais significativas tais como destruição óssea associada à goma sifilítica e uma possível predisposição ao carcinoma espinocelular. Com o aumento da prevalência da sífilis infecciosa, há também um aumento gradual de crianças nascidas com sífilis congênita. Consequentemente esta patologia leva a anomalias faciais de ordem dentária, óssea, dermatológica e neurológica. O objetivo deste artigo é revisar as lesões orais associadas á sífilis, bem como discorrer brevemente sobre a relação entre a infecção pelo vírus da imunodefici

  12. [Tertiary syphilis diagnosed in a psychiatric unit in Buenos Aires, XXI century].

    Science.gov (United States)

    Cestaro, Omar A; Calicchio, Ada D; Loidl, Fabián; Presas, Lina

    2012-01-01

    It is a common belief that syphilis, since its effective treatment, is eradicated. However, because of failure prevention and control it is still present. Therefore, we describe what happened in our service with a young patient who was admitted with a presumptive diagnosis of delusional syndrome with a history of multiple symptoms and signs that led him to wander around different specialties in many hospitals. Semiology led us to think of neurosyphilis which was confirmed by laboratory tests on blood and cerebrospinal fluid. Due was then applied in addition to psychiatric treatment for syphilis, but despite this, the patient had a torpid evolution given the lateness of his picture. In this paper we wish to make a warning to doctors about the need to consider when framing neurosyphilis differential diagnosis and thus avoid the progression of the disease.

  13. Type of female sex worker and other risk factors of syphilis

    Directory of Open Access Journals (Sweden)

    Roselinda Roselinda

    2016-03-01

    Full Text Available AbstrakLatar belakang: Sifilis termasuk salah satu dari penyakit infeksi menular seksual kronis disebabkankuman Treponema pallidum yang dapat menyebabkan kecacatan pada penderita dan anak yang dilahirkan.Tujuan analisis ini adalah untuk melihat hubungan tipe dan lama kerja sebagai Wanita Pekerja Seks(WPS dengan kejadian penyakit sifilis di 7 kota di Indonesia.Metode: Data dari Survei WPS menggunakan kuesioner terstruktur di 7 kota (Kupang, Samarinda,Pontianak, Yogyakarta, Timika, Makassar dan Tangerang di Indonesia tahun 2007, desain potong lintangdan responden dipilih secara cluster random sampling dari WPS langsung dan tidak langsung yangmemenuhi kriteria definisi operasional. Diagnosa Sifilis ditegakkan dengan pemeriksaan laboratoriumRapid Plasma Reagent (RPR dan Treponema pallidum Haemaglutination Assay (TPHA.Hasil: Sebanyak 1750 responden ikut dalam penelitian dan 12.2% terindikasi sifilis. Kota Makassar mempunyaiprevalensi yang tertinggi sebesar 55,2%. WPS yang berlokasi di luar pulau Jawa memiliki risiko terinfeksi sifilis3,16 kali lebih tinggi dibandingkan dengan WPS yang berlokasi dipulau Jawa [risiko relatif suaian (RRa = 3,16 ;P= 0,000]. Tipe WPS tidak langsung memiliki risiko 46% lebih banyak untuk terinfeksi sifilis dibandingkan denganWPS langsung (RRa = 1,46 ; 95%; P = 0,002, sedangkan WPS yang mencari pengobatan ke dokter memiliki risiko58% lebih besar dibandingkan yang berobat ke sarana kesehatan langsung (RRa = 1,58; P = 0.006.Kesimpulan: Lokasi WPS yang berada di luar pulau Jawa, tipe WPS tidak langsung memiliki risiko lebihtinggi untuk terinfeksi penyakit sifilis. Wanita pekerja seks yang mencari pengobatan ke dokter menyebabkanpenyakit terindikasi lebih tinggi dibandingkan jika berobat ke sarana pelayanan kesehatan lainnya. (HealthScience Journal of Indonesia 2015;6:132-6Kata kunci: sifilis, wanita pekerja seks, Indonesia AbstractBackground: Syphilis is one of the chronicle sexual transmission diseases which is caused by

  14. [Staging of scientific facts in syphilis education. "The Shipwrecked" in the Berlin German Theater (1913)].

    Science.gov (United States)

    Lazardzig, J

    2002-04-01

    The "Deutsche Gesellschaft zur Bekämpfung der Geschlechtskrankheiten" (DGBG) used plays as a means of public education. The play "Damaged Goods" (Les Avariés) by the French dramatist Eugéne Brieux (1858-1932) was used extensively for this purpose in Germany between 1910 and 1920. By proliferating a specific image of both the medical profession and the syphilis, it helped established the self-confidence of the then new dermatological discipline. The teaching of Alfred Fournier (1832-1914) provided the medical background for the play. In "The Inheritance of Syphilis" (1882) Fournier had laid the dramatic framework for Brieux' play. Analyzing the Berlin premiere of "Damaged Goods" on June 25 1913 in the German Theatre/Berlin, the interplay between scientific facts and theatrical license and their diverse influences on the public becomes obvious.

  15. Congenital Syphilis Presenting with Only Nephrotic Syndrome: Reemergence of a Forgotten Disease.

    Science.gov (United States)

    Kim, Yun Hee; Song, Ji Ho; Kim, Chan Jong; Yang, Eun Mi

    2017-08-01

    Syphilis infection has re-emerged after years of declining incidence. The prevalence of congenital syphilis (CS) has increased in Korea and other countries during the last few decades. Untreated infants develop symptoms such as rhinorrhea, anemia, jaundice, cutaneous lesions, hepatosplenomegaly, and pseudoparalysis within weeks or months. Significant renal disease is uncommon in CS, and clinical renal involvement varies from mild transient proteinuria to frank nephrosis. We report a 2-month-old infant with CS who presented with only nephrotic syndrome (NS). The previously healthy infant presented with NS and showed no other syphilitic manifestations. Remission of the NS was achieved with adequate penicillin treatment. No recurrence of proteinuria was observed during the 1 year of follow-up. Although rare, this long forgotten disease continues to affect pregnant women, resulting in prenatal or postnatal mortality. We still consider the possibility of syphilitic nephropathy and therefore serologic testing for congenital NS. © 2017 The Korean Academy of Medical Sciences.

  16. Panuveitis as a manifestation of ocular syphilis leading to HIV diagnosis

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    Jay Kumar Chhablani

    2010-01-01

    Full Text Available Syphilis is a rare cause of panuveitis. We present the case of a 33-year-old man who presented with diminution of vision of three months duration in his left eye (OS, without any other systemic illness. Ophthalmic examination showed features of pauveitis with dense vitreous exudates, disc pallor and sheathing of vessels on fundoscopy. A diagnosis of probable endogenous endophthalmitis was made and vitreous tap performed. Vitreous biopsy showed no growth of fungus or bacteria. Rapid plasma reagin (RPR and Treponema pallidum hemagglutination (TPHA test were positive. Enzyme-Linked Immuno Sorbent Assay (ELISA and Western Blot test were then performed, which revealed concurrent HIV infection. The patient improved dramatically with intravenous penicillin therapy. HIV positive patients may present with panuveitis secondary to ocular syphilis, as the only presenting feature in HIV positive patient in absence of any other systemic features.

  17. Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acute posterior multifocal placoid epitheliopathy

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    Jong Hoon Park

    2013-01-01

    Full Text Available A 55-year-old female presented with bilateral progressive retinal vasculitis. She was on systemic and intravitreal steroids on the basis of uveitis work-up result (negative result including rapid plasma reagin, but her visual acuity continued to deteriorate to light perception only. Ocular examination showed retinal vasculitis, multiple yellow placoid lesions and severe macula edema in both eyes. Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid. Ocular syphilis was diagnosed. And intravenous penicillin G resulted in rapid resolution of vasculitis and macular edema. To avoid delay in the diagnosis of ocular syphilis, high index of suspicion and repeating serological tests (including both treponemal and non-treponemal tests are warranted.

  18. Influence of mother VDRL titers on the outcome of newborns with congenital syphilis.

    Science.gov (United States)

    Vasquez-Manzanilla, Omira; Dickson-Gonzalez, Sonia M; Salas, José G; Teguedor, Luis E; Rodriguez-Morales, Alfonso J

    2008-04-01

    Congenital syphilis still represents a significant public health problem worldwide, and particularly in developing countries. Despite years of research on different clinical and immunological features, many physiopathological aspects still lacks of knowledge, one of them the role of immune response against Treponema pallidum by infected mothers on the birth outcomes, e.g. birthweight. In this study we analyzed if the mother VDRL titers were significantly associated with the birthweight of newborns with congenital syphilis. We observed a highly significant association between both variables, finding at the linear regression that with higher mother VDRL titers, the newborn birthweight was lower (p=0.0345). We identified that higher VDRL titers are associated with lower birth weights, although the physiopathological reasons to explain this still remains unclear.

  19. [Circulating anticoagulant and focal liver lesions associated to rich clinical expression in the secondary syphilis].

    Science.gov (United States)

    Ortega, S Suárez; Brito, J López; Lémes, H Mendoza; Socorro, C R Hernández; Sánchez, E Melado; Martínez, J Delgardo

    2007-07-01

    A 37-year-old male was admitted at our hospital for evaluation of clinical presentation of 8 weeks evolution of malaise, fever, sore throat and nose, arthralgias, holocraneal headache, photophobia and nausea. With the shower he noticed spots in palms of hands and plants of feet. A year before had noticed painless erosions in foreskin. He had risk factors for sexual transmission diseases. The analytical showed criteria of dissociated colestasis, nephrotic syndrome, presence of circulating anticoagulant, and positivity for the reaginic and specific serological syphilis. In an abdominal ultrasonic multiple, focal and small liver lesions were watched. With two weeks of treatment with penicillin the clinical manifestations reverted, and the analytical and of image was watched bettering, which dissapeared at the three months of treatment. We comment the rich clinical expression and the peculiarities of presenting focal liver lesions and circulating anticoagulant, in a case of secondary syphilis.

  20. Incidence of syphilis seroconversion among HIV-infected persons in Asia: results from the TREAT Asia HIV Observational Database

    Science.gov (United States)

    Ahn, Jin Young; Boettiger, David; Kiertiburanakul, Sasisopin; Merati, Tuti Parwati; Huy, Bui Vu; Wong, Wing Wai; Ditangco, Rossana; Lee, Man Po; Oka, Shinichi; Durier, Nicolas; Choi, Jun Yong

    2016-01-01

    Introduction Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Methods Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. Results We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY). Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, p<0.001). Among MSM, the incidence rate ratio (IRR) for every additional year from 2009 was 1.19 (p=0.051). MSM status (IRR 3.48, 95% confidence interval (CI) 1.88–6.47), past syphilis diagnosis (IRR 5.15, 95% CI 3.69–7.17) and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706–0.997) were significantly associated with syphilis seroconversion. Conclusions We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population. PMID:27774955

  1. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis.

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    Jiabi Qin

    Full Text Available To estimate probability of adverse pregnancy outcomes (APOs among women with and without syphilis through a systematic review of published literatures.Chinese and English literatures were searched for studies assessing pregnancy outcomes in the presence of maternal syphilis through August 2013. The prevalence estimates were summarized and analyzed by meta-analysis. Fifty-four literatures involving 11398 syphilitic women and 43342 non-syphilitic women were included from 4187 records initially found. Among untreated mothers with syphilis, pooled estimates were 76.8% for all APOs, 36.0% for congenital syphilis, 23.2% for preterm, 23.4% for low birth weight, 26.4% for stillbirth or fetal loss, 14.9% for miscarriage and 16.2% for neonatal deaths. Among syphilitic mother receiving treatment only in the late trimester (>28 weeks, pooled estimates were 64.4% for APOs, 40.6% for congenital syphilis, 17.6% for preterm, 12.4% for low birth weight, and 21.3% for stillbirth or fetal loss. Among syphilitic mothers with high titers (≥1∶8, pooled estimates were 42.8% for all APOs, 25.8% for congenital syphilis, 15.1% for preterm, 9.4% for low birth weight, 14.6% for stillbirth or fetal loss and 16.0% for neonatal deaths. Among non-syphilitic mothers, the pooled estimates were 13.7% for all APOs, 7.2% for preterm birth, 4.5% for low birth weight, 3.7% for stillbirth or fetal loss, 2.3% for miscarriage and 2.0% for neonatal death. Begg's rank correlation test indicated little evidence of publication bias (P>0.10. Substantial heterogeneity was found across studies in the estimates of all adverse outcomes for both women with syphilis (I2 = 93.9%; P<0.0001 and women without syphilis (I2 = 94.8%; P<0.0001.Syphilis continues to be an important cause of substantial perinatal morbidity and mortality, which reminds that policy-makers charged with resource allocation that the elimination of mother-to-child transmission of syphilis is a public health priority.

  2. Incidence of syphilis seroconversion among HIV-infected persons in Asia: results from the TREAT Asia HIV Observational Database

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    Jin Young Ahn

    2016-10-01

    Full Text Available Introduction: Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Methods: Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. Results: We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY. Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, p<0.001. Among MSM, the incidence rate ratio (IRR for every additional year from 2009 was 1.19 (p=0.051. MSM status (IRR 3.48, 95% confidence interval (CI 1.88–6.47, past syphilis diagnosis (IRR 5.15, 95% CI 3.69–7.17 and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706–0.997 were significantly associated with syphilis seroconversion. Conclusions: We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population.

  3. Hepatitis B, HIV, and Syphilis Seroprevalence in Pregnant Women and Blood Donors in Cameroon

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    Jodie Dionne-Odom

    2016-01-01

    Full Text Available Objectives. We estimated seroprevalence and correlates of selected infections in pregnant women and blood donors in a resource-limited setting. Methods. We performed a cross-sectional analysis of laboratory seroprevalence data from pregnant women and voluntary blood donors from facilities in Cameroon in 2014. Rapid tests were performed to detect hepatitis B surface antigen, syphilis treponemal antibodies, and HIV-1/2 antibodies. Blood donations were also tested for hepatitis C and malaria. Results. The seroprevalence rates and ranges among 7069 pregnant women were hepatitis B 4.4% (1.1–9.6%, HIV 6% (3.0–10.2%, and syphilis 1.7% (1.3–3.8% with significant variability among the sites. Correlates of infection in pregnancy in adjusted regression models included urban residence for hepatitis B (aOR 2.9, CI 1.6–5.4 and HIV (aOR 3.5, CI 1.9–6.7. Blood donor seroprevalence rates and ranges were hepatitis B 6.8% (5.0–8.8%, HIV 2.2% (1.4–2.8%, syphilis 4% (3.3–4.5%, malaria 1.9%, and hepatitis C 1.7% (0.5–2.5%. Conclusions. Hepatitis B, HIV, and syphilis infections are common among pregnant women and blood donors in Cameroon with higher rates in urban areas. Future interventions to reduce vertical transmission should include universal screening for these infections early in pregnancy and provision of effective prevention tools including the birth dose of univalent hepatitis B vaccine.

  4. Evaluation of the recombinant protein TpF1 of Treponema pallidum for serodiagnosis of syphilis.

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    Jiang, Chuanhao; Zhao, Feijun; Xiao, Jinhong; Zeng, Tiebing; Yu, Jian; Ma, Xiaohua; Wu, Haiying; Wu, Yimou

    2013-10-01

    Syphilis is a chronic infection caused by Treponema pallidum subsp. pallidum, and diagnosis with sensitive and specific methods is a challenging process that is important for its prevention and treatment. In the present study, we established a recombinant protein TpF1-based indirect immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and a Western blot assay for human and rabbit sera. The 20-kDa recombinant protein TpF1 was detected by Western blotting performed with sera from rabbits immunized with recombinant TpF1 and infected with the T. pallidum Nichols strain and T. pallidum clinical isolates but was not detected by Western blotting with sera from uninfected rabbits. The sensitivity of the recombinant protein was determined by screening sera from individuals with primary, secondary, latent, and congenital syphilis (n = 82). The specificity of the recombinant protein was determined by screening sera from uninfected controls (n = 30) and individuals with potentially cross-reactive infections, including Lyme disease (n = 30) and leptospirosis (n = 5). The sensitivities of TpF1-based ELISAs were 93.3%, 100%, 100%, and 100% for primary, secondary, latent, and congenital syphilis, respectively, and the specificities were all 100% for sera from uninfected controls and individuals with potentially cross-reactive infections. In Western blot assays, the sensitivities and specificities of TpF1 for human sera were all 100%. The reactivities of TpF1 with syphilitic sera were proportional to the titers of the T. pallidum particle agglutination (TPPA) assay. These data indicate that the recombinant protein TpF1 is a highly immunogenic protein in human and rabbit infections and a promising marker for the screening of syphilis.

  5. Oral syphilis: report of three cases and characterization of the inflammatory cells.

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    Strieder, Luciana Rocha; León, Jorge Esquiche; Carvalho, Yasmin Rodarte; Kaminagakura, Estela

    2015-04-01

    Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Antibiotic Desensitization Therapy in Secondary Syphilis and Listeria Infection: Case Reports and Review of Desensitization Therapy

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    Magpantay, Gil; Madar, Cristian S; Hsue, Gunther; Belnap, Conrad

    2011-01-01

    Two adult cases, one of secondary syphilis and one of Listeria monocytogenes bacteremia, in which antibiotic desensitization therapy was utilized to assist treatment of active infection in the face of severe penicillin allergy. Clinical considerations are discussed that led to the decision to employ a formal desensitization procedure. Antibiotic desensitization protocols can facilitate optimal and safe antibiotic therapy in the appropriate clinical setting. PMID:22187514

  7. Comparisons of fully automated syphilis tests with conventional VDRL and FTA-ABS tests.

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    Choi, Seung Jun; Park, Yongjung; Lee, Eun Young; Kim, Sinyoung; Kim, Hyon-Suk

    2013-06-01

    Serologic tests are widely used for the diagnosis of syphilis. However, conventional methods require well-trained technicians to produce reliable results. We compared automated nontreponemal and treponemal tests with conventional methods. The HiSens Auto Rapid Plasma Reagin (AutoRPR) and Treponema Pallidum particle agglutination (AutoTPPA) tests, which utilize latex turbidimetric immunoassay, were assessed. A total of 504 sera were assayed by AutoRPR, AutoTPPA, conventional VDRL and FTA-ABS. Among them, 250 samples were also tested by conventional TPPA. The concordance rate between the results of VDRL and AutoRPR was 67.5%, and 164 discrepant cases were all VDRL reactive but AutoRPR negative. In the 164 cases, 133 showed FTA-ABS reactivity. Medical records of 106 among the 133 cases were reviewed, and 82 among 106 specimens were found to be collected from patients already treated for syphilis. The concordance rate between the results of AutoTPPA and FTA-ABS was 97.8%. The results of conventional TPPA and AutoTPPA for 250 samples were concordant in 241 cases (96.4%). AutoRPR showed higher specificity than that of VDRL, while VDRL demonstrated higher sensitivity than that of AutoRPR regardless of whether the patients had been already treated for syphilis or not. Both FTA-ABS and AutoTPPA showed high sensitivities and specificities greater than 98.0%. Automated RPR and TPPA tests could be alternatives to conventional syphilis tests, and AutoRPR would be particularly suitable in treatment monitoring, since results by AutoRPR in cases after treatment became negative more rapidly than by VDRL. Copyright © 2013. Published by Elsevier Inc.

  8. BIOCHEMICAL STUDIES ON SO-CALLED SYPHILIS ANTIGEN.

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    Noguchi, H; Bronfenbrenner, J

    1911-01-01

    Noguchi has repeatedly done before) that the antigen should be selected from the aceton-insoluble fractions. Iodine Value in Relation to Antigenic Value.-Speaking generally of the aceton-insoluble fraction, a high antigenic value is associated with a high iodine value of lipoids obtained from the liver and heart. This rule does not, however, apply to the corresponding fraction from the brain. Standard Antigen.-The preparation of a standard antigen for Noguchi's method for the diagnosis of syphilis is given just before the summary. The directions will enable one to make a stock solution, from which, at any time, a suitable antigenic emulsion may be obtained.

  9. The syphilis epidemics in Hungary 1985-2004, before entering the European Union.

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    Talha, Elyas; Nagy, Károly; Horváth, Attila

    2013-09-01

    In the decade prior to the turn of the millennium, great interest was raised, and rightly so, by the STD (syphilis and HIV/AIDS) epidemic that developed in the Eastern-Central European Region. Its coincidence with the far-reaching political and economic changes that took place at that time suggested a link between the two events.Hungary, where these infections had had low incidence before the period investigated, also experienced an increase in STD incidence. The trend in syphilis infection during the 20 years between 1985-2004, that preceded the turn of the millennium and when finally Hungary joined the European Union, have been analyzed. Due to the nature of venereological epidemiological surveillance in Hungary, syphilis prevalence data are appropriate for further analysis from socio-demographic aspects. Behavioural changes underlying the specific features of the epidemics in Hungary had developed several years earlier and cannot be linked to the political and economic changes that started in the early 90s. The only exception is the phenomenon of growing migration that appeared simultaneously with the political changes and had a decisive impact on the spread and level of infection in some areas in the country. As shown by our data, trends seen in specific demographic groups (females, rural population) preceded the suddenly occurring political changes by about 15 years.

  10. Co-infection of Primary Syphilis and HIV after a Single Exposure - a Case Report

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    Geleki Stamatina

    2015-09-01

    Full Text Available Human immunodeficiency virus type 1- infected patients with syphilis are among the most important transmitters of HIV-1 infection due to biological effects of genital ulcerations, and aggravation due to their continued risky behavior. The association between primary syphilis and acute HIV-1 co-infection is not well documented, and reports on isolated cases are raising special interest and indicate that this double primary co-infection may occur. We present a case of a 31-year-old man with no past medical history who presented with fever, papular rash on the face which lasted for a few days, and a single genital ulcer. He was diagnosed with primary syphilis and primary HIV-1 infection after a single exposure with an infected female sex worker. Male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. However, high prevalence of sexually transmitted diseases among female sex workers contributed to high HIV transmission probability, as in our case.

  11. The trade-off between accuracy and accessibility of syphilis screening assays.

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    Pieter W Smit

    Full Text Available The availability of rapid and sensitive methods to diagnose syphilis facilitates screening of pregnant women, which is one of the most cost-effective health interventions available. We have evaluated two screening methods in Tanzania: an enzyme immunoassay (EIA, and a point-of-care test (POCT. We evaluated the performance of each test against the Treponema pallidum particle agglutination assay (TPPA as the reference method, and the accessibility of testing in a rural district of Tanzania. The POCT was performed in the clinic on whole blood, while the other assays were performed on plasma in the laboratory. Samples were also tested by the rapid plasma Reagin (RPR test. With TPPA as reference assay, the sensitivity and specificity of EIA were 95.3% and 97.8%, and of the POCT were 59.6% and 99.4% respectively. The sensitivity of the POCT and EIA for active syphilis cases (TPPA positive and RPR titer ≥ 1/8 were 82% and 100% respectively. Only 15% of antenatal clinic attenders in this district visited a health facility with a laboratory capable of performing the EIA. Although it is less sensitive than EIA, its greater accessibility, and the fact that treatment can be given on the same day, means that the use of POCT would result in a higher proportion of women with syphilis receiving treatment than with the EIA in this district of Tanzania.

  12. The Trade-Off between Accuracy and Accessibility of Syphilis Screening Assays

    Science.gov (United States)

    Smit, Pieter W.; Mabey, David; Changalucha, John; Mngara, Julius; Clark, Benjamin; Andreasen, Aura; Todd, Jim; Urassa, Mark; Zaba, Basia; Peeling, Rosanna W.

    2013-01-01

    The availability of rapid and sensitive methods to diagnose syphilis facilitates screening of pregnant women, which is one of the most cost-effective health interventions available. We have evaluated two screening methods in Tanzania: an enzyme immunoassay (EIA), and a point-of-care test (POCT). We evaluated the performance of each test against the Treponema pallidum particle agglutination assay (TPPA) as the reference method, and the accessibility of testing in a rural district of Tanzania. The POCT was performed in the clinic on whole blood, while the other assays were performed on plasma in the laboratory. Samples were also tested by the rapid plasma Reagin (RPR) test. With TPPA as reference assay, the sensitivity and specificity of EIA were 95.3% and 97.8%, and of the POCT were 59.6% and 99.4% respectively. The sensitivity of the POCT and EIA for active syphilis cases (TPPA positive and RPR titer ≥1/8) were 82% and 100% respectively. Only 15% of antenatal clinic attenders in this district visited a health facility with a laboratory capable of performing the EIA. Although it is less sensitive than EIA, its greater accessibility, and the fact that treatment can be given on the same day, means that the use of POCT would result in a higher proportion of women with syphilis receiving treatment than with the EIA in this district of Tanzania. PMID:24066175

  13. Population Dependency of Measles, Syphilis, and Amebiasis in Japan and Community Evolution.

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    Yoshikura, Hiroshi; Takeuchi, Fumihiko

    2017-05-24

    The population dependency of measles, syphilis, and amebiasis was expressed as P = kN(m), where P, N, and m were number of patients, population size, and a constant (~2 for measles, and 1.3~1.4 for syphilis and amebiasis), respectively. The population size dependency emerged only when conditions other than population size, such as infant mortality, hygienic condition, vaccination practices, and others, improved to the same level in all the prefectures in Japan. The formation of prefectures and municipalities was well simulated by the random coin toss assuming that people are attracted to a community with a probability proportional to the number of the residents to the 1.3rd power. When the number of inflow population was plotted against the number of the resident population in a prefecture, or when the number of coins that were added in a round was plotted against the number of coins that were present before the coin toss, the plots fell on a straight line with the slope ~1.3, which was almost the same as the slope obtained when the number of cases of syphilis or amebiasis was plotted against the population size.

  14. Recombinant antigen-based immuno-slot blot method for serodiagnosis of syphilis

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    N.S. Sato

    2004-07-01

    Full Text Available Three recombinant antigens of Treponema pallidum Nichols strain were fused with GST, cloned and expressed in Escherichia coli, resulting in high levels of GST-rTp47 and GST-rTp17 expression, and supplementation with arginine tRNA for the AGR codon was needed to obtain GST-rTp15 overexpression. Purified fusion protein yields were 1.9, 1.7 and 5.3 mg/l of cell culture for GST-rTp47, GST-rTp17 and GST-rTp15, respectively. The identities of the antigens obtained were confirmed by automated DNA sequencing using ABI Prism 310 and peptide mapping by Finningan LC/MS. These recombinant antigens were evaluated by immuno-slot blot techniques applied to 137 serum samples from patients with a clinical and laboratory diagnosis of syphilis (61 samples, from healthy blood donors (50 samples, individuals with sexually transmitted disease other than syphilis (3 samples, and from individuals with other spirochetal diseases such as Lyme disease (20 samples and leptospirosis (3 samples. The assay had sensitivity of 95.1% (95% CI, 86.1 to 98.7% and a specificity of 94.7% (95% CI, 87.0 to 98.7%; a stronger reactivity was observed with fraction rTp17. The immunoreactivity results showed that fusion recombinant antigens based-immuno-slot blot techniques are suitable for use in diagnostic assays for syphilis.

  15. Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia.

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    Lauc, Tomislav; Fornai, Cinzia; Premužić, Zrinka; Vodanović, Marin; Weber, Gerhard W; Mašić, Boris; Rajić Šikanjić, Petra

    2015-10-01

    To analyse the dental remains of an individual with signs of congenital syphilis by using macroscopic observation, CBCT and micro-CT images, and the analysis of the enamel thickness. Anthropological analysis of human skeletal remains from the 16th century archaeological site Park Grič in Zagreb, Croatia discovered a female, 17-20 years old at the time of death, with dental signs supportive of congenital syphilis: mulberry molars and canine defects, as well as non-specific hypoplastic changes on incisors. The focus of the analysis was on three aspects: gross morphology, hypoplastic defects of the molars, canines and incisors, as well as enamel thickness of the upper first and second molars. The observed morphology of the first molars corresponds to the typical aspect of mulberry molars, while that of the canines is characterised by hypomineralisation. Hypoplastic grooves were observed on the incisal edges of all incisors. The enamel of the first molars is underdeveloped while in the second molars a thick-enamelled condition is observed. Our observations for the dental and skeletal evidence are supportive to a diagnosis of congenital syphilis for this specimen from XVI century Croatia. The use of CT imaging helped documenting the diagnostic features and quantifying the effect of the dental stigmata on first molars. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Response of HIV-infected patients with syphilis to therapy with penicillin or intravenous ceftriaxone

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    Spornraft-Ragaller P

    2011-02-01

    Full Text Available Abstract Background Ceftriaxone is commonly used as an alternative antibiotic drug in treating syphilis but clinical data on its efficacy are limited. Objective: To evaluate the response of HIV-infected patients with active syphilis to treatment with penicillin or ceftriaxone. Methods A retrospective study involving 24 consecutive patients with a positive Veneral Disease Research Laboratory test (VDRL and at least one specific treponemal test. 12 patients were treated with different regimens of high-dose penicillin G for at least 2 weeks. Another 12 patients were treated with ceftriaxone 1-2 g per day intravenously for 10-21 days. Results After a median follow up of 18,3 months all patients of the penicillin-treated group and 11 of 12 ceftriaxone-treated patients showed a ≥ 4-fold decline in VDRL-titers; 91% of them already within 6 months after therapy. Conclusion Our serological data demonstrate a comparable efficacy of currently recommened penicillin and ceftriaxone treatment regimens for active syphilis in HIV-infected patients.

  17. Syphilis and prostitution in the socio-medical geographies of Turkey's early republican provinces.

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    Evered, Kyle T; Evered, Emine Ö

    2012-05-01

    During and after the Ottoman Empire's collapse, Turkey's fledgling public health and social services ministry sought to deal with the increasing prevalence of syphilis-especially in its rural communities. This article examines the emergence of state-led information collection in Turkey during the 1920s and early 1930s and the anti-syphilis campaigns that resulted, and thus explores how the state created a new medical and moral order surrounding its citizens' sexualities that came to focus its gaze upon prostitution. Utilizing information from official primary sources, we analyze this transformation as part of a broader process of medicalization and state expansion that made syphilis a subject for state regulation. Within this context, moral pronouncements regarding the disease, traditional medicine, and prostitution and the potential benefits of regulated brothels were reframed, represented, and dispersed as directives for public health policy. Through this research, we assess how field-based surveys contributed ultimately to republican regimes of regulating sex work that still persist.

  18. Risk of syphilis in STI clinic patients: a cross‐sectional study of 11 500 cases in Guangxi, China

    Science.gov (United States)

    Wong, Susan P Y; Yin, Yue‐Ping; Gao, Xing; Wei, Wan‐Hui; Shi, Mei‐Qin; Huang, Pei‐Yong; Wang, Hong; Chen, Qiang; Liu, MuSang; Tucker, Joseph D; Chen, Xiang‐Sheng; Cohen, Myron S

    2007-01-01

    Objective To measure prevalence of syphilis among the STI clinic population in Guangxi, China, and to assess the socioeconomic and behavioural characteristics associated with the infection. Methods We undertook a cross‐sectional survey and syphilis and HIV serologic testing among 11 473 patients attending 14 community and hospital‐based dermatovenereal clinics across eight cities in Guangxi between December 2004 and February 2006. Results 1297 (11.9%) patients demonstrated positive toludine red unheated serum test and Treponema pallidum particle agglutination results with serologic testing. A total of 58% (752) of seropositive subjects presented with a genital ulcer, palmar/plantar rash or inguinal lymphadenopathy. Female sex (OR = 2.23, 95% confidence intervals (CI) = 1.69 to 3.00, p30 000 RMB yuan) were associated with serologically positive status. Syphilis infection was significantly more prevalent in city 2 (19.5%, OR = 3.07, 95% CI = 1.83 to 5.16, pinfected subjects engaged in commercial sex and increased rates of the infection was associated with multiple sexual partners (OR = 1.54, 95% CI = 1.16 to 2.06, p = 0.003). A total of 1.2% (133) of participants carried laboratory markers for HIV and 1.8% (23) of patients with syphilis were positive for HIV. Conclusions Syphilis infection has reached alarming rates in China's STI clinic population, suggesting a generalised spread of the disease through commercial sex and bridging populations. Syphilis control is deserving of China's highest priority. Universal screening for syphilis and HIV testing in STI clinics should be considered as measures for control. PMID:17591664

  19. Factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients: immunosuppression or behaviors

    Institute of Scientific and Technical Information of China (English)

    Jong Hun Kim; George Psevdos Jr; Jin Suh; Victoria Sharp

    2011-01-01

    Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus (HIV) co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer (RPR) into success/serofast (4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase), and failure/re-infection (failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline).Results Among a total of 156 patients who met the eligibility criteria, 122 (78.2%) were under success/serofast category,and 34 (21.8%) were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy (HAART) were not associated with syphilis treatment failure/re-infection. However, early syphilis stage (OR:11.036, 95% CI: 2.499-48.740, P=0.002) and high (>1∶64) RPR titers (OR: 715.921, 95% CI: 422.175-23 113.396, P <0.001) were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.

  20. Evaluation of a new serological test for syphilis based on chemiluminescence assay in a tertiary care hospital

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    Aseem K Tiwari

    2015-01-01

    Full Text Available Context: Syphilis is a transfusion transmissible infections and it is mandatory to do serological test for syphilis (STS on all donor blood samples. STS is usually based on detection of antibodies against the cardiolipin-lecithin antigen or against the Treponema-specific antigen. STS with good sensitivity and specificity helps enhance blood safety and consolidation of STS along with other transfusion transmittable infections such as human immunodeficiency virus, hepatitis-C virus, and hepatitis-B virus helps in reducing the errors and enhances efficiency. Aims: This study was designed to evaluate the performance of newly introduced VITROS ® syphilis Treponema pallidum agglutination (TPA assay based on enhanced chemiluminescence principle for its analytical performance for use as a STS on donor blood samples at a tertiary care health center in National Capital Region, India. Materials and Methods: A total of 108 random blood units collected from the donors (both voluntary and replacement donors and 28 known syphilis sero-reactive samples stored at −20°C, were used to evaluate the performance of VITROS ® syphilis TPA assay based on enhanced chemiluminescence assay on VITROS ® ECiQ immunodiagnostics system along with its analytical performance in terms of its sensitivity, precision, cross-reactivity and interference studies. Results: VITROS ® syphilis TPA showed 100% sensitivity and specificity with precision (20 days study of <10% co-efficient of variation. There was no cross-reactivity with other viral and auto-immune antibodies. No interference was observed from endogenous interfering substances like free hemoglobin or fats. Conclusions: Performance of the VITROS ® syphilis TPA assay meets the requirements for its use as STS in blood bank, thus allowing consolidation with other transfusion transmittable infections screening assay on chemiluminescence platform, which is highly valuable for optimizing workflow and efficiency.

  1. Regulatory T cells in peripheral blood and cerebrospinal fluid of syphilis patients with and without neurological involvement.

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    Kang Li

    2013-11-01

    Full Text Available BACKGROUND: Syphilis, a sexually transmitted disease caused by spirochetal bacterium Treponema pallidum, can progress to affect the central nervous system, causing neurosyphilis. Accumulating evidence suggest that regulatory T cells (Tregs may play an important role in the pathogenesis of syphilis. However, little is known about Treg response in neurosyphilis. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed Treg frequencies and Transforming Growth Factor-β (TGF-β levels in the blood and CSF of 431 syphilis patients without neurological involvement, 100 neurosyphilis patients and 100 healthy donors. Suppressive function of Tregs in peripheral blood was also assessed. Among syphilis patients without neurological involvement, we found that secondary and serofast patients had increased Treg percentages, suppressive function and TGF-β levels in peripheral blood compared to healthy donors. Serum Rapid Plasma Reagin (RPR titers were positively correlated with Treg numbers in these patients. Compared to these syphilis patients without neurological involvement, neurosyphilis patients had higher Treg frequency in peripheral blood. In the central nervous system, neurosyphilis patients had higher numbers of leukocytes in CSF compared to syphilis patients without neurological involvement. CD4(+ T cells were the predominant cell type in the inflammatory infiltrates in CSF of neurosyphilis patients. Interestingly, among these neurosyphilis patients, a significant decrease in CSF CD4(+ CD25(high Treg percentage and number was observed in symptomatic neurosyphilis patients compared to those of asymptomatic neurosyphilis patients, which may be associated with low CSF TGF-β levels. CONCLUSIONS: Our findings suggest that Tregs might play an important role in both bacterial persistence and neurologic compromise in the pathogenesis of syphilis.

  2. Barriers to control syphilis and HIV vertical transmission in the health care system in the city of Sao Paulo

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    Valdete Maria Ramos

    2014-12-01

    Full Text Available OBJECTIVE: The objective of this study was to identify possible barriers to control vertical transmission of syphilis and HIV through the analysis of the orientation process of pregnant women from prenatal care to the obstetric center at an university hospital in Sao Paulo (Reference and their return (with their exposed babies for follow-up after hospital discharge (counter-reference. METHODS: It is a retrospective cross-sectional study including interviews with healthcare personnel. Pregnant women with syphilis and/or HIV-infection admitted for labor or miscarriage were identified from August 2006 to August 2007. Routine care for mothers and babies were analyzed. RESULTS: 56 pregnant women were identified: 43 were HIV-infected, 11 had syphilis and two were coinfected (syphilis/HIV; 22 health care professionals were interviewed. Prenatal care was identified in 91.1% of these women: 7/11 (63.6% with syphilis; 44/45 (97.8% HIV-infected or coinfected. The reference for delivery was satisfactory for 57.7% of the syphilis-infected women and 97.7% of the HIV-infected ones. The counter-reference was satisfactory for all babies and mothers at hospital discharge, besides the non-adherence to this recommendation. Interviews with health care professionals showed there are better routines for assisting and following-up pregnant women, puerperal women and HIV-infected or exposed babies than for those infected with syphilis. The epidemiological report and surveillance system are also better for HIV-infected patients. CONCLUSION: The difficulties in the reference and counter-reference system of these women and their babies are evident barriers to control the vertical transmission of these infectious diseases.

  3. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance

    National Research Council Canada - National Science Library

    Ansbro, Éimhín M; Gill, Michelle M; Reynolds, Joanna; Shelley, Katharine D; Strasser, Susan; Sripipatana, Tabitha; Tshaka Ncube, Alexander; Tembo Mumba, Grace; Terris-Prestholt, Fern; Peeling, Rosanna W; Mabey, David

    2015-01-01

    .... Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing...

  4. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance: e0127728

    National Research Council Canada - National Science Library

    Éimhín M Ansbro; Michelle M Gill; Joanna Reynolds; Katharine D Shelley; Susan Strasser; Tabitha Sripipatana; Alexander Tshaka Ncube; Grace Tembo Mumba; Fern Terris-Prestholt; Rosanna W Peeling; David Mabey

    2015-01-01

    .... Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST) allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing...

  5. HIV and syphilis infections among street-based female sex workers in China, 2010-2012

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    Li Dongmin; Wang Lu; Lin Wen; Li Peilong; Wang Lan; Guo Wei; Ge Lin

    2014-01-01

    Background Female sex workers (FSW) were high-risk population for HIV and other sexually transmitted diseases (STD) earlier,and now are an important driver of the HIV/AIDS epidemic in China.Sentinel surveillance for FSW was set up to monitor the trend of HIV prevalence and risk behavior-related HIV infection.This study collected the data on street-based FSW from HIV sentinel surveillance system to understand HIV and syphilis infections,risk behaviors,and intervention in China from 2010 to 2012.Methods The study population was the street-based FSW who were recruited for the national HIV integrated biological and behavioral surveillance between 2010 and 2012.Demographic information,HIV-related risk behaviors,and HIV and syphilis testing results were described and trend analysis was performed.Results Between 2010 and 2012,the number of street-based FSW surveyed was 3725,3425,and 3335,respectively.HIV knowledge awareness rate significantly increased from 74.6% in 2010 to 76.8% in 2011 and 82.2% in 2012 (P <0.01).More FSW consistently used condom in the last month (49.0% in 2010; 51.0% in 2011; and 59.0% in 2012) and in the last commercial sex (72.0% in 2010; 78.5% in 2011; and 80.0% in 2012) over time.The proportions of individuals who received HIV testing in the last year were 31.2% (2010),37.0% (2011),and 36.9% (2012) (P-trend <0.01).HIV prevalence rate changed from 1.5% in 2010 to 1.4% in 2011 and 2.3% in 2012 (P-trend=0.01).Syphilis prevalence rate was 6.9%,7.2%,and 7.1% in the same period.The top three provinces with the highest average HIV prevalence rates over the 3 years were Guangxi (5.9%),Yunnan (4.2%),and Sichuan (1.2%).Conclusions Street-based FSW are at high risk of HIV and syphilis infections.Intervention efforts need to target streetbased FSW who are of old age and minority,who use illicit drugs and have syphilis infection.

  6. Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China.

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    Qin, J-B; Feng, T-J; Yang, T-B; Hong, F-C; Lan, L-N; Zhang, C-L; Liu, X-L; Yang, Y-Z; Xiao, S-Y; Tan, H-Z

    2014-12-01

    The purpose of this investigation was to assess the effectiveness of an intervention program on mother-to-child transmission (MTCT) of syphilis and investigate determinants of congenital syphilis (CS) and adverse pregnancy outcomes (APOs). The Shenzhen local government initiated an intervention program of MTCT of syphilis in 2001. Based on this program, maternal and paternal factors associated with CS and APOs among syphilitic women were investigated from 2007 to 2012 by a prospective cohort study. From 2002 to 2012, 2,441,237 pregnant women were screened and screening coverage reached 97.2 % in 2012. In the background of continuing growth of CS in China, CS in Shenzhen significantly decreased from 109.3 cases in 2002 to 9.9 cases in 2012 per 100,000 live births. Maternal education (adjusted odds ratio [aOR]CS = 0.65; aORAPOs = 0.79) and history of syphilis (aORCS = 0.28; aORAPOs = 0.61), as well as paternal age (aORCS = 0.62; aORAPOs = 0.86) and education (aORCS = 0.66; aORAPOs = 0.86) were negatively associated with CS and APOs, but maternal unmarried status (aORCS = 1.95; aORAPOs = 2.61), inadequate antenatal care (ANC) (aORCS = 3.61; aORAPOs = 1.79), more sexual partners (aORCS = 1.51; aORAPOs = 1.39), every week of delay in treatment (aORCS = 2.82; aORAPOs = 1.27), higher baseline titers of nontreponemal antibodies (aORCS = 5.65; aORAPOs = 1.47), early syphilis (aORCS = 23.24; aORAPOs = 26.95), and non-penicillin treatment (aORCS = 3.00; aORAPOs = 2.16), as well as paternal history of cocaine use (aORCS = 2.70; aORAPOs = 2.44) and positive (aORCS = 4.14; aORAPOs = 1.50) or unknown (aORCS = 2.37; aORAPOs = 2.06) status of syphilis increased the risk of CS and APOs. Condom use (aOR = 0.70) decreased MTCT of syphilis. A ten-year program consisting of screening and treatment, early ANC, health education, partners tracking, detection, and treatment, follow-up visits, and information management is an effective means to block MTCT of syphilis. Maternal and paternal

  7. 妊娠梅毒孕妇不同药物治疗效果研究%Study on anti-syphilis therapy for pregnant syphilis

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    张长英; 徐东萍; 梁萍; 丁超英

    2014-01-01

    OBJECTIVE To discuss the effects of the timing and medication treatment for pregnancy syphilis on patients′prognosis of the full-term delivery rates ,premature delivery rates ,fetal death rates ,occurrences of low weight infants ,deformity rates ,and titers of RPR of mothers and infants .METHODS From Feb .2006 to Dec . 2012 ,160 cases of pregnant syphilis treated in our hospital were chosen for this study . They were randomly divided into four groups (40 cases in each group ):group A ,B ,C and D . The four groups were detected and compared with respect to full-term delivery rates ,premature delivery rates ,fetal death rates ,occurrences of low weight infants ,deformity rates and titers of RPR of mothers and infants .The three treatment groups (A ,B and C) of pregnant women were treated respectively with benzathine penicillin , ceftriaxone and azithromycin . A comparison was made among the three groups about the infants′ prognoses .Data collected were processed with SPSS12 .0 .RESULTS The study found that ,the full-term delivery rate was 90 .0% in group A and 40 .0% in group D ;the premature delivery rate ,fetal death rate ,occurrence of low weight infants ,and deformity rate was 10 .0% ,0 .0% ,10 .0% and 0 .0% respectively in group A ,and 30 .0% ,30 .0% ,30 .0% and 20 .0% respectively in group D ,which showed a significant difference (P<0 .05) .The titers of RPR of mothers and infants <1∶8 of group A (≤ 12 weeks of treatment) was significantly higher than those of the other groups (P< 0 .05) .The occurrence rate of congenital syphilis in the infants was 13 .6% in the group treated with benzathine penicillin ,and was 20% in the group treated with ceftriaxone ,which showed no significant difference .The occurrence rate of congenital syphilis in the infants was 66 .7% in the group treated with the azithromycin , which showed a statistically significant difference (P<0 .05) ,compared to the other two treatment groups .CONCLUSIONS Early anti-syphilis therapy and

  8. CLINICAL EVALUATION OF FOUR RECOMBINANT TREPONEMA PALLIDUM ANTIGEN-BASED RAPID TESTS IN THE DIAGNOSIS OF SYPHILIS

    Institute of Scientific and Technical Information of China (English)

    Lin-na Wang; Lei Yang; He-yi Zheng

    2007-01-01

    To assess the sensitivity, specificity, and feasibility of 4 recombinant Treponema pallidum antigenbased rapid tests in the diagnosis of syphilis.Methods A total of 970 outpatients were selected from the Sexually Transmitted Diseases Centre of Peking Union Medical College Hospital. Venous blood was collected and serum was extracted. T. pallidum antibodies in whole blood, anticoagulant whole blood, and serum were detected using 4 recombinant T. pallidum antigen-based rapid tests.T. pallidum haemagglutination test (TPHA) was considered as the gold standard for the detection of T. pallidum specific antibodies in serum. The sensitivities and specificities of four methods were analyzed.Results The sensitivities and specificities of Abbott Determine Syphilis TP test, SD-BIOLINE Syphilis 3.0 test,VISITECT-SYPHILIS test, and Syphicheck-WB test for serum specimens were 100% and 98.9%, 95.7% and 98.0%, 94.6% and 98.2%, 68.1% and 98.9%; for whole blood were 74.1% and 99.5%, 87.9% and 99.4%,73.2% and 99.7%, 64.7% and 99.7%. The observed sensitivities of the 4 rapid diagnosis tests were not significantly different with TPHA ( P>0.05 ).Conclusions The 4 rapid tests show good performance and characteristics in the diagnosis of syphilis. Furthermore, they are more sensitive for serum specimens than whole blood.

  9. Consistently low prevalence of syphilis among female sex workers in Jinan, China: findings from two consecutive respondent driven sampling surveys.

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    Meizhen Liao

    Full Text Available BACKGROUND: Routine surveillance using convenient sampling found low prevalence of HIV and syphilis among female sex workers in China. Two consecutive surveys using respondent driven sampling were conducted in 2008 and 2009 to examine the prevalence of HIV and syphilis among female sex workers in Jinan, China. METHODS: A face-to-face interview was conducted to collect demographic, behavioral and service utilization information using a structured questionnaire. Blood samples were drawn for serological tests of HIV-1 antibody and syphilis antibody. Respondent Driven Sampling Analysis Tool was used to generate population level estimates. RESULTS: In 2008 and in 2009, 363 and 432 subjects were recruited and surveyed respectively. Prevalence of syphilis was 2.8% in 2008 and 2.2% in 2009, while no HIV case was found in both years. Results are comparable to those from routine sentinel surveillance system in the city. Only 60.8% subjects in 2008 and 48.3% in 2009 reported a consistent condom use with clients during the past month. Over 50% subjects had not been covered by any HIV-related services in the past year, with only 15.6% subjects in 2008 and 13.1% in 2009 ever tested for HIV. CONCLUSIONS: Despite the low prevalence of syphilis and HIV, risk behaviors are common. Targeted interventions to promote the safe sex and utilization of existing intervention services are still needed to keep the epidemic from growing.

  10. Incidence of HIV and Syphilis among Men Who Have Sex with Men (MSM in Beijing: An Open Cohort Study.

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    Guowu Liu

    Full Text Available This study investigated HIV and syphilis incidence among men who have sex with men (MSM in Beijing, China.An open cohort was established from September 2009 to April 2012. Participants were followed up with every three to four months after recruitment and for thirty-one months in total. Chi-square tests were used to compare demographic and behavioral characteristics between participants who were followed up with and those lost to follow up. Univariate and multivariate Cox proportional hazards regression analyses were used to examine demographic and behavioral associations with HIV and syphilis incidence.69.7% (699/1,003 of the participants finished at least two follow-up surveys during the study period. Variables which corresponded to increased loss to follow-up included younger age, less education, non-identification of homosexual identity, and migrant status. A total of 1,045 person-years (PYs and 1,016.4 PYs were followed up for HIV and syphilis incidence estimation, respectively. The HIV incidence was 5.9 per 100 PYs and 7.8 per 100 PYs for syphilis. The predictors for the high HIV incidence included unsafe anal sex, sex after drinking alcohol and STI infection.HIV incidence increased rapidly within the cohort, but syphilis incidence remained stable and decreased. More research is needed to provide multi-pronged HIV prevention interventions among MSM in order to reduce the increasing burden of HIV and sexually transmitted infections (STIs in China.

  11. MORBIDITY WITH SYPHILIS AND GONORRHEA IN CHILDREN IN RUSSIAN FEDERATION: REGIONAL DIFFERENCES IN 2000–2006 YEARS

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    A.I. Novikov

    2009-01-01

    Full Text Available The data on children’s under the age of 14 years old morbidity with syphilis and gonorrhea analysis around the territory of the Russian Federation during the period from 2000 to 2006 are presented in this article. It is mentioned that the rate of children’s morbidity with syphilis has always been 2 times higher than by gonorrhea. The decrease of rate of children’s morbidity in Russia with syphilis is reduced twice, with gonorrhea — in 2.4 times. Authors detected essential interregional variability of rates, with the best results in European and South part of the country and with the worst results in Siberia and in the Far East. The social macroeconomic and national factors of children’s morbidity formation with syphilis and gonorrhea in Russia, and the various quality of registration of the pathology in regions of the country are supposed.Key words: children, syphilis, gonorrhea, morbidity.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4:32-36

  12. HIV and syphilis infection among men who have sex with men--Bangkok, Thailand, 2005-2011.

    Science.gov (United States)

    2013-06-28

    Although efforts to control the heterosexual human immunodeficiency virus (HIV) epidemic in Thailand had shown success by the late 1990s, HIV continued to spread in other risk groups, including men who have sex with men (MSM). In 2003, the Thailand Ministry of Public Health-U.S. CDC Collaboration (TUC) started surveillance among MSM in Bangkok, finding an HIV prevalence of 17.3%. By 2005, HIV prevalence in this group had risen to 28.3% and has since stabilized at around 30%. To obtain additional information about HIV and sexually transmitted infection (STI) prevalence and incidence in a clinic-based population of MSM, TUC, in collaboration with the Thai Red Cross AIDS Research Center, analyzed data collected at the Silom Community Clinic (SCC), an HIV and STI testing center targeting MSM. This report describes trends in HIV and syphilis prevalence and incidence seen among SCC MSM clients during 2005-2011. At first clinic visit, the prevalence of HIV infection among 4,762 clients was 28.3% and of syphilis (all stages) was 9.8%. Among those returning for HIV or syphilis testing before the end of 2011, the incidence of HIV infection was 6.3 per 100 person-years (PY) and 3.6 per 100 PY for syphilis. These results show ongoing epidemics of HIV and syphilis infection in MSM in Bangkok, underscoring the urgent need for preventive interventions to reduce the spread of HIV and STI in this population.

  13. Rapid-Testing Technology and Systems Improvement for the Elimination of Congenital Syphilis in Haiti: Overcoming the “Technology to Systems Gap”

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    Linda Severe

    2013-01-01

    Full Text Available Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child syphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than 3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time series, multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy. The two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on quality improvement (QI methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (P<0.001 and further increased to 96.8% (P<0.001 after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment lagged behind and only increased from 70.3% to 74.7% after the introduction of rapid tests (P=0.27, but it improved significantly from 70.2% to 84.3% (P<0.001 after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic testing and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare interventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of systems-based quality improvement approaches.

  14. Rapid-Testing Technology and Systems Improvement for the Elimination of Congenital Syphilis in Haiti: Overcoming the “Technology to Systems Gap”

    Science.gov (United States)

    Benoit, Daphne; Zhou, Xi K.; Pape, Jean W.; Peeling, Rosanna W.; Fitzgerald, Daniel W.; Mate, Kedar S.

    2013-01-01

    Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child syphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than 3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time series, multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy. The two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on quality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (P < 0.001) and further increased to 96.8% (P < 0.001) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment lagged behind and only increased from 70.3% to 74.7% after the introduction of rapid tests (P = 0.27), but it improved significantly from 70.2% to 84.3% (P < 0.001) after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic testing and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare interventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of systems-based quality improvement approaches. PMID:26316955

  15. The importance of not jumping to conclusions: syphilis as an organic cause of neurological, psychiatric and endocrine presentations.

    Science.gov (United States)

    Noblett, Joanne; Roberts, Emmert

    2015-02-25

    A 66-year-old Caucasian man was admitted to an acute psychiatric ward under section 2 of the Mental Health Act after presenting with auditory hallucinations and partition delusions. He had been known to mental health services since 2005 but had never been treated with psychotropic medication or given a formal psychiatric diagnosis. He was also diagnosed with hypopituitarism of unknown aetiology in 2002. In light of this presentation, his medical history was reviewed in full, hormone levels and a full delirium screen including blood borne virus and syphilis serology was completed to ensure no organic cause had been missed. The treponemal antibody was positive, and he reported no previous syphilis treatment, as such a diagnosis of neurosyphilis was performed. This case demonstrates a patient presenting with two potential complications of syphilis; psychosis and hypopituitarism where screening for this infection had not been previously considered.

  16. Cost-effectiveness of enhanced syphilis screening among HIV-positive men who have sex with men: a microsimulation model.

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    Ashleigh R Tuite

    Full Text Available Syphilis co-infection risk has increased substantially among HIV-infected men who have sex with men (MSM. Frequent screening for syphilis and treatment of men who test positive might be a practical means of controlling the risk of infection and disease sequelae in this population.We evaluated the cost-effectiveness of strategies that increased the frequency and population coverage of syphilis screening in HIV-infected MSM receiving HIV care, relative to current standard of care.We developed a state-transition microsimulation model of syphilis natural history and medical care in HIV-infected MSM receiving care for HIV. We performed Monte Carlo simulations using input data derived from a large observational cohort in Ontario, Canada, and from published biomedical literature. Simulations compared usual care (57% of the population screened annually to different combinations of more frequent (3- or 6-monthly screening and higher coverage (100% screened. We estimated expected disease-specific outcomes, quality-adjusted survival, costs, and cost-effectiveness associated with each strategy from the perspective of a public health care payer.Usual care was more costly and less effective than strategies with more frequent or higher coverage screening. Higher coverage strategies (with screening frequency of 3 or 6 months were expected to be cost-effective based on usually cited willingness-to-pay thresholds. These findings were robust in the face of probabilistic sensitivity analyses, alternate cost-effectiveness thresholds, and alternate assumptions about duration of risk, program characteristics, and management of underlying HIV.We project that higher coverage and more frequent syphilis screening of HIV-infected MSM would be a highly cost-effective health intervention, with many potentially viable screening strategies projected to both save costs and improve health when compared to usual care. The baseline requirement for regular blood testing in this

  17. Secondary Syphilis in Patients Treated at the City Institute for Skin and Venereal Diseases in Belgrade from 2010 to 2014

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    Bjekić Milan

    2015-06-01

    Full Text Available The aim of this study was to analyze the characteristics and clinical manifestations of secondary syphilis among patients registered at the City Institute for Skin and Venereal Diseases in Belgrade, during the period from 2010 to 2014. The study was designed as a case-note review. In the five-year period, a total of 62 patients with secondary syphilis were registered. The average patient age was 32 years. There were 45 (72.6% HIV-negative, and 17 (27.4% HIV-positive patients. The incidence of HIV–positive patients was significantly different from random distribution (p = 0.016. All HIV-positive patients were unmarried men. A significant percentage of HIV-positive patients were unemployed (p < 0.001, reported unknown source of infection (p = 0.002 and were all homosexuall (p = 0.026. More than 25% of all patients with syphilis had a history of chancres, and it was still present at the time of examination in 11.3% of all patients. The majority of cases (87.1% had a rash, and lymphadenopathy was found in 20% of patients. However, syphilitic alopecia was detected only in HIV-positive cases (p = 0.004. There were no statistically significant differences between HIV-positive and HIV-negative patients in regard to other clinical manifestations, such as mucous patches and condylomata lata. Being a great imitator, secondary syphilis may manifest in a myriad of diverse morphological entities and clinical manifestations. We review a range of cutaneous manifestations of secondary syphilis and skin diseases it may mimic. Clinicians must be vigilant and consider syphilis in differential diagnosis, and maintain a high index of suspicion, especially when assessing vulnerable populations, such as men who have sex with men and HIV-infected individuals.

  18. Comparative effectiveness of single and dual rapid diagnostic tests for syphilis and HIV in antenatal care services in Colombia.

    Science.gov (United States)

    Gaitán-Duarte, Hernando Guillermo; Newman, Lori; Laverty, Maura; Habib, Ndema Abu; González-Gordon, Lina María; Ángel-Müller, Edith; Abella, Catleya; Barros, Esther Cristina; Rincón, Carlos; Caicedo, Sidia; Gómez, Bertha; Pérez, Freddy

    2016-12-01

    To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC) centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A) or to dual HIV and syphilis rapid diagnostic tests (Arm B). The four main outcomes measured were: (1) acceptability of the test, (2) uptake in testing, (3) treatment on the same day (that is, timely treatment), and (4) treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69%) in Arm A and 16 of 20 patients (80%) in Arm B (relative risk (RR), 1.10; 95% confidence interval (CI): (1.00 -1.20). Treatment at any time was given to 24 of 29 patients (83%) in Arm A and to 20 of 20 (100%) in Arm B (RR, 1.11; 95% CI: 1.01-1.22). There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.

  19. Rapid Treponema pallidum clearance from blood and ulcer samples following single dose benzathine penicillin treatment of early syphilis.

    Science.gov (United States)

    Tipple, Craig; Jones, Rachael; McClure, Myra; Taylor, Graham

    2015-02-01

    Currently, the efficacy of syphilis treatment is measured with anti-lipid antibody tests. These can take months to indicate cure and, as a result, syphilis treatment trials require long periods of follow-up. The causative organism, Treponema pallidum (T. pallidum), is detectable in the infectious lesions of early syphilis using DNA amplification. Bacteraemia can likewise be identified, typically in more active disease. We hypothesise that bacterial clearance from blood and ulcers will predict early the standard serology-measured treatment response and have developed a qPCR assay that could monitor this clearance directly in patients with infectious syphilis. Patients with early syphilis were given an intramuscular dose of benzathine penicillin. To investigate the appropriate sampling timeframe samples of blood and ulcer exudate were collected intensively for T. pallidum DNA (tpp047 gene) and RNA (16S rRNA) quantification. Sampling ended when two consecutive PCRs were negative. Four males were recruited. The mean peak level of T. pallidum DNA was 1626 copies/ml whole blood and the mean clearance half-life was 5.7 hours (std. dev. 0.53). The mean peak of 16S rRNA was 8879 copies/ml whole blood with a clearance half-life of 3.9 hours (std. dev. 0.84). From an ulcer, pre-treatment, 67,400 T. pallidum DNA copies and 7.08 x 107 16S rRNA copies were detected per absorbance strip and the clearance half-lives were 3.2 and 4.1 hours, respectively. Overall, T. pallidum nucleic acids were not detected in any sample collected more than 56 hours (range 20-56) after treatment. All patients achieved serologic cure. In patients with active early syphilis, measuring T. pallidum levels in blood and ulcer exudate may be a useful measure of treatment success in therapeutic trials. These laboratory findings need confirmation on a larger scale and in patients receiving different therapies.

  20. Neelaredoxin, an iron-binding protein from the syphilis spirochete, Treponema pallidum, is a superoxide reductase.

    Science.gov (United States)

    Jovanović, T; Ascenso, C; Hazlett, K R; Sikkink, R; Krebs, C; Litwiller, R; Benson, L M; Moura, I; Moura, J J; Radolf, J D; Huynh, B H; Naylor, S; Rusnak, F

    2000-09-15

    Treponema pallidum, the causative agent of venereal syphilis, is a microaerophilic obligate pathogen of humans. As it disseminates hematogenously and invades a wide range of tissues, T. pallidum presumably must tolerate substantial oxidative stress. Analysis of the T. pallidum genome indicates that the syphilis spirochete lacks most of the iron-binding proteins present in many other bacterial pathogens, including the oxidative defense enzymes superoxide dismutase, catalase, and peroxidase, but does possess an orthologue (TP0823) for neelaredoxin, an enzyme of hyperthermophilic and sulfate-reducing anaerobes shown to possess superoxide reductase activity. To analyze the potential role of neelaredoxin in treponemal oxidative defense, we examined the biochemical, spectroscopic, and antioxidant properties of recombinant T. pallidum neelaredoxin. Neelaredoxin was shown to be expressed in T. pallidum by reverse transcriptase-polymerase chain reaction and Western blot analysis. Recombinant neelaredoxin is a 26-kDa alpha(2) homodimer containing, on average, 0.7 iron atoms/subunit. Mössbauer and EPR analysis of the purified protein indicates that the iron atom exists as a mononuclear center in a mixture of high spin ferrous and ferric oxidation states. The fully oxidized form, obtained by the addition of K(3)(Fe(CN)(6)), exhibits an optical spectrum with absorbances at 280, 320, and 656 nm; the last feature is responsible for the protein's blue color, which disappears upon ascorbate reduction. The fully oxidized protein has a A(280)/A(656) ratio of 10.3. Enzymatic studies revealed that T. pallidum neelaredoxin is able to catalyze a redox equilibrium between superoxide and hydrogen peroxide, a result consistent with it being a superoxide reductase. This finding, the first description of a T. pallidum iron-binding protein, indicates that the syphilis spirochete copes with oxidative stress via a primitive mechanism, which, thus far, has not been described in pathogenic

  1. Clinical and laboratory characteristics of ocular syphilis: a new face in the era of HIV co-infection.

    Science.gov (United States)

    Lee, Sun Young; Cheng, Vincent; Rodger, Damien; Rao, Narsing

    2015-12-01

    Ocular syphilis is reemerging as an important cause of uveitis in the new era of common co-infection with HIV. This study will reveal the clinical and laboratory characteristics in the group of individuals co-infected with ocular syphilis and HIV compared with HIV-negative individuals. In this retrospective observational case series, medical records of patients diagnosed with ocular syphilis with serologic support from 2008 to 2014 were reviewed. Ocular and systemic manifestation and laboratory profiles were reviewed. Twenty-nine eyes of 16 consecutive patients (10 HIV-positive and 6 HIV-negative) were included. All patients were males, and mean age of onset for ocular syphilis was 43 (mean 42.65 ± 13.13). In both HIV-positive and HIV-negative groups, ocular manifestations of syphilis were variable including anterior uveitis (4 eyes), posterior uveitis (8 eyes), panuveitis (13 eyes), and isolated papillitis (4 eyes). In HIV-positive patients, panuveitis was the most common feature (12/18 eyes, 67 %) and serum rapid plasma reagin (RPR) titers were significantly higher (range 1:64-1:16,348; mean 1:768; p = 0.018) than in HIV-negative patients. Upon the diagnosis of ocular syphilis in HIV-positive patients, HIV-1 viral load was high (median 206,887 copies/ml) and CD4 cell count ranged from 127 to 535 cells/ml (mean 237 ± 142; median 137). Regardless of HIV status, cerebrospinal fluid (CSF) exam was frequently abnormal: positive CSF fluorescent treponemal antibody absorption (FTA-ABS) or Venereal Disease Research Laboratory (VDRL) test results in seven patients or either elevated CSF WBC count or elevated CSF protein in six patients. Our results reveal that the patients with ocular syphilis with high serum RPR titers may have concomitant HIV infection requiring further testing for HIV status and ocular syphilis is likely associated with the central nervous system involvement and therefore needs to be managed according to the treatment recommendations for

  2. Evaluation of a new rapid plasma reagin card test as a screening test for syphilis.

    OpenAIRE

    1982-01-01

    This study evaluates the American Dade (Biokit Laboratories) rapid plasma reagin (Dade RPR) card test, currently used in Spain for the diagnosis of syphilis, which has been recently released to the U.S. market. Used as a basis for comparison with the Dade card test were the 18-mm standard rapid plasma reagin (standard RPR) card test and the Venereal Disease Research Laboratory (VDRL) slide test, using both fresh sera obtained from 505 individuals and paired serum-plasma specimens from 174 ind...

  3. Meta-analysis of ceftriaxone compared with penicillin for the treatment of syphilis.

    Science.gov (United States)

    Liang, Zhen; Chen, Ya-Ping; Yang, Chun-Sheng; Guo, Wen; Jiang, Xiao-Xiao; Xu, Xi-Feng; Feng, Shou-Xin; Liu, Yan-Qun; Jiang, Guan

    2016-01-01

    Penicillin is the gold standard for treating syphilis. However, allergic reactions, poor drug tolerance and limited efficacy in patients remain a challenging problem. The objective of this meta-analysis was to compare the efficacy of ceftriaxone and penicillin based on data obtained from published randomised controlled trials (RCTs). The Cochrane Library, Medline, EBSCO, EMBASE and Ovid databases were searched for RCTs of ceftriaxone vs. penicillin for the treatment of syphilis. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were used to investigate the following outcome measures: 3-month response rate; 6-month response rate; 12-month response rate; relapse rate; serofast rate; and failure rate. Seven RCTs involving 281 participants (159 patients who received ceftriaxone and 122 patients who received penicillin) were included in the meta-analysis. There were no significant differences in 3-month response rate (RR=1.12, 95% CI 0.89-1.42), 6-month response rate (RR=1.02, 95% CI 0.75-1.38), 12-month response rate (RR=1.04, 95% CI 0.82-1.32), relapse rate (RR=0.91, 95% CI 0.45-1.84), serofast rate (RR=0.69, 95% CI 0.22-2.12) or failure rate (RR=0.66, 95% CI 0.03-15.76) in patients treated with ceftriaxone compared with those treated with penicillin. In conclusion, there is no evidence in the literature that ceftriaxone is less efficient than penicillin.

  4. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features.

    Science.gov (United States)

    Marra, Christina M; Maxwell, Clare L; Smith, Stacy L; Lukehart, Sheila A; Rompalo, Anne M; Eaton, Molly; Stoner, Bradley P; Augenbraun, Michael; Barker, David E; Corbett, James J; Zajackowski, Mark; Raines, Charles; Nerad, Judith; Kee, Romina; Barnett, Scott H

    2004-02-01

    To define clinical and laboratory features that identify patients with neurosyphilis. Subjects (n=326) with syphilis but no previous neurosyphilis who met 1993 Centers for Disease Control and Prevention criteria for lumbar puncture underwent standardized history, neurological examination, venipuncture, and lumbar puncture. Neurosyphilis was defined as a cerebrospinal fluid (CSF) white blood cell count >20 cells/ microL or reactive CSF Venereal Disease Research Laboratory (VDRL) test result. Sixty-five subjects (20.1%) had neurosyphilis. Early syphilis increased the odds of neurosyphilis in univariate but not multivariate analyses. In multivariate analyses, serum rapid plasma reagin (RPR) titer > or =1 : 32 increased the odds of neurosyphilis 10.85-fold in human immunodeficiency virus (HIV)-uninfected subjects and 5.98-fold in HIV-infected subjects. A peripheral blood CD4+ T cell count < or =350 cells/ microL conferred 3.10-fold increased odds of neurosyphilis in HIV-infected subjects. Similar results were obtained when neurosyphilis was more stringently defined as a reactive CSF VDRL test result. Serum RPR titer helps predict the likelihood of neurosyphilis. HIV-induced immune impairment may increase the risk of neurosyphilis.

  5. Neurological findings in early syphilis: a comparison between HIV positive and negative patients

    Directory of Open Access Journals (Sweden)

    Alejandra González-Duarte

    2013-11-01

    Full Text Available After a decade of steady decline, syphilis has reemerged within the past few years and it is seeping back into the HIV negative population. We describe herein 16 consecutive cases of neurosyphilis and compare its clinical characteristics. Of the 16 patients, 14 (87% were men. Mean age at onset was 43 years old (range: 23-82. Twelve patients (75% were HIV positive; stage was B2 in 2 patients, B3 and C2 in one patient each, and C3 in 8 patients. The clinical presentation was meningitis in 6 (40%, stroke in 3 (18%, ocular manifestations in 4 (27%, and psychiatric manifestations in 2 (13% cases. Five additional patients had ocular involvement after a formal ophthalmologic examination. High venereal disease research laboratory test (VDRL titers in serum and cerebrospinal fluid (CSF were found. Patients in C3 stage of HIV had less CSF pleocytosis (<5 cells/mm3 than patients in earlier stages (P=0.018. Disease onset was earlier in patients older than 50 years old with HIV (P=0.049. We found that meningitis, ocular manifestations and stroke were the most common clinical findings in early syphilis. Moreover, stroke included the carotid and cerebrobasilar vascular territories. CSF VDRL continues to be a crucial test in all idiopathic cases of meningitis, stroke and uveitis, regardless of the HIV status or CSF pleocytosis. Except for less pleocytosis, there were no important differences between HIV positive and HIV negative patients.

  6. Sex and the capital city: the political framing of syphilis and prostitution in early republican Ankara.

    Science.gov (United States)

    Evered, Emine Ö; Evered, Kyle T

    2013-04-01

    In its initial years, the nascent Turkish republic established the Ministry of Health and Social Assistance in order to promote public health. Beyond simply facilitating its modernizing agenda for the emergent nation-state as it sought to define itself against an Ottoman past, this institution was also geared toward remedying a self-defined population crisis by prioritizing and confronting particular diseases and health conditions. One of the maladies of utmost concern was syphilis. Based upon an analysis of official primary sources, this article engages with how the developing republic distinguished and consequently politically constructed-or framed-the syphilis problem from the vantage of its new forward capital, Ankara. Integral to this project of confronting this sexually transmitted disease, public health officials projected upon both this ailment and their understanding of the suitable means for its treatment their own views of what constituted appropriate sexual practices and relations. In doing so, certain subgroups of the population, especially prostitutes, were particularized as targets for surveillance and policing through regimes of licensing and compulsory medical examinations. Stemming from the state's framing of the disease-and its definition of appropriate sexual practices-this article also examines the subsequent legislative and public health education projects that followed.

  7. Characteristics of patients with primary and late latent syphilis patients who were initially non-reactive to the rapid plasma reagin test.

    Science.gov (United States)

    Jun, Li; He-Yi, Zheng

    2013-01-01

    We aimed at determining the characteristics of patients with primary and late latent syphilis who were non-reactive on initial screening by rapid plasma reagin (RPR) but reactive by treponemal tests. We collected the RPR test results of all primary and late latent syphilis patients in our hospital from December 2000 to March 2012. The characteristics of syphilis patients who were non-reactive by RPR testing were compared to those of reactive patients. Multiple logistic regression was used to identify factors associated with non-reactive RPR results. Among primary syphilis patients, 37 (16.5%) were non-reactive on initial RPR and were compared with the 187 reactive cases. Age >35 years was an independent factor associated with a non-reactive result in primary cases (odds ratio [OR], 95% confidence intervals [CI] = 3.55 [1.39-9.07]). Of the late latent patients, 61 (8.8%) were non-reactive by RPR and 636 were reactive. Age >34 years was also an independent factor associated with a non-reactive result in late latent cases (OR [95% CI] = 4.30 [2.28-8.12]). This study suggests that RPR testing alone is insufficient to diagnose primary and late latent infections, especially in middle-aged and elderly individuals. Syphilis detection was lower for patients with primary syphilis than for those with late latent syphilis based on the results of the RPR.

  8. El control de la sífilis reciente The control of recent syphilis

    Directory of Open Access Journals (Sweden)

    Denis Berdasquera Corcho

    2006-12-01

    Full Text Available Durante los últimos años se ha observado a nivel mundial una disminución en la notificación de pacientes con sífilis y un aumento de los VIH/SIDA. En la presente investigación se realizó un estudio descriptivo, de casos, donde se incluyeron todos las personas con diagnóstico de sífilis notificados en el municipio Guanajay, provincia La Habana, en el período comprendido desde el año 2000 a 2004, con el objetivo de describir su comportamiento y caracterizar el cumplimiento de determinados indicadores del programa. A partir del año 2000 se observó una tendencia a la disminución de las tasas de incidencia, siendo este el de mayor tasa (54,8. La enfermedad fue más frecuente en personas entre los 20 y los 29 años, en hombres (52,3 %, en personas de la raza blanca (48,1 %, con un nivel de escolaridad medio (66,7 % y obreros (48,1 %. Más del 85 % de los pacientes no tenían pareja estable al momento de infectarse. La sífilis reciente adquirida sintomática fue la forma clínica que se observó con mayor frecuencia (59,3 %. Se incumplieron el índice de contactos (2,5, el índice epidemiológico (0,17 y el seguimiento serológico de los pacientes, fundamentalmente después de los 9 meses de diagnóstico. Se concluyó que el comportamiento de los casos de sífilis en el municipio no difiere de lo que ocurre a nivel nacional e internacional. A pesar de registrarse una disminución gradual de la incidencia, el control de la sífilis parece constituir un problema de salud.During the last years, it has been observed a reduction of the notification of patients with syphilis and an increase of HIV/AIDS patients at the world level. In the present research, it was conducted a descriptive case study, where all the persons with diagnosis of syphilis reported by the municipality of Guanajay, Havana province, from 2000 to 2004, were included aimed at describing their behavior and characterizing the fufillment of certain indicators of the program

  9. Unexpectedly high prevalence of Treponema pallidum infection in the oral cavity of human immunodeficiency virus-infected patients with early syphilis who had engaged in unprotected sex practices.

    Science.gov (United States)

    Yang, C-J; Chang, S-Y; Wu, B-R; Yang, S-P; Liu, W-C; Wu, P-Y; Zhang, J-Y; Luo, Y-Z; Hung, C-C; Chang, S-C

    2015-08-01

    Between 2010 and 2014, we obtained swab specimens to detect Treponema pallidum, with PCR assays, from the oral cavities of 240 patients with 267 episodes of syphilis who reported engaging in unprotected sex practices. The detected treponemal DNA was subjected to genotyping. All of the syphilis cases occurred in men who have sex with men (MSM), and 242 (90.6%) occurred in human immunodeficiency virus-infected patients. The stages of syphilis included 38 cases (14.2%) of primary syphilis of the genital region, 76 (28.5%) of secondary syphilis, 21 (7.9%) of primary and secondary syphilis, 125 (46.8%) of early latent syphilis, and seven (2.6%) others. Concurrent oral ulcers were identified in 22 cases (8.2%). Treponemal DNA was identified from the swabs of 113 patients (42.2%), including 15 (68.2%) with oral ulcers. The most common genotype of T. pallidum was 14f/f. The presence of oral ulcers was associated with identification of T. pallidum in the swab specimens (15/22 (68.2%) vs. 98/245 (40.0%)) (p = 0.01). In multivariate analysis, secondary syphilis (adjusted OR 6.79; 95% CI 1.97-23.28) and rapid plasma reagin (RPR) titres of ≥1: 32 (adjusted OR 2.23; 95% CI 1.02-4.89) were independently associated with the presence of treponemal DNA in patients without oral ulcers. We conclude that detection of treponemal DNA in the oral cavity with PCR assays is not uncommon in MSM, most of whom reported having unprotected oral sex. Although the presence of oral ulcers is significantly associated with detection of treponemal DNA, treponemal DNA is more likely to be identified in patients without oral ulcers who present with secondary syphilis and RPR titres of ≥1: 32.

  10. Seroprevalence of HIV, HBV, HCV and syphilis infections among blood donors at Gondar University Teaching Hospital, Northwest Ethiopia: declining trends over a period of five years

    Directory of Open Access Journals (Sweden)

    Amsalu Anteneh

    2010-05-01

    Full Text Available Abstract Background Transfusion-transmissible infectious agents such as human immunodeficiency virus (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV and syphilis are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence, risk factors and trends of HIV, HBV, HCV and syphilis infections among blood donors over a period of five years at Gondar University Teaching Hospital, Northwest Ethiopia. Methods A retrospective analysis of consecutive blood donors' records covering the period between January 2003 and December 2007 was conducted. Logistic regression analysis was used to determine risk factors associated with HIV, HBV, HCV and syphilis infections. Results From the total of 6361 consecutive blood donors, 607 (9.5% had serological evidence of infection with at least one pathogen and 50 (0.8% had multiple infections. The overall seroprevalence of HIV, HBV, HCV and syphilis was 3.8%, 4.7%, 0.7%, and 1.3% respectively. Among those with multiple infections, the most common combinations were HIV - syphilis 19 (38% and HIV - HBV 17 (34%. The seropositivity of HIV was significantly increased among female blood donors, first time donors, housewives, merchants, soldiers, drivers and construction workers. Significantly increased HBV seropositivity was observed among farmers, first time donors and age groups of 26 - 35 and 36 - 45 years. Similarly, the seroprevalence of syphilis was significantly increased among daily labourers and construction workers. Statistically significant association was observed between syphilis and HIV infections, and HCV and HIV infections. Moreover, significantly declining trends of HIV, HCV and syphilis seropositivity were observed over the study period. Conclusions A substantial percentage of the blood donors harbour HIV, HBV, HCV and syphilis infections. Strict selection of blood donors and comprehensive screening of donors' blood using standard methods are highly

  11. A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis.

    Science.gov (United States)

    Gliddon, Harriet D; Peeling, Rosanna W; Kamb, Mary L; Toskin, Igor; Wi, Teodora E; Taylor, Melanie M

    2017-07-26

    Mother-to-child transmission (MTCT) of syphilis and HIV continue to be important yet preventable causes of perinatal and infant morbidity and mortality. To systematically review, critically appraise and perform a meta-analysis to evaluate the operational characteristics of dual rapid diagnostic tests (RDTs) for HIV/syphilis and evaluate whether they are cost effective, acceptable and easy to use. Systematic review and meta-analysis. We searched seven electronic bibliographic databases from 2012 to December 2016 with no language restrictions. Search keywords included HIV, syphilis and diagnosis. We included studies that evaluated the operational characteristics of dual HIV/syphilis RDTs. Outcomes included diagnostic test accuracy, cost effectiveness, ease of use and interpretation and acceptability. All studies were assessed against quality criteria and assessed for risk of bias. Of 1914 identified papers, 18 were included for the meta-analysis of diagnostic accuracy for HIV and syphilis. All diagnostic accuracy evaluation studies showed a very high sensitivity and specificity for HIV and a lower, yet adequate, sensitivity and specificity for syphilis, with some variation among types of test. Dual screening for HIV and syphilis was more cost effective than single rapid tests for HIV and syphilis and prevented more adverse pregnancy outcomes. Qualitative data suggested dual RDTs were highly acceptable to clients, who cited time to result, cost and the requirement of a single finger prick as important characteristics of dual RDTs. The results of this systematic review and meta-analysis can be used by policy-makers and national programme managers who are considering implementing dual RDTs for HIV and syphilis. PROSPERO 2016:CRD42016049168. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Medical and Social Aspects of Syphilis in the Balkans from the mid-19th Century to the Interwar

    Directory of Open Access Journals (Sweden)

    Tsiamis Costas

    2016-03-01

    Full Text Available The current study presents some aspects of syphilis in the Balkan Peninsula from the 19th century until the Interwar. Ever since the birth of modern Balkan States (Greece, Bulgaria, Turkey and Serbia, urbanization, poverty and the frequent wars have been considered the major factors conducive to the spread of syphilis. The measures against sex work and sexually transmitted diseases (STDs were taken in two aspects, one medical and the other legislative. In this period, numerous hospitals for venereal diseases were established in the Balkan countries. In line with the international diagnostic approach and therapeutic standards, laboratory examinations in these Balkan hospitals included spirochete examination, Wassermann reaction, precipitation reaction and cerebrospinal fluid examination. Despite the strict legislation and the adoption of relevant laws against illegal sex work, public health services were unable to curb the spread of syphilis. Medical and social factors such as poverty, citizen’s ignorance of STDs, misguided medical perceptions, lack of sanitary control of prostitution and epidemiological studies, are highlighted in this study. These factors were the major causes that helped syphilis spread in the Balkan countries during the 19th and early 20th century. The value of these aspects as a historic paradigm is diachronic. Failure to comply with the laws and the dysfunction of public services during periods of war or socioeconomic crises are both factors facilitating the spread of STDs.

  13. Medical and Social Aspects of Syphilis in the Balkans from the mid-19th Century to the Interwar.

    Science.gov (United States)

    Tsiamis, Costas; Vrioni, Georgia; Poulakou-Rebelakou, Effie; Gennimata, Vasiliki; Murdjeva, Mariana А; Tsakris, Athanasios

    2016-03-01

    The current study presents some aspects of syphilis in the Balkan Peninsula from the 19th century until the Interwar. Ever since the birth of modern Balkan States (Greece, Bulgaria, Turkey and Serbia), urbanization, poverty and the frequent wars have been considered the major factors conducive to the spread of syphilis. The measures against sex work and sexually transmitted diseases (STDs) were taken in two aspects, one medical and the other legislative. In this period, numerous hospitals for venereal diseases were established in the Balkan countries. In line with the international diagnostic approach and therapeutic standards, laboratory examinations in these Balkan hospitals included spirochete examination, Wassermann reaction, precipitation reaction and cerebrospinal fluid examination. Despite the strict legislation and the adoption of relevant laws against illegal sex work, public health services were unable to curb the spread of syphilis. Medical and social factors such as poverty, citizen's ignorance of STDs, misguided medical perceptions, lack of sanitary control of prostitution and epidemiological studies, are highlighted in this study. These factors were the major causes that helped syphilis spread in the Balkan countries during the 19th and early 20th century. The value of these aspects as a historic paradigm is diachronic. Failure to comply with the laws and the dysfunction of public services during periods of war or socioeconomic crises are both factors facilitating the spread of STDs.

  14. Co-morbidity of HIV, Hepatitis B, and Syphilis, among victims of sexual assaults in Transkei region, South Africa

    Directory of Open Access Journals (Sweden)

    Banwari L. Meel

    2009-04-01

    Full Text Available Background: The human immunodeficiency virus (HIV, acquired immune deficiency syndrome (AIDS, hepatitis B and syphilis have a common mode of transmission, which is through sexual intercourse. These are also transmitted percutaneously and by blood transfusion. The purpose of this study was to determine the prevalence of HIV, hepatitis B and syphilis among victims of sexual assault by analysing serology results.Method: This is a record review of victims of sexual assault who attended the Sinawe Centre (a clinic for victims of sexual assault between January and December 2004.Results: A total of 188 victims of sexual assault was reported. 35 (19.8% tested HIV sero-positive. Hepatitis B antibodies were detected in seven (7.6% and syphilis serology (RPR was positive in five (2.9%. All were under 50 years of age, except one victim. Of the 35 who tested positive, 30 were below 30 years of age. Of those who were 30 years and younger, 12 were between 21 and 30 years old, 16 were between 11 and 20 years old and two were younger than 10. None was positive for all three tests. Two were positive for hepatitis B and HIV and two were positive for RPR and HIV.Conclusion: No significant co-morbidity of HIV, hepatitis B or syphilis was observed in this study, even though these diseases have the same mode of transmission.

  15. [A comprehensive prevention programs on AIDS, HBV and syphilis among pregnant women and couples experienced premarital medical examination].

    Science.gov (United States)

    Gui, Xi-En; Zhang, Yuan-Zhen; Yang, Rong-Rong; Rezivan, Silafu; Li, Feng-Liang; Qin, Ai-Hua; Li, Li; Wu, Li-Zhen; Zong, Li-Li

    2010-08-01

    To evaluate the effect of comprehensive prevention programs on HIV, HBV and syphilis transmission from mother to child and between premarital couples. HIV, HBV and syphilis were screened among pregnant women with interventional measure for infected women; HIV, HBV and syphilis (TP) were screened among premarital couples with medical advice. The HIV, HBsAg and TP positive rates were 8.4‰ (111/13 280), 54‰ (711/13 186) and 12.8‰ (159/12 401) respectively among pregnant women and the total positive rate of the three diseases was 73.8‰ which was significantly higher than HIV positive rate (P premarital couples and the total positive rate of the three diseases was 131.5‰ which was significantly higher than HIV positive rate alone (P < 0.001). Comprehensive prevention was more economical than prevention for HIV alone. The comprehensive strategies for prevention of HIV, HBV and syphilis was feasible, effective and economical that could help to actively conduct the preventive measures.

  16. Ludwik Fleck and the causative agent of syphilis: sociology or pathology of science? A rejoider to Jean Lindenmann

    NARCIS (Netherlands)

    Belt, van den H.

    2002-01-01

    In 1905 two different microbes were proposed to fill the vacant role of etiologic agent for syphilis, one, the Cytorrhyctes luis, by John Siegel, the other, Spirochaeta pallida, by Fritz Schaudinn. After gathering and reviewing the evidence the majority of medical scientists decided in favor of

  17. Co-morbidity of HIV, Hepatitis B, and Syphilis, among victims of sexual assaults in Transkei region, South Africa

    Directory of Open Access Journals (Sweden)

    Banwari L. Meel

    2009-04-01

    Full Text Available Background: The human immunodeficiency virus (HIV, acquired immune deficiency syndrome (AIDS, hepatitis B and syphilis have a common mode of transmission, which is through sexual intercourse. These are also transmitted percutaneously and by blood transfusion. The purpose of this study was to determine the prevalence of HIV, hepatitis B and syphilis among victims of sexual assault by analysing serology results.Method: This is a record review of victims of sexual assault who attended the Sinawe Centre (a clinic for victims of sexual assault between January and December 2004.Results: A total of 188 victims of sexual assault was reported. 35 (19.8% tested HIV sero-positive. Hepatitis B antibodies were detected in seven (7.6% and syphilis serology (RPR was positive in five (2.9%. All were under 50 years of age, except one victim. Of the 35 who tested positive, 30 were below 30 years of age. Of those who were 30 years and younger, 12 were between 21 and 30 years old, 16 were between 11 and 20 years old and two were younger than 10. None was positive for all three tests. Two were positive for hepatitis B and HIV and two were positive for RPR and HIV.Conclusion: No significant co-morbidity of HIV, hepatitis B or syphilis was observed in this study, even though these diseases have the same mode of transmission.

  18. Jarisch-Herxheimer reaction among HIV-positive patients with early syphilis: azithromycin versus benzathine penicillin G therapy

    Directory of Open Access Journals (Sweden)

    Mao-Song Tsai

    2014-08-01

    Full Text Available Introduction: The Jarisch-Herxheimer reaction, a febrile inflammatory reaction that often occurs after the first dose of chemotherapy in spirochetal diseases, may result in deleterious effects to patients with neurosyphilis and to pregnant women. A single 2-g oral dose of azithromycin is an alternative treatment to benzathine penicillin G for early syphilis in areas with low macrolide resistance. With its potential anti-inflammatory activity, the impact of azithromycin on the incidence of the Jarisch-Herxheimer reaction in HIV-positive patients with early syphilis has rarely been investigated. Methods: In HIV-positive patients with early syphilis, the Jarisch-Herxheimer reaction was prospectively investigated using the same data collection form in 119 patients who received benzathine penicillin G between 2007 and 2009 and 198 who received azithromycin between 2012 and 2013, when shortage of benzathine penicillin G occurred in Taiwan. Between 2012 and 2013, polymerase chain reaction (PCR assay was performed to detect Treponema pallidum DNA in clinical specimens, and PCR restriction fragment length polymorphism of the 23S ribosomal RNA was performed to detect point mutations (2058G or A2059G that are associated with macrolide resistance. Results: The overall incidence of the Jarisch-Herxheimer reaction was significantly lower in patients receiving azithromycin than those receiving benzathine penicillin G (14.1% vs. 56.3%, p<0.001. The risk increased with higher rapid plasma reagin (RPR titres (adjusted odds ratio [AOR] per 1-log2 increase, 1.21; confidence interval [CI], 1.04–1.41, but decreased with prior penicillin therapy for syphilis (AOR, 0.37; 95% CI, 0.19–0.71 and azithromycin treatment (AOR, 0.15; 95% CI, 0.08–0.29. During the study period, 310 specimens were obtained from 198 patients with syphilis for PCR assays, from whom T. pallidum was identified in 76 patients, one of whom (1.3% was found to be infected with T. pallidum

  19. Peer Group Intervention Studies of High-Risk Behavior Among MSM Syphilis%MSM人群梅毒高危行为同伴群干预研究

    Institute of Scientific and Technical Information of China (English)

    林绍光; 戴磊; 张冬梅; 麦建林; 管喜红; 张琳玲; 罗伟杰; 麦卫平; 邓惠玲; 麦爱芬

    2016-01-01

    目的:综合分析男男性行为(MSM)人群梅毒(Syphilis)高危行为同伴群干预研究。方法招募2011年12月至2014年12月有过肛交或者口交(MSM)人群资料131名,并且在MSM人群知晓的情况下参与调查实验,建立同伴群干预队列。采用SPSS15.0统计学软件进行统计学分析MSM人群的资料以及干预前、干预3.5个月后的MSM同伴群的梅毒高危行为。结果干预前对艾滋病知识的知晓率为36.88%,干预后对艾滋病知识的知晓率为85.98%,干预后131名MSM对艾滋病知识的知晓率显著提高,差异有统计学意义(P<0.05);干预前梅毒感染率为12.1%,干预后梅毒感染率为9.14%,差异有统计学意义(P<0.05);干预前最近1次与男性固定性伴侣发生肛交或者口交的安全套使用率为46.54%,干预后最近1次与男性固定性伴侣发生肛交或者口交的安全套使用率为82.67%,差异有统计学意义(P<0.05)。结论由核心人物发起与同伴趋动相结合的方法能够显著降低梅毒感染率,减少MSM人群无保护肛交或者口交行为。%objective To analyze MSM(MSM) Syphilis(syphilis) Peer group risk behavior intervention. Methods Initiated by the central figure and fellow-driven method of combining recruited in December 2011-2014 December MSM (had anal or oral sex) population data 131, and participate in the investigation in the case known among MSM experiment to establish peer group intervention queue. Using SPSS15.0 statistical software for statistical analysis of the data before the MSM population and intervention, 3.5 months after the MSM peer group of syphilis in high-risk behavior. Results Before intervention on the knowledge of AIDS awareness was 36.88%, after the intervention of the awareness of AIDS knowledge was 85.98%, after the intervention of the knowledge of AIDS awareness significantly increased 131 MSM, data difference was statistically significant (P<0.05); pre

  20. The girl from the Church of the Sacrament: a case of congenital syphilis in XVIII century Lisbon

    Directory of Open Access Journals (Sweden)

    Sheila Mendonça de Souza

    2006-12-01

    Full Text Available Syphilis is a sexually or congenitally transmitted infectious disease with an impact on the health of human populations that has undergone important cycles in different countries and periods of history. Its presence was first diagnosed in Europe in the late XIV century. In Portugal, although there are various written records of the infection in the last centuries, there are rare references to it in archeological findings (mummified bodies are also rare in Portugal. The current study describes a probable case of congenital syphilis in an 18-month-old girl buried in the Church of the Sacrament in Lisbon. Her body, dating to the XVIII century, was found mummified together with dozens of others, still not studied. Symmetrical periostitis of the long bones, osteitis, metaphyseal lesions, left knee articular, and epiphyseal destruction, and a rarefied lesion with a radiological appearance compatible with Wimberger's sign all point to a diagnosis of congenital syphilis. The diagnosis of this severe form of the infection, possibly related to the cause of death in this upper-class girl, calls attention to the disease's presence in XVIII century Lisbon and is consistent with the intense mobilization at the time in relation to the risks posed by so-called heredosyphilis. It is the first case of congenital syphilis in a child reported in archeological findings in Portugal, and can be correlated with other cases in skeletons of adults buried in cemeteries in Lisbon (in the XVI to XVIII centuries and Coimbra (XIX century. Finally, this finding highlights the need to study the entire series of mummified bodies in the Church of the Sacrament in order to compare the paleopathological findings and existing historical documents on syphilis, so as to expand the paleoepidemiological knowledge of this infection in XVIII century Lisbon.

  1. Early syphilis treatment in HIV-infected patients: single dose vs. three doses of benzathine penicillin G.

    Science.gov (United States)

    Costa-Silva, M; Azevedo, C; Azevedo, F; Lisboa, C

    2016-10-01

    Current treatment guidelines for early stages of syphilis are the same regardless of HIV serostatus. There is still controversy about the best treatment for syphilis in HIV patients and the current recommendations are based on limited data. The primary goal of this study was to compare the serological response rates to a single dose vs. three weekly doses of benzathine penicillin G (BPG) in HIV-infected patients with early syphilis and to assess the adequacy of current recommendations. Clinical and laboratory data of HIV patients with early syphilis treated in Sexually Transmitted Disease Clinic between January 2000 and December 2014 were recorded. A good serological response was defined as a ≥4-fold decline in Venereal Disease Research Laboratory (VDRL) titre within 12 months after treatment. Serological failure was defined as a lack of at least fourfold decrease in VDRL titres within 12 months after treatment. After applying inclusion and exclusion criteria, 60 patients were enrolled in the study. Seventeen (28.3%) patients were treated with a single dose of BPG, while in 43 (71.7%) patients, three weekly doses were used. Fifty eight (96.7%) had a good serological response at 12 months and seroconversion was confirmed in 29 (48.3%) patients. There was no statistically significant difference between the two treatment groups regarding serological response, seroconversion rate and the time needed to obtain a good serological response. Furthermore, treatment response was not affected by the number of CD4 cells. The results of our study support the current international treatment guidelines, recommending early syphilis treatment with a single dose of BPG in HIV patients. © 2016 European Academy of Dermatology and Venereology.

  2. BARIUM SULPHATE ABSORPTION AND THE SERUM DIAGNOSIS OF SYPHILIS.

    Science.gov (United States)

    Noguchi, H; Bronfenbrenner, J

    1911-02-01

    The so-called syphilitic antibodies can be removed from a serum by means of absorption with barium sulphate. The removal is due either to an adsorption or a mechanical absorption. The activity of the syphilitic antibodies is thereby unimpaired. The readiness with which the absorption is accomplished with barium sulphate varies considerably with different syphilitic sera. That barium sulphate exerts the same absorbing effect upon non-syphilitic serum components is made evident by the interfering property which the latter manifest in the absorption experiment of the syphilitic antibodies. The selective removal of the serum components, other than the syphilitic antibodies, by means of barium sulphate absorption is, therefore, impossible. On the other hand, a partial removal of these components, with but little removal of the syphilitic antibodies, may be effected when the content of a given serum is poor in syphilitic antibodies and comparatively rich in the indifferent serum components. But this is impossible if the conditions are reversed. The main reasons why some negative syphilitic sera may be so modified by the barium sulphate treatment as to give positive reactions, are explained below, but these apply only to those methods in which inactivated serum is employed. The inactivation reduces the antibody content to about one-fourth to one-fifth of the original. When the serum is very rich in antibodies, this does not affect the result of the fixation test. But when the amount of the antibodies is small, the process of inactivation creates conditions quite unexpected. It may produce such a condition that a given amount of the serum contains, after inactivation, only one or two antibody units, while the other serum components remain undiminished. Here one must not lose sight of the vital fact that these apparently indifferent serum constituents are not at all indifferent in the fixation processes. They may possess affinities which are similar to those of complement

  3. Sífilis: diagnóstico, tratamento e controle Syphilis: diagnosis, treatment and control

    Directory of Open Access Journals (Sweden)

    João Carlos Regazzi Avelleira

    2006-03-01

    Full Text Available A sífilis é doença infecto-contagiosa, transmitida pela via sexual e verticalmente durante a gestação. Caracteriza-se por períodos de atividade e latência; pelo acometimento sistêmico disseminado e pela evolução para complicações graves em parte dos pacientes que não trataram ou que foram tratados inadequadamente. É conhecida desde o século XV, e seu estudo ocupou todas as especialidades médicas e, de modo especial, a dermatologia. Seu agente etiológico, o Treponema pallidum, nunca foi cultivado e, apesar de descrito há mais de 100 anos e sendo tratado desde 1943 pela penicilina, sua droga mais eficaz, continua como um problema de saúde importante em países desenvolvidos ou subdesenvolvidos. Dadas as características da forma de transmissão, a doença acompanhou as mudanças comportamentais da sociedade e nos últimos anos tornou-se mais importante ainda devido à possibilidade de aumentar o risco de transmissão da síndrome de imunodeficiência adquirida. Novos testes laboratoriais e medidas de controle principalmente voltadas para o tratamento adequado do paciente e parceiro, uso de preservativo, informação à população fazem parte das medidas adotadas para controle da sífilis pelos responsáveis por programas de saúde.Syphilis is an infectious disease transmitted through sex or vertically during pregnancy. It is characterized by periods of activity and latency, disseminated systemic involvement, and progression to acute complications in patients that remain untreated or have been inadequately treated. Syphilis is known since the 15th century and studied by all medical specialties, particularly by Dermatology. The etiologic agent Treponema pallidum has never been cultured and was described over 100 years ago. The disease has been effectively treated with penicillin since 1943, but it remains an important health problem in developed and developing countries. Given its transmission characteristics, the condition has

  4. [Evaluation of the serological response to syphilis treatment using an automated RPR test].

    Science.gov (United States)

    Itoda, Ichiro

    2014-05-01

    We evaluated the clinical usefulness of serological monitoring with an automated rapid plasma reagin (RPR) test in syphilis patients. Serum samples were obtained from 68 syphilis patients, including 57 cases infected with human immunodeficiency virus (HIV) from our clinic between February 2010 and May 2012. RPR titers were measured with both the conventional serial dilution manual method and the automated method before (baseline) and at several intervals after treatment. The criteria of a cure were defined based on RPR titers as equal to and/or more than a 4-fold decrease (with the manual method) or by RPR values lowered to the level of equal and/or less than 25% (with the automated method) within 6 months in comparison with baseline values. A serological cure was observed in 19 (95%) and 17 (85%) of the 20 cases with the manual method and the automated method after 6 months, respectively. For the other 3 cases, the RPR value ratios with the automated method were 25.4%, 25.9% and 37.9%. Among all 68 patients, 9 cases (13.2%) did not meet the criteria for a cure by both methods within 6 months, but all cases did within 12 months. The ratio of RPR values after several months against that of baseline was evaluated with a t-test; the RPR values with the automated method were significantly lower than those obtained with the manual method (p RPR value ratios of HIV-positive cases were significantly higher 1 and 2 months after (with the manual method) and 1 month after (with the automated method) than those of HIV-negative cases; however, no statistical significance was observed after 6 months between the RPR ratio of HIV-positive and HIV-negative cases. Based on these results, we infer that the RPR test with the automated method can be used in the same manner as the manual method for treatment monitoring of HIV-positive and HIV-negative syphilis patients, especially in the early phase of treatment.

  5. TRUST与TPPA在梅毒诊断和疗效中的应用价值分析%Value analysis of TRUST and TPPA testing for syphilis diagnosis and curative effect

    Institute of Scientific and Technical Information of China (English)

    罗德维; 王开宇; 王顺东; 周林碧; 彭焕文; 袁丹

    2016-01-01

    Objective To compare the clinical value of TPPA (treponema pallidum Antibody particles agglutinate experiment) and TRUST (toluidine red unheated serum test) in the diagnosis and treatment of syphilis.Methods 1763 cases of STD clinic patients, 120 cases of non syphilis patients ,120 cases of normal ,100 cases of syphilis patients treated for 3 months and 6 months were selected as subjects. The results of the joint detection with TRUST and TPPA were recorded and compared.Results In 1763 cases of STD clinic patients, 303 cases (17.19%) were syphilis positive in TRUST tests, 493 cases(27.96%) were syphilis positive in TPPA tests , and 296 cases(16.79%) were syphilis positive both in TRUST and TPPA tests. Among the 120 cases of non syphilis patients with TRUST and TPPA, the positive rates were 6.67% and 0. Among the 120 cases of normal with TRUST and TPPA, the positive rates were 0.83% and 0. The TPPA results were differences between the TRUST titer> 1:4 samples and the TRUST titer ≤1:4 samples. 100 cases of syphilis patients follow-up test results showed that, TPPA was positive, TRUST titer was decreased or negative.Conclusion Both the TRUST test and TPPA test could be the fast and effective method in diagnosis of syphilis. TPPA, as confirmed diagnose test in the specificity and sensitivity is significantly higher than TRUST. However, TRUST was more suitable foe screening a large number of specimens, and significantly better than TPPA in clinical therapeutic effect observation. The author suggested that the high-risk groups and the first-visit patients should be tested by TRUST and TPPA joint detection, the patients in treatment can only be detected by TRUST.%目的:比较梅毒甲苯胺红不加热血清试验(TRUST)与梅毒螺旋体明胶颗粒凝集试验(TPPA)在梅毒诊断和疗效中的应用价值。方法:对1763例性病门诊就诊者、120例非梅毒病例患者、120例健康体检者、100例梅毒治疗患者随访3个月、6个月后的

  6. Are Treponema pallidum specific rapid and point-of-care tests for syphilis accurate enough for screening in resource limited settings? Evidence from a meta-analysis

    National Research Council Canada - National Science Library

    Jafari, Yalda; Peeling, Rosanna W; Shivkumar, Sushmita; Claessens, Christiane; Joseph, Lawrence; Pai, Nitika Pant

    2013-01-01

    Rapid and point-of-care (POC) tests for syphilis are an invaluable screening tool, yet inadequate evaluation of their diagnostic accuracy against best reference standards limits their widespread global uptake...

  7. Prevalence of Treponema pallidum DNA among blood donors with two different serologic tests profiles for syphilis in São Paulo, Brazil.

    Science.gov (United States)

    Ferreira, S C; de Almeida-Neto, C; Nishiya, A S; Di-Lorenzo-Oliveira, C; Ferreira, J E; Alencar, C S; Levi, J E; Salles, N A; Mendrone-Junior, A; Sabino, E C

    2014-05-01

    The presence of Treponema pallidum DNA was assessed by real-time PCR in samples of blood donors with reactive serologic tests for syphilis. Treponema pallidum DNA was detected in two (1·02%) of 197 samples of VDRL>8, EIA+ and FTA-ABS+ donors, and in no sample from 80 VDRL−, EIA+ and FTA-ABS+ donors. Donors VDRL−, EIA+ and FTA-ABS+ lack demonstrable T. pallidum DNA in their blood and are unlike to transmit syphilis. Donors VDRL>8, EIA+ and FTA-ABS+ carry the risk of syphilis infectivity even in concomitance to antibodies detection. Serologic screening for syphilis may still play a role to prevent its transfusion transmission.

  8. Clinical Study of Ceftriaxone Sodium in Treatment of Pregnancy Syphilis and Prevention of Congenital Syphilis%头孢曲松钠治疗妊娠梅毒预防先天性梅毒的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙静茹

    2015-01-01

    Objective To explore the effect of ceftriaxone sodium in in treatment of pregnancy syphilis and prevention of congenital syphilis. Methods 100 pregnant women with syphilis were selected into observation group(50 cases)and control group(50 cases). The patients in observation group were treated with ceftriaxone sodium,the control group patients were treated with benzathine penicillin. The incidences of congenital syphilis between two groups were compared. Results There were no significant difference between observation group and control group, the difference was not statistically significant(P>0.05). Conclusion Ceftriaxone sodium and benzathine penicillin have the same results in the prevention of congenital syphilis,for penicillin allergy persons,ceftriaxone sodium can be used as the medicine for preventing congenital syphilis. It can make more patients benefit.%目的:探讨头孢曲松钠治疗妊娠梅毒预防先天性梅毒的效果。方法选取我处接受治疗的梅毒孕妇100例,随机分为观察组和对照组,其中,观察组患者50例,以头孢曲松钠进行治疗。对照组患者50例,以苄星青霉素进行治疗。对比两组患者先天梅毒的发病率。结果观察组与对照组的组间无显著差异,结果不具有统计意义(P>0.05)。结论头孢曲松钠与苄星青霉素在预防先天性梅毒的效果中具有相同的结果,因此对于青霉素过敏者,可以使用头孢曲松钠作为预防先天性梅毒的药物,使得更多患者受益。

  9. Evaluation of three serological tests manufactured in Belarus for the diagnosis of syphilis.

    Science.gov (United States)

    Shimanskaya, Iryna; Zhurauskaya, Larisa; Pankratov, Oleg; Unemo, Magnus; Ballard, Ronald C; Domeika, Marius

    2011-05-01

    The performance of three serological tests manufactured in Belarus for the diagnosis of syphilis, i.e. a microprecipitation reaction (MPR) and two enzyme-linked immunosorbent assays (ELISAs) were compared with internationally recognized assays, namely the rapid plasma reagin test and the Treponema pallidum passive particle agglutination assay (TPPA). Sera from 392 consecutive patients attending Brest (Belarus) regional dermatovenereological dispensaries were tested. The sensitivity of the MPR test was low (77.3%) compared with the rapid plasma reagin test, while the specificity was high (100%). In contrast, both Belarusian ELISAs performed well when compared with the TPPA (sensitivities of 99.2% and 100%, specificities of 98.7% and 99.0%, respectively). There is a clear need to improve the sensitivity of the existing Belarusian MPR test or to use a more sensitive screening test in order to improve diagnosis of the disease in Belarus.

  10. Nonconvulsive status epilepticus associated with periodic lateralized epileptiform discharges in a patient with syphilis

    Directory of Open Access Journals (Sweden)

    Xin Yu

    2016-09-01

    Full Text Available Nonconvulsive status epilepticus (NCSE has been increasingly recognized as a cause of impaired level of consciousness in the ICU and emergency rooms. The confirmation of NCSE is largely based on the EEG, given the nonspecific and pleomorphic clinical manifestations. Debate remains over electroencephalograms (EEG criteria for NCSE. Periodic lateralized epileptiform discharges (PLEDs, have sparked controversy with regard to being part of the ictal vs. interictal spectrum. We report a case of a patient with syphilis who had cognitive decline and damaged consciousness with PLEDs and T2 hyperintensity at temporal and occipital lobe in MRI. After antiepileptic treatment only, his consciousness improved markedly together with the EEG in few days, while the change of MRI was still serious. In this case PLEDs is the sign of NCSE and change of MRI is limbic encephalitis (LE. This report discusses the association of PLEDs and NCSE, and supports the concept of PLEDs as an ictal pattern in some condition.

  11. Factors associated to the notification of congenital syphilis: an indicator of quality of prenatal care

    Directory of Open Access Journals (Sweden)

    Inacia Sátiro Xavier de França

    2015-07-01

    Full Text Available Objective: to analyze factors associated to the notification of congenital syphilis. Methods: a cross-sectional documentary, quantitative study, made through the National System of Notifiable Diseases. The study consisted of 113 notified cases. A data collection form was used and Chi-square and Fisher tests were made. Results: women had prenatal exams (80.2%, serologic testing before six months of pregnancy (46.7% and after (53.3%. There was an association for the variables race (p = 0.005 and serological test (p = 0.044. The treatment of the pregnant woman was inadequate (64.5% and the partner was not treated (85.7%. Conclusion: it was found that the number of cases is growing, increasing the possibility of children with severe sequelae. So improvements in prenatal care are still needed.

  12. Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study.

    Science.gov (United States)

    McGready, Rose; Kang, Joy; Watts, Isabella; Tyrosvoutis, Mary Ellen G; Torchinsky, Miriam B; Htut, Aung Myo; Tun, Nay Win; Keereecharoen, Lily; Wangsing, Chirapat; Hanboonkunupakarn, Borimas; Nosten, François H

    2014-01-01

    The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates. From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border. Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (>75% were < 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors. As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies.

  13. [Syphilis detection using ELISA and VDRL tests on blood donors at the blood center of Guarapuava, State of Paraná].

    Science.gov (United States)

    Oliveira, Viviane Matoso de; Verdasca, Izabel Cristina; Monteiro, Marta Chagas

    2008-01-01

    The aim of this study was to evaluate the syphilis seroprevalence among 5,752 blood donors who were attended at the blood center of Guarapuava, State of Paraná, in 2006. The seropositivity rates were 2.1% for enzyme Linked Immuno Sorbent Assay and 0.2% for Veneral Disease Research Laboratory, thus showing low prevalence of syphilis among the individuals who came to this blood bank.

  14. Contribution of a Comparative Western Blot Method to Early Postnatal Diagnosis of Congenital Syphilis.

    Science.gov (United States)

    Marangoni, Antonella; Foschi, Claudio; Capretti, Maria Grazia; Nardini, Paola; Compri, Monica; Corvaglia, Luigi Tommaso; Faldella, Giacomo; Cevenini, Roberto

    2016-05-01

    Serology has a pivotal role in the diagnosis of congenital syphilis (CS), but problems arise because of the passive transfer of IgG antibodies across the placenta. The aim of this study was to assess the diagnostic value of a comparative Western blot (WB) method finalized to match the IgG immunological profiles of mothers and their own babies at birth in order to differentiate between passively transmitted maternal antibodies and antibodies synthesized by the infants against Treponema pallidum Thirty infants born to mothers with unknown or inadequate treatment for syphilis were entered in a retrospective study, conducted at St. Orsola-Malpighi Hospital, Bologna, Italy. All of the infants underwent clinical, instrumental, and laboratory examinations, including IgM WB testing. For the retrospective study, an IgG WB assay was performed by blotting T. pallidum antigens onto nitrocellulose sheets and incubating the strips with serum specimens from mother-child pairs. CS was diagnosed in 11 out of the 30 enrolled infants; 9/11 cases received the definitive diagnosis within the first week of life, whereas the remaining two were diagnosed later because of increasing serological test titers. The use of the comparative IgG WB testing performed with serum samples from mother-child pairs allowed a correct CS diagnosis in 10/11 cases. The CS diagnosis was improved by a strategy combining comparative IgG WB results with IgM WB results, leading to a sensitivity of 100%. The comparative IgG WB test is thus a welcome addition to the conventional laboratory methods used for CS diagnosis, allowing identification and adequate treatment of infected infants and avoiding unnecessary therapy of uninfected newborns. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  15. Evaluation of the automated ADVIA centaur® XP syphilis assay for serological testing.

    Science.gov (United States)

    Saw, Sharon; Zhao, Huiqin; Tan, Phyllis; Saw, Betty; Sethi, Sunil

    2017-05-01

    We evaluated the performance of the ADVIA Centaur XP Syphilis assay (Siemens Healthcare Diagnostics, Tarrytown, NY, USA) using samples previously tested on the ARCHITECT i4000SR system (Abbott Diagnostics, Lake Forest, IL, USA) and confirmed by the Treponema pallidum particle agglutination assay (TPPA) (SERODIA-TPPA, Fujirebio Diagnostics Inc., Malvern, PA, USA). Clinical patient information was included to aid resolution of discordant samples where available. Precision, interference, and cross-reactivity were also assessed. Relative to patient clinical status, the sensitivity of both the ADVIA Centaur XP and the ARCHITECT assays was 100% (95% CI, 93.9-100), and the specificity of the ADVIA Centaur XP assay was 95.5% (95% CI, 90.4-98.3), which was slightly higher than that of the ARCHITECT assay at 93.9% (95% CI, 88.4-97.3). Overall agreement relative to patient clinical status was 96.9% (95% CI, 93.3-98.8) for the ADVIA Centaur XP assay and 95.8% (95% CI, 91.9-98.2) for the ARCHITECT assay. Overall agreement between the two automated assays was 96.9% (95% CI, 93.3-98.8). ADVIA Centaur XP assay precision was <5% at all index values tested. No significant interference was observed for lipemia or hemolysis; a small effect was seen with some samples for bilirubin. The assay exhibited no significant cross-reactivity with a number of potential interfering factors. The ADVIA Centaur XP Syphilis assay can be considered a sensitive and accurate assay for identification of treponemal antibodies in screening populations as well as patients presenting with suspicion of syphilitic infection. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Survival of Treponema pallidum in banked blood for prevention of Syphilis transmission

    Directory of Open Access Journals (Sweden)

    Adeolu O Adegoke

    2011-01-01

    Full Text Available Background: Every year, millions of people are exposed to avoidable, life-threatening risks through the trans-fusion of unsafe blood. Aim : To determine the survival time of Treponema pallidum in banked donor blood. Material and Methods : Two groups of male Wistar rats (group A and B were inoculated intratesticularly with 0.5ml of artificially infected donor blood (final density of Nichols treponemes: 5x10 5 /ml stored at 4 o C for various periods of time. In group A, a pair each of the rats was injected every 12 hours, starting at 0 hr, up to a maximal storage time of 96 hr. In group B, the rats were injected after 72, 120, 192 and 336 hours of storage of the treponemes-blood mixture. Group C which is a control group was injected with blood only, while group D rats were injected with heat-killed treponemes suspended in blood every 12 hours. The detection of Treponema pallidum IgG/IgM was based on the principle of double antigen sandwich immunoassay, in which purified recombinant antigens are employed sufficiently to identify antibodies to Syphilis. The outcomes of interest included the proportion of Syphilis positive rats and the maximal survival hours of T. pallidum in banked blood. Results : 14 rats (77.8% out of the 18 rats that were involved in group A developed orchitis and positive serology up to 72 hours of storage time, p<0.05. 2 rats (25% in group B developed orchitis after 72hrs of storage time. All the 18 rats (100% in the control group C and D showed neither clinical nor serological changes. Conclusion : It was concluded that the survival time of T. pallidum in banked donor blood lies between 72-120hrs in this study. Regardless of blood banking temperature, T. pallidum and other transfusion transmissible infections should be screened for prior to allogeneic transfusion.

  17. Syphilis Test

    Science.gov (United States)

    ... helpful? Also known as: Venereal Disease Research Laboratory; VDRL; Rapid Plasma Reagin; RPR; Fluorescent Treponemal Antibody Absorption ... test for treponemal antibodies is positive (see below). VDRL (Venereal Disease Research Laboratory)--in addition to blood, ...

  18. Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study

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    Asare Isaac

    2008-03-01

    Full Text Available Abstract Background Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg. These data were analyzed using both univariate and multivariate techniques. Results Almost 18% (1336 of 7652 eligible inmates and 21% (445 of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84 and 38.1 years (range 25–59, respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis

  19. Enzyme-linked immunosorbent assay for detection of antibodies to the venereal disease research laboratory (VDRL) antigen in syphilis.

    Science.gov (United States)

    Pedersen, N S; Orum, O; Mouritsen, S

    1987-09-01

    An enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin G (IgG) and IgM to cardiolipin, lecithin, and cholesterol (VDRL [Venereal Disease Research Laboratory] ELISA) is described. The specificity of the VDRL ELISA for IgG and IgM was 99.6 and 99.5%, respectively, with sera from 1,008 persons without syphilis. For a group of patients with false-positive results in traditional nontreponemal tests and for patients with autoimmune diseases, the VDRL ELISA for IgG had a higher specificity than the VDRL ELISA for IgM. The sensitivity for IgG and IgM with 118 sera from patients with untreated syphilis was 96.6 and 94.9%, respectively, which was equivalent to the sensitivities of the traditional nontreponemal tests. The performance of the VDRL ELISA was compared with that of an ELISA that uses cardiolipin as the antigen (cardiolipin ELISA). The VDRL ELISA was significantly more sensitive (P less than or equal to 0.01) than the cardiolipin ELISA with 25 sera from syphilis patients but was less sensitive (P less than or equal to 0.01) with 53 sera from patients with autoimmune diseases. The antibody reactivity in the VDRL ELISA could not be absorbed out by lecithin and cholesterol, and the sera from patients with syphilis did not react in an ELISA that uses cholesterol and lecithin as the antigen. This indicates that cholesterol and lecithin, although not antigenic by themselves, may change the structural form of the epitope on cardiolipin so that it becomes more recognizable for antibodies in syphilis and less recognizable for antibodies in autoimmune diseases. The results of the VDRL ELISA were expressed in percentages of the absorbance value of a positive control. The VDRL ELISA gave, without titration of sera, quantitative results that correlated with the quantitative results of the traditional nontreponemal tests obtained by titration. The VDRL ELISA will be well suited for large-scale testing for syphilis and may replace other nontreponemal tests.

  20. Syphilis and cirrhosis: a lethal combination in a XIX century individual identified from the Medical Schools Collection at the University of Coimbra (Portugal

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    Célia Lopes

    2010-12-01

    Full Text Available Syphilis is a chronic infection that is categorized by a three-stage progression. The tertiary stage may affect bones and produce distinctive skull lesions called caries sicca. This paper aims to present an unusual case of syphilis associated with a diagnosis of cirrhosis, which was recorded as the cause of death in a 28-year-old female in 1899. The appearance and distribution of the lesions were compatible with acquired syphilis, as observed in the skull from the Medical Schools Collection of the University of Coimbra. However, the cause of death was recorded as "hypertrophic cirrhosis of the liver", this is a condition that is compatible with several liver disorders, including a primary liver disorder, such as cirrhosis provoked by alcoholism, infection of the liver by syphilis pathogens or by damage to the liver from the use of mercury compounds, which was the common treatment for syphilis at the time. This paper represents a contribution to the understanding of the natural evolution of syphilis.

  1. Syphilis epidemiology in 1994-2013, molecular epidemiological strain typing and determination of macrolide resistance in Treponema pallidum in 2013-2014 in Tuva Republic, Russia.

    Science.gov (United States)

    Khairullin, Rafil; Vorobyev, Denis; Obukhov, Andrey; Kuular, Ural-Herel; Kubanova, Anna; Kubanov, Alexey; Unemo, Magnus

    2016-07-01

    The incidence of syphilis in the Tuva Republic (geographical centre of Asia), Russia has been exceedingly high historically. No detailed examinations and no molecular investigations of Treponema pallidum strains transmitted in the Tuva Republic, or in general, in Russia, were published internationally. We examined the syphilis epidemiology in 1994-2013, and the molecular epidemiology and macrolide resistance in T. pallidum strains in 2013-2014 in the Tuva Republic. Among 95 mainly primary or secondary syphilis patients, the arp, tpr, tp0548 and 23S rRNA genes in 85 polA gene-positive genital ulcer specimens were characterized. The syphilis incidence in Tuva Republic peaked in 1998 (1562), however declined to 177 in 2013. Among the 70 (82%) completely genotyped specimens, six molecular strain types were found. Strain type 14d/f accounted for 91%, but also 14c/f, 14d/g, 14b/f, 14i/f, 9d/f, and 4d/f were identified. Two (2.4%) specimens contained the 23S rRNA A2058G macrolide resistance mutation. This is the first internationally published typing study regarding T. pallidum in Russia, performed in the Tuva Republic with the highest syphilis incidence in Russia. The two molecular strain types 4d/f and 9d/f have previously been described only in Eastern and Northern China and for the first time, macrolide-resistant syphilis was described in Russia.

  2. Syphilis serology in pregnancy: an eight-year study (2005-2012) in a large teaching maternity hospital in Dublin, Ireland.

    Science.gov (United States)

    McGettrick, Padraig; Ferguson, Wendy; Jackson, Valerie; Eogan, Maeve; Lawless, Mairead; Ciprike, Vaneta; Varughese, Alan; Coulter-Smith, Sam; Lambert, John S

    2016-03-01

    All cases of positive syphilis serology detected in antenatal and peripartum screening in a large teaching maternity hospital in inner city Dublin, Ireland over an eight-year period (2005-2012 inclusive) were reviewed and included in our study. Demographic, antenatal registration, laboratory (including co-infections), partner serology, treatment and delivery data were recorded in our database. Infant follow-up, treatment and outcome data were also collected. During this period, 194 women had positive syphilis serology, of which 182 completed their pregnancies at the institution. This accounts for 0.28% of the total number of women completing their pregnancies during this time (N = 66038); 79 had no previous diagnosis of infection. There was one case of re-infection during pregnancy. Thirty-two women were co-infected with human immunodeficiency virus, hepatitis B or hepatitis C. There was one case suggestive of congenital syphilis infection. Our study is a comprehensive analysis of the diagnosis, management and clinical outcomes of women testing positive for syphilis infection in pregnancy. It reveals the relatively high prevalence of syphilis infection in the population utilising the maternity services in north inner-city Dublin. It re-enforces the importance of continued active surveillance to prevent morbidity and mortality associated with maternal syphilis infection. It also highlights the importance of strategies such as re-testing high-risk groups and definitive screening of spouse serology.

  3. Indonesian National Inmate Bio-Behavioral Survey for HIV and Syphilis Prevalence and Risk Behaviors in Prisons and Detention Centers, 2010

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    Suzanne Blogg

    2014-01-01

    Full Text Available Prisons are considered high-risk environments for HIV transmission. This study aimed to measure HIV and syphilis prevalence and risk behaviors among inmates in Indonesia. An integrated HIV and syphilis biological and behavior survey was conducted on random samples of 900 male and 402 female inmates in 2010. Male inmates from 18 general prisons and detention centers were randomly selected using probability proportional to size. Female inmates were randomly selected from nine eligible institutions. HIV tests included two rapid tests and enzyme-linked immunosorbent assay (ELISA for quality control. A rapid test was used for syphilis. Audio computer-assisted self-interview was used for collecting risk behavior information. HIV prevalence was 1.1% among male and 6.0% among female inmates. Syphilis prevalence was 5.1% for male and 8.5% for female inmates. A history of injecting drugs was the most important risk factor for HIV infection in male inmates; for females, it was co-infection with syphilis and being sentenced for illicit drug use. Inmates’ high-risk activities in prison included tattooing, piercing and inserting genital accessories without sterile equipment, and sex without condoms. The study found high-risk practices by male inmates and high HIV and syphilis prevalence in female inmates. Inmates need harm reduction initiatives.

  4. Assessment of an evolutive tertiary syphilis by bone scintigraphy. A case report; Evaluation d'une syphilis tertiaire evolutive en scintigraphie osseuse. A propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Andriamisandratsoa, N.; Scheiber, C.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Dery, M. [Medecine Generale, Geriatrie, 67 - Strasbourg (France)

    2003-10-01

    One patient complained of persisting diffuse bone pain, with greater intensity in the pelvis. HDP {sup 99m}Tc bone scintigraphy showed increased uptake around the right sacro-iliac joint and in the right iliac area due to increased osteoblastic activity, thereby providing functional information about the evolutive nature of the bone lesion. The X-scanner only revealed osteolysis in the same location. A blood test confirmed the diagnosis of tertiary syphilis. (author)

  5. Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS: a cross-sectional study.

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    Neela D Goswami

    Full Text Available To determine the feasibility and case detection rate of a geographic information systems (GIS-based integrated community screening strategy for tuberculosis, syphilis, and human immunodeficiency virus (HIV.Prospective cross-sectional study of all participants presenting to geographic hot spot screenings in Wake County, North Carolina.The residences of tuberculosis, HIV, and syphilis cases incident between 1/1/05-12/31/07 were mapped. Areas with high densities of all 3 diseases were designated "hot spots." Combined screening for tuberculosis, HIV, and syphilis were conducted at the hot spots; participants with positive tests were referred to the health department.Participants (N = 247 reported high-risk characteristics: 67% previously incarcerated, 40% had lived in a homeless shelter, and 29% had a history of crack cocaine use. However, 34% reported never having been tested for HIV, and 41% did not recall prior tuberculin skin testing. Screening identified 3% (8/240 of participants with HIV infection, 1% (3/239 with untreated syphilis, and 15% (36/234 with latent tuberculosis infection. Of the eight persons with HIV, one was newly diagnosed and co-infected with latent tuberculosis; he was treated for latent TB and linked to an HIV provider. Two other HIV-positive persons had fallen out of care, and as a result of the study were linked back into HIV clinics. Of 27 persons with latent tuberculosis offered therapy, nine initiated and three completed treatment. GIS-based screening can effectively penetrate populations with high disease burden and poor healthcare access. Linkage to care remains challenging and will require creative interventions to impact morbidity.

  6. Point-of-care screening for syphilis and HIV in the borderlands: challenges in implementation in the Brazilian Amazon.

    Science.gov (United States)

    Ruffinen, Carole Zen; Sabidó, Meritxell; Díaz-Bermúdez, Ximena Pamela; Lacerda, Marcus; Mabey, David; Peeling, Rosanna W; Benzaken, Adele Schwartz

    2015-11-05

    Point-of-care (POC) screening for HIV and syphilis using rapid testing was implemented in indigenous communities in the triple-border area of the Brazilian Amazon. We describe the context of the early introduction of POC screening, explore hindering and enabling factors for POC implementation, and recommend strategies for feasible, viable, and sustainable syphilis and HIV screening interventions. This was a qualitative study based on grounded theory methodology. Data were collected using in-depth interviews, semi-structured questionnaires, and field observations and were analysed using the framework approach. Qualitative information was complemented by quantitative data for descriptive purposes. An overall high score for vulnerability to acquiring HIV and syphilis was observed among the indigenous communities. Health professionals reported satisfactory rapid testing acceptance, although concerns were raised about the pain of the fingerprick. Counselling-related challenges included ensuring the accuracy of translations, collaborating with translators and communicating positive test results. Over 3 months, 86.7% of the syphilis-positive individuals began treatment, and all of them notified their partners. Accessibility, measured as travel time via the local transportation network, was a barrier to health care access. A lack of gasoline for boats and other transportation was also a hindering factor at all levels of implementation. The recommendations address the preparation phase at the coordination level as well as at the training level. Tools such as strengths, weaknesses, opportunities, and threats (SWOT) analyses; checklists; context-adapted protocols; and fact sheets are very simple methods to facilitate implementation. The findings of this study are important because they may inform the implementation of new health technologies in low-resource national disease control programmes in remote communities.

  7. The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

    Science.gov (United States)

    Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

    2015-01-01

    Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

  8. Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains?

    Science.gov (United States)

    Šmajs, David; Paštěková, Lenka; Grillová, Linda

    2015-10-01

    Treponema pallidum ssp. pallidum (TPA) causes over 10 million new cases of syphilis worldwide whereas T. pallidum ssp. pertenue (TPE), the causative agent of yaws, affects about 2.5 million people. Although penicillin remains the drug of choice in the treatment of syphilis, in penicillin-allergic patients, macrolides have been used in this indication since the 1950s. Failures of macrolides in syphilis treatment have been well documented in the literature and since 2000, there has been a dramatic increase in a number of clinical samples with macrolide-resistant TPA. Scarce data regarding the genetics of macrolide-resistant mutations in TPA suggest that although macrolide-resistance mutations have emerged independently several times, the increase in the proportion of TPA strains resistant to macrolides is mainly due to the spread of resistant strains, especially in developed countries. The emergence of macrolide resistance in TPA appears to require a two-step process including either A2058G or A2059G mutation in one copy of the 23S rRNA gene and a subsequent gene conversion unification of both rRNA genes. Given the enormous genetic similarity that was recently revealed between TPA and TPE strains, there is a low but reasonable risk of emergence and spread of macrolide-resistant yaws strains following azithromycin treatment.

  9. Diagnosis of Mercurial Teeth in a Possible Case of Congenital Syphilis and Tuberculosis in a 19th Century Child Skeleton

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    Stella Ioannou

    2015-01-01

    Full Text Available Without the presence of “caries sicca,” “sabre shins,” and nodes/expansion of the long bones with superficial cavitation, differential diagnosis of venereal syphilis and tuberculosis (TB may be difficult as various infections produce similar responses. However, congenital syphilis has distinctive features facilitating a diagnosis. A case study of remains of a juvenile European settler (probably male, 8–10 years old (B70 buried in the 19th century and excavated in 2000 from the cemetery of the Anglican Church of St. Marys in South Australia is presented. B70 demonstrated that the two diseases might have been present in the same individual, congenital syphilis and TB. Widespread destruction of vertebral bodies and kyphosis-related rib deformations indicate advanced TB. Severe dental hypoplasia is limited to permanent incisors and first molars; there is pitting on the palate, periosteal reaction on the skull vault, and thinned clavicles. Dental signs are not limited to “screwdriver” central incisors and mulberry molars. Apical portions of the crowns of permanent upper, lower, central, and lateral incisors have multiple hypoplastic-disorganized defects; deciduous canines have severely hypoplastic crowns while possibly hypoplastic occlusal surfaces of lower deciduous second molars are largely destroyed by extensive caries. These dental abnormalities resemble teeth affected by mercurial treatment in congenital syphilitic patients as described by Hutchinson.

  10. Reactivity of microhemagglutination, fluorescent treponemal antibody absorption, Venereal Disease Research Laboratory, and rapid plasma reagin tests in primary syphilis.

    Science.gov (United States)

    Huber, T W; Storms, S; Young, P; Phillips, L E; Rogers, T E; Moore, D G; Williams, R P

    1983-03-01

    Seroreactivity of sera from 109 patients with first-infection primary syphilis was 98.2% in the fluorescent treponemal antibody absorption test, 92.7% in the rapid plasma reagin 18-mm circle card test, 72.5% in the microhemagglutination test (MHA-TP), and 72.5% in the Venereal Disease Research Laboratory test. Seroreactivity of sera from 18 patients with primary syphilis with documented previous infection(s) was 100% in the fluorescent treponemal antibody absorption test, the rapid plasma reagin 18-mm circle card test, and the MHA-TP test and 88.9% in the Venereal Disease Research Laboratory test. The MHA-TP test failed to confirm reactivity in 13 of 79 sera which were reactive in the Venereal Disease Research Laboratory test and in 24 of 101 sera which were reactive in the rapid plasma reagin 18-mm circle card test. Testing another production lot of MHA-TP reagents resulted in even poorer correlation. The reactivity of the MHA-TP test in primary syphilis appeared to vary with the sensitivity of the production lot of reagents.

  11. ORIGINAL ARTICLE: Blood Donor’s Status of HIV, HBV, HCV and Syphilis in this Region of Marathwada, India

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    Rangrao H. Deshpande

    2012-07-01

    Full Text Available Aims & Objectives: Blood transfusion can cause the transmission of infections to recipients. This is an important mode of infection. The aim of study was to assess the prevalence of such type of infections among blood donors and to compare the seroprevalence of transfusion transmitted diseases in voluntary donors and replacement donors. Retrospective study of five years from Jan. 2007 to Dec. 2011 was done. This study was conducted at Blood bank, MIMSR Medical College Latur, Govt. Medical College, Latur and Bhalchandra Blood bank, Latur. Material & Methods: Total 10, 4925 donors were tested. Donors were screened for seroprevalence of HIV, HBC, HCV and Syphilis. Screening of HIV, HBV & HCV was done by ELISA method & Syphilis was screened by RPR type. Results: The comparison of seroprevalence of HIV, HBV, HCV & Syphilis in voluntary donors and replacement donors showed significant difference only for HIV in the years 2007, 2010, and 2011. Conclusion: The seroprevalence of transfusion transmitted diseases in the study is very low or negligible in voluntary donors as compared to replacement donors. There was a declining trend of seroprevalence for all the disease screened. But in our study the difference is not significant, which indicates that the selection of donors is of low quality. The selection of high quality voluntary donors should be achieved by creation of awareness by education of the prospective donor populations.

  12. SEROPREVALENCE OF HEPATITIS B, HEPATITIS C, SYPHILIS AND HIV IN PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL, GUJARAT, INDIA

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    Swati Dhirajlal Jethava

    2017-08-01

    Full Text Available BACKGROUND This study was conducted to assess the extent of seropositivity of hepatitis B, hepatitis C, syphilis and HIV in pregnant women at tertiary care hospitals in Gujarat from December 2015 to June 2016 and to re-evaluate the need for routine antenatal care screening for these infections among obstetric patients. MATERIALS AND METHODS Patients were enrolled for study after taking informed consent. All samples were tested to detect HbsAg by Enzyme-Linked Immunosorbent Assay (ELISA, anti-HCV by ELISA, samples were also tested for antibodies to Treponema pallidum by Rapid Plasma Regain (RPR, samples were tested for antibodies to HIV by three different methods as per strategy III of the National AIDS Control Organisation by using different systems of testing to establish a diagnosis of HIV. RESULTS Total 1000 samples were tested. Out of this, seropositivity of hepatitis B was (0.6%, hepatitis C was (0.2%, syphilis was (0.0% and HIV was 0.1%. Out of the 1000 samples, no coinfection was found between hepatitis B, hepatitis C, syphilis or HIV. CONCLUSION This study can help the health professionals to efficiently treat antenatal patients. Early diagnosis of disease in antenatal period is helpful for proper management and initiation of treatment to prevent transmission to newborn.

  13. Quantitative evaluation of the FTA-ABS-IgM and VDRL test in treated and untreated syphilis.

    Science.gov (United States)

    Luger, A; Schmidt, B; Spendlingwimmer, I

    1977-01-01

    Observations made on fluorescent treponemal antibody absorption (FTA-ABS) immunoglobulin M (IgM) titres in patients with untreated early syphilis showed non-reactive or weakly reactive results in patients with primary (one of five cases) and secondary (two of 16 cases) lesions. In patients with primary (19.5%) and secondary (15%) syphilis sera remained reactive with increased titres for more than one year after treatment. The respective figures in the results of the Venereal Disease Research Laboratory (VDRL) test were zero in primary and 20% in secondary syphilis. The non-reactive FTA-ABS IgM results may possibly be explained by competitive inhibition of IgM by immunoglobulin G (IgG). The persistence of reactivity in a comparable percentage has been observed by other investigators (Grin et al., 1974; Wilkinson and Rodin, 1976). The current results therefore suggest that FTA-ABS IgM titres are less reliable for assessing the effect of treatment than the course of the VDRL titres. The phenomenon of a decrease in FTA-ABS IgM titres soon after treatment with a later rise before final non-reactivity is a matter for further investigation. PMID:338124

  14. Predictors of syphilis seroreactivity and prevalence of HIV among street recruited injection drug users in Los Angeles County, 1994–6

    Science.gov (United States)

    Lopez-Zetina, J.; Ford, W.; Weber, M.; Barna, S.; Woerhle, T.; Kerndt, P.; Monterroso, E.

    2000-01-01

    Objectives: To describe HIV prevalence and the association between syphilis incidence and sexual and drug injection risk behaviours in a cohort of street recruited injecting drug users (IDUs) in Los Angeles County, between 1994 and 1996. Methods: During the study period, 513 street recruited African-American and Latino IDUs were screened for syphilis and antibodies to HIV. Subjects were administered a risk behaviour survey at baseline and followed up at 6 month intervals for 18 months with repeated interviews and serological screening. Rate ratios were used to examine associations between syphilis incidence and demographic characteristics and risk behaviours. A proportional hazard model was used to identify predictors of syphilis incidence independent of demographic characteristics. Results: 74% of the sample were male, 70% African-American, 30% Latino; and the median age was 43 years. Overall baseline serological prevalence of HIV was 2.5% and of syphilis 5.7%. None of the participants were co-infected for HIV and syphilis at baseline or at any of the 6 month follow ups. Among 390 eligible IDUs retained for analysis of incidence data, the overall syphilis incidence was 26.0 per 1000 person years. Higher syphilis incidence was found for women compared with men (RR=2.70; 95% CI 1.60, 4.55), and for those 44 years of age or younger compared with those 45 years of age and older (RR=2.26; 95% CI 1.25, 4.08). African-Americans were more likely to be syphilis incident cases when compared with Latinos, although the difference did not reach statistical significance (RR=1.27; 95% CI 0.72, 2.23). In bivariate analysis, risk behaviours significantly associated with higher syphilis incidence included injection of cocaine, "speedball" and heroin, "crack" smoking, recency of first injection event, backloading of syringes, injecting with others, exchanging drugs or money for sex, multiple sex partners, and non-heterosexual sexual preference. Variables that significantly predicted

  15. A retrospective study on syphilis infection and its epidemiological characteristics%梅毒感染及其流行特征的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    徐峰; 张洪为

    2014-01-01

    目的:分析梅毒检测结果,以了解梅毒的感染及其流行特征。方法收集728例确诊梅毒且未经治疗的患者。将其按年龄、性别、梅毒种类进行分类并进行回顾性分析。结果728例梅毒患者中,隐性梅毒446例(61.26%),显性梅毒211例(28.98%),神经梅毒32例(4.40%),先天梅毒39例(5.36%)。梅毒平均检出率为1.49%。女性患者332例(45.60%),男性396例(54.40%)。男性梅毒患者以20~60岁年龄段多见,而女性以20~50岁年龄段居多。显性梅毒主要发生于20~40岁年龄段;隐性梅毒则在20~60岁多发。结论梅毒检出率逐年上升,以隐性梅毒的增幅最高,青壮年为主要发病群体。%Objective To analyze the results of syphilis test and to understand the syphilis infection and its epidemiological characteristics .Methods 728 untreated patients with definite diagnosis of syphilis were enrolled and classified according to their age ,gender and syphilis types ,and retrospectively analysis was conducted .Results Among 728 syphilis patients ,446(61 .26% ) were diagnosed with latent syphilis ,211 (28 .98% ) with dominant syphilis ,32(4 .40% ) with neurosyphilis and 39(5 .36% ) with congenital syphilis .The average detection rate of syphilis was 1 .49% .332(45 .60% ) cases were found in female patients while 396 (54 .40% ) in male .Male syphilis patients were mainly in the 20 to 60 age group ,and female in the 20 to 50 age group .Dominant syphilis occurred mainly in the 20 to 40 age group and latent syphilis in the 20 to 60 age group .Conclusion The detection rate of syphilis increases year by year ,with the highest growing rate in latent syphilis and young adults as major incidence groups .

  16. Syphilis serology: Seroprevalence in a selected population and considerations on the Euroline WB test

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    Andrea Amodeo

    2010-06-01

    Full Text Available Introduction: The clinical diagnosis of syphilis is always supported by appropriate laboratory tests and the test results are interpreted with reference to the patient’s history. In the diagnosis of syphilis, the use of tests based on antibody search that recognize both treponemal and reaginic antigens increases the diagnostic chances. Our study discusses the various serological and alternative tests currently available along with their limitations, and relates their results to the likely corresponding clinical stage of the disease. Methods: in our laboratory were analyzed 264 sera and 4 liquor (123 Females, 145 Males. 187 patients are subject at low risk for luetic infection, including pregnant woman, patient with organ transplant, outpatients or hospitalized undergoing routine serological, and 81 from patients with confirmed syphilis including 4 pregnant women in antibiotic treatment, patients with suspected disease, HIV positive and patients with autoimmune diseases with Cardiolipin positive. All sera were tested with ELISA Anti-Treponema pallidum Screen (IgG / IgM and in parallel with agglutination tests VDRL and TPHA. On all positive sera was tested Euroline-WB EUROIMMUN and reading done with the program EuroLineScan. Results: by ELISA Anti-Treponema pallidum Screen IgG / IgM 162 sera were negative and 106 sera positive (39.5%, distributed as follows: 45 (42% with a value greater than 200 RU / ml, 43 (41% with a value> 22 RU / ml and 18 (17% with a borderline value between> 16 to <22 RU / ml. The execution of the Blot IgG showed: 18 negative sera, 6 with borderline value with one only band of specific antigens (p15, p45, p47 or p17, while 82, including 4 liquor (neurolue, were certainly positive showing more than one band antibody to the treponemal antigens. Only one patient had in place at the time of screening, an initial infection; in fact, there was a single clear positivity in the IgM protein bands, while 7 sera was uncertain values

  17. Evaluation of FlaB1, FlaB2, FlaB3, and Tp0463 of Treponema pallidum for serodiagnosis of syphilis.

    Science.gov (United States)

    Jiang, Chuanhao; Xiao, Jinhong; Xie, Yafeng; Xiao, Yongjian; Wang, Chuan; Kuang, Xingxing; Xu, Man; Li, Ranhui; Zeng, Tiebing; Liu, Shuanquan; Yu, Jian; Zhao, Feijun; Wu, Yimou

    2016-02-01

    Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum, and accurate diagnosis is important for the prevention and treatment of syphilis. Here, to identify appropriate diagnostic antigens for serodiagnosis of syphilis, 6 recombinant proteins were expressed in Escherichia coli and purified, including flagellins (FlaB1 [Tp0868], FlaB2 [Tp0792], and FlaB3 [Tp0870]), Tp0463, Tp0751, and Tp1038. The sensitivities were determined by screening sera from individuals with primary (n=82), secondary (n=115), latent (n=105), and congenital (n=65) syphilis. The specificities were determined by screening sera from uninfected controls (n=30) and potentially cross-reactive infections including Lyme disease (n=30), leptospirosis (n=5), and hepatitis B (n=30). Our data showed that FlaB1, FlaB2, FlaB3, Tp0463, and Tp1038 exhibited higher overall sensitivities and specificities for detecting IgG antibody, with 95.4% and 98.9%, 92.6% and 95.8%, 95.1% and 95.8%, 92.6% and 97.9%, and 95.9% and 98.9%, respectively. In contrast, Tp0751 demonstrated only an overall sensitivity of 39.2%. For comparison, the sensitivity and specificity of Architect Syphilis TP were determined to be 98.1% and 93.7%, respectively. In addition, FlaB1, FlaB2, FlaB3, and Tp0463 demonstrated excellent performance for detecting IgM antibody in primary and congenital syphilis, with sensitivities of 76.8% and 83.1%, 72.0% and 87.7%, 74.4% and 89.2%, and 64.6% and 75.3%, respectively. These results indicate that FlaB1, FlaB2, FlaB3, and Tp0463 could be as novel diagnostic candidates for serodiagnosis of syphilis.

  18. Drug-Related Behaviors Independently Associated with Syphilis Infection among Female Sex Workers in two Mexico-U.S. Border Cities

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    Loza, O.; Patterson, T.L.; Rusch, M.; Martínez, G.A.; Lozada, R.; Staines-Orozco, H.; Magis-Rodríguez, C.; Strathdee, S.A.

    2012-01-01

    AIMS To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. DESIGN Cross-sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers >1:8) were identified by logistic regression. SETTING Tijuana and Ciudad Juarez, two Mexican cities on the U.S. border that are situated on major drug trafficking routes and where prostitution is quasi-legal. PARTICIPANTS 914 FSWs aged ≥18 years without known HIV infection who had recent unprotected sex with clients. MEASUREMENTS Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. FINDINGS Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 37.7% had clients who injected drugs in the last 6 months, and 68.6% reported having clients from the U.S. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.80), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65), and having any U.S. clients (AOR: 2.85; 95% CI: 1.43, 5.70). CONCLUSIONS Among female sex workers in Tijuana and Ciudad Juarez, drug-using behaviors were more closely associated with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer-sex negotiation in the context of drug use. PMID:20456292

  19. Evaluation of a new Syphilis assay on Vitros® 5600 Integrated System

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    Giusy Longo

    2010-12-01

    Full Text Available Introduction. A new homogeneous immunoassay for detection of primary infection of Treponema Pallidum (TP on Vitros® 5600 Integrated System was evaluated.The scope of the study was to verify analytical performances and diagnostic accuracy in comparison to commercial methods (Immunoblotting test, ELISA test, Immunoturbidimetric test. Methods. The new Syphilis assay from SENTINEL CH. SpA, is an immunoturbidimetric assay, using microparticles coated with TP fixed on the surface of polystyrene latex particles which agglutinate by an antigen-antibody reaction when anti-TP antigen is present in the specimen. The assay was implemented on Vitros® 5600 Integrated System. Modified CLSI protocols were adopted. Acceptance criteria for total imprecision were 5% for negative samples (or SD 0.5 U/mL and 4% for positive samples. In comparison to commercial methods, sensitivity must be 99.5% and specificity 99.5%. Results. Total imprecision (22 days gave SD at 6 U/mL lower than 0.5 U/mL, and CV% at 10 U/mL and 45 U/mL lower than 4%. Low quantitation limit is 5 U/mL. No prozone up to 13000 U/mL was found. In the on-board calibration stability study no drift was found up to 4 weeks. 153 samples were tested vs immunoblotting method and specificity was 100%, sensitivity was 100%. 495 samples were tested vs ELISA method and test specificity and sensitivity were 99.6% and 100% respectively. 521 samples were tested vs immunoturbidimetric method and specificity was 99.8%, sensitivity was 100%. Interference from Bilirubin (20 mg/dL, Hemoglobin (500 mg/dL and Triglycerides (1000 mg/dL was not detected.All the sample collection tubes tested (K2EDTA, SST, LH PST II, LH, NH did not interfere with the assay. Conclusion. Performances of the new SENTINEL Syphilis assay on Vitros® 5600 Integrated System meet the requirements for its use as screening tool in blood bank, thus allowing consolidation with general chemistry on a single high volume chemistry analyzer, which is

  20. Educational intervention in Primary Care for the prevention of congenital syphilis.

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    Lazarini, Flaviane Mello; Barbosa, Dulce Aparecida

    2017-01-30

    to evaluate the efficiency of educational interventions related to the knowledge of health care professionals of Primary Care and to verify the impact on the vertical transmission rates of congenital syphilis. a quasi-experimental study conducted in the city of Londrina, Paraná, between 2013 and 2015. An educational intervention on diagnosis, treatment and notification was carried out with 102 professionals with knowledge measurement before and after the intervention. Incidence and mortality data from congenital syphilis were taken from the system for notifiable diseases (SINAN) and the Mortality Information System (SIM). Excel tabulation and statistical analysis was done in the Statistical Package for Social Sciences, version 2.1. A descriptive and inferential analysis was performed. the mean number of correct responses increased from 53% to 74.3% after the intervention (p Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informação sobre Mortalidade (SIM). A tabulação em Excel e a análise estatística no Statistical Package for Social Sciences, versão 2.1. Realizou-se análise descritiva e inferencial. a média de respostas corretas passou de 53% para 74,3% após a intervenção (p Sistema de Información de Enfermedades de Notificación (SINAN) y del Sistema de Información sobre Mortalidad (SIM). La tabulación fue realizada en el Excel y el análisis estadístico en el Statistical Package for Social Sciences, versión 2.1. Se realizó un análisis descriptivo e inferencial. la media de respuestas correctas pasó de 53% para 74,3%, después de la intervención (p < 0,01). La adhesión al entrenamiento de los profesionales fue de 92,6%. Existió reducción importante en la tasa de transmisión vertical de la sífilis de 75% en 2013 para 40,2% en 2015. En 2014 y 2015 no ocurrieron registros de mortalidad infantil por esa enfermedad. la intervención educacional aumentó significativamente el conocimiento de los profesionales de la

  1. HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: Prevalence and risk factors

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    Evjen-Olsen Bjørg

    2008-06-01

    Full Text Available Abstract Background Evidence suggests that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2. Thus, the magnitude of HSV-2 infection in an area may suggest the expected course of the HIV epidemic. We determined prevalence of genital herpes, syphilis and associated factors among pregnant women from a remote rural Tanzanian community that has a low but increasing HIV prevalence. Methods We analysed 1296 sera and responses to a standard structured questionnaire collected from pregnant women aged between 15–49 years, attending six different antenatal clinics within rural Manyara and Singida regions in Tanzania. Linked anonymous testing (with informed consent of the serum for specific antibodies against HSV-2 was done using a non-commercial peptide- 55 ELISA. Antibodies against syphilis were screened by using rapid plasma reagin (RPR and reactive samples confirmed by Treponema pallidum haemagglutination assay (TPHA. Results Previous analysis of the collected sera had shown the prevalence of HIV antibodies to be 2%. In the present study the prevalence of genital herpes and syphilis was 20.7% (95% CI: 18.53–23.00 and 1.6% (95% CI: 1.03–2.51, respectively. The presence of HSV-2 antibodies was associated with polygamy (OR 2.2, 95% CI: 1.62 – 3.01 and the use of contraceptives other than condoms (OR 1.7, 95% CI: 1.21 – 2.41. Syphilis was associated with reporting more than one lifetime sexual partner (OR 5.4, 95% CI: 1.88 – 15.76 and previous spontaneous abortion (OR 4.3, 95% CI: 1.52–12.02. Conclusion The low prevalence of HIV infection offers a unique opportunity for strengthening HIV prevention in a cost-effective manner. The identification and control of other prevalent curable STIs other than syphilis and specific intervention of HSV-2 in specific populations like pregnant women would be one among approaches towards preventing incident HIV infections.

  2. Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia.

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    Rebecca Guy

    Full Text Available BACKGROUND: Since 2005, Australian clinicians were advised to undertake quarterly syphilis testing for all sexually active HIV-positive men who have sex with men (MSM. We describe differences in syphilis testing frequency among HIV-positive MSM by clinic testing policies since this recommendation. METHODS: Three general practices, two sexual health clinics and two hospital HIV outpatient clinics provided data on HIV viral load and syphilis testing from 2006-2010. Men having ≥1 viral load test per year were included; >95% were MSM. We used Chi-2 tests to assess changes in syphilis testing frequency over time, and differences by clinic testing policy (opt-out, opt-in and risk-based. RESULTS: The proportion of men having HIV viral loads with same-day syphilis tests increased from 37% in 2006 to 63% in 2007 (p<0.01 and 68-69% thereafter. In 2010, same-day syphilis testing was highest in four clinics with opt-out strategies (87%, range:84-91% compared with one clinic with opt-in (74%, p = 0.121 and two clinics with risk-based strategies (22%, range:20-24%, p<0.01. The proportion of men having ≥3 syphilis tests per year increased from 15% in 2006 to 36% in 2007 (p<0.01 and 36-38% thereafter. In 2010, the proportion of men having ≥3 syphilis tests in a year was highest in clinics with opt-out strategies (48%, range:35-59%, compared with opt-in (39%, p = 0.121 and risk-based strategies (8.4%, range:5.4-12%, p<0.01. CONCLUSION: Over five years the proportion of HIV-positive men undergoing syphilis testing at recommended frequencies more than doubled, and was 5-6 times higher in clinics with opt-out and opt-in strategies compared with risk-based policies.

  3. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

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    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-05-01

    Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients

  4. Application of Goldmag immune probe in timely detection of syphilis based on GIS platform.

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    Tang, Zhong; Liang, Zhisheng; Nong, Yi; Wu, Xiaochun; Luo, Hui; Gao, Kun

    2017-05-01

    The purpose of this study was to apply goldmag immunoprobes into establishment of nanoparticles-based colorimetric assay as well as construction of immunochromatography quantitative and qualitative system by exploring point-of-care testing of syphilis with goldmag particles carrier-based immunoprobe and analysis of spatial data of Geographic Information System (GIS) platform. Goat anti-rabbit immunoglobulin G (IgG) was coupled on the surface of modified nanoparticles, taking N-(3-dimethylaminopropyl)-N'-ethyl-carbodiimide as the connector. Then the nanoparticles were used for colorimetric detection of goat-anti-rabbit IgG in liquid phase system. Based on the analysis of spatial data in GIS platform, we found the probe constructed based on MUA-Fe304/Au nanoparticles responded more sensitive to detection objects compared with the probe designed based on PAA-Fe3O4/Au nanoparticles, and its reaction rate constant was two times that of PAA-Fe3O4/Au nanoparticles based goldmag immunoprobe. Goldmag particles not only can be coupled with biomolecules such as antibody/antigen and glycoprotein but also possess superparamagnetism.

  5. Cardiovascular syphilis complicated by Lower thoracic and upper abdominal aneurysm – A rare case report

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    K Gayathri

    2016-01-01

    Full Text Available A 50-year-old male presented with left lower abdominal pain, visible pulsation below xiphoid process, and tenderness in the left iliac fossa for the past 10 days. Chest X-ray revealed blunting of left cardiophrenic angle. Echocardiogram revealed descending thoracic aortic pseudoaneurysm. Contrast-enhanced computed tomography of the chest and abdomen revealed dissecting aneurysm of lower thoracic and upper abdominal aorta. Thoracoabdominal aortogram revealed erosion of D12 vertebra and infected aneurysm of adjacent thoracoabdominal aorta. Serum venereal disease research laboratory assay was positive in 1:4 dilution Treponema pallidum hemagglutination assay was positive. The patient was treated with Injection procaine penicillin for 20 days undercover of steroids. Cerebrospinal fluid analysis was normal. Aortic aneurysm repair with reconstruction was done. Histopathology was in favor of syphilitic etiology. This case is being presented as descending thoracic and upper abdominal aortic aneurysm due to syphilis complicated by dissection and erosion of vertebral body is rare and has not been reported nowadays to the best of our knowledge.

  6. The binary protein interactome of Treponema pallidum--the syphilis spirochete.

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    Björn Titz

    Full Text Available Protein interaction networks shed light on the global organization of proteomes but can also place individual proteins into a functional context. If we know the function of bacterial proteins we will be able to understand how these species have adapted to diverse environments including many extreme habitats. Here we present the protein interaction network for the syphilis spirochete Treponema pallidum which encodes 1,039 proteins, 726 (or 70% of which interact via 3,649 interactions as revealed by systematic yeast two-hybrid screens. A high-confidence subset of 991 interactions links 576 proteins. To derive further biological insights from our data, we constructed an integrated network of proteins involved in DNA metabolism. Combining our data with additional evidences, we provide improved annotations for at least 18 proteins (including TP0004, TP0050, and TP0183 which are suggested to be involved in DNA metabolism. We estimate that this "minimal" bacterium contains on the order of 3,000 protein interactions. Profiles of functional interconnections indicate that bacterial proteins interact more promiscuously than eukaryotic proteins, reflecting the non-compartmentalized structure of the bacterial cell. Using our high-confidence interactions, we also predict 417,329 homologous interactions ("interologs" for 372 completely sequenced genomes and provide evidence that at least one third of them can be experimentally confirmed.

  7. Neonate Human Remains: A Window of Opportunity to the Molecular Study of Ancient Syphilis

    Science.gov (United States)

    Montiel, Rafael; Solórzano, Eduvigis; Díaz, Nancy; Álvarez-Sandoval, Brenda A.; González-Ruiz, Mercedes; Cañadas, Mari Pau; Simões, Nelson; Isidro, Albert; Malgosa, Assumpció

    2012-01-01

    Ancient DNA (aDNA) analysis can be a useful tool in bacterial disease diagnosis in human remains. However, while the recovery of Mycobacterium spp. has been widely successful, several authors report unsuccessful results regarding ancient treponemal DNA, casting doubts on the usefulness of this technique for the diagnosis of ancient syphilis. Here, we present results from an analysis of four newborn specimens recovered from the crypt of “La Ermita de la Soledad” (XVI–XVII centuries), located in the province of Huelva in the southwest of Spain. We extracted and analyzed aDNA in three independent laboratories, following specific procedures generally practiced in the aDNA field, including cloning of the amplified DNA fragments and sequencing of several clones. This is the most ancient case, reported to date, from which detection of DNA from T. pallidum subspecies pallidum has been successful in more than one individual, and we put forward a hypothesis to explain this result, taking into account the course of the disease in neonate individuals. PMID:22567153

  8. Prevalence of Hepatitis B, C, HIV and syphilis markers among refugees in Bari, Italy.

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    Tafuri, Silvio; Prato, Rosa; Martinelli, Domenico; Melpignano, Livio; De Palma, Maria; Quarto, Michele; Germinario, Cinzia

    2010-07-20

    The aim of this study was to assess the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) serological markers and the prevalence of VDRL positive subjects in a population of refugees of various nationalities, living in the Asylum Seeker Centre in Bari Palese, Southern Italy. The study was carried out in the period May-July 2008 and recruited only voluntarily enrolled healthy refugees. HBsAg, anti-HBc, anti-HCV and anti-HIV virus antibodies were detected. VDRL syphilis screening was also carried out on the serum samples. A total of 529 refugees, 442 males and 87 females, aged between 7 and 52 years, were studied. Of these, 510 were from Africa and 19 from Asia.Forty-four individuals (8.3%) were HBsAg positive and 241 (45.6%) were anti-HBc positive. A total of 24 (4.5%) individuals were anti-HCV positive. Eight asylum seekers (1.5%) were HIV positive. VDRL tests were performed on 269 subjects and 4 (1.5%) were positive. 12.3% of the study population had serological markers of chronic and transmissible infections with potential blood-borne or sexual transmission. In Italy, a suitable protocol is necessary for the early diagnosis of infectious diseases on entering Asylum Centres, so allowing the adoption of prevention measures to safeguard the health of the individuals, the residents and workers in the Centres and the general population.

  9. Historia del tratamiento de la Sífilis The history of Syphilis´ treatment

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    R M C Leitner

    2007-03-01

    los alérgicos a la penicilina. Últimamente se confirmó la eficacia de la azitromicina en dosis de 500mg cada día, durante los 10 días o el régimen de 500mg en días alternos.The name Syphilis comes from greek language: Siph: Pig and Philus: Love, meaning, in honor of the Sheppard of a story where the Character, Named Syphilo, is punished by the gods to suffer a terrible disease. Data about Syphilis was analized in ancient times (which differ according to the source. Its mention in the middle age, its controversial origin, the help provided from paleopathologists to find it. When the French revolution and the beginning of the contemporary age began, the percentage of sick people grew. The segregation of these is proved by the society. From the year 1500 to the beginnings of the XX century, the treatment of Syphilis depended on mercury. There were a great variety of application methods: topical: the grey ointment, in «calomelanos or tabs», in injections, in frictions and fumigations where the mercury was introduced in the body by the lungs. Guayacos wood was named with curative features which it did not posses. The iodides were used for tertiary syphilis. In 1907, Ehrlich formulates the 606 compound or Salvarsan and in 1910 the Neo-Salvarsan or Arsfenamina or compound 914.Due to these discoveries he received the nobel prize. In 1887, Julius Wagner of Jauregg suggested that: the inducted therapeutic fiber was useful in the treatment of the psychosis. In 1912 he published his satisfactory results in treating the paresis with a combination of mercury and iodides and tuberculin of Koch. In 1917 he treated a patient who had malaria and instead of giving him immediately quinine, he made a scarification with his paludic blood the skin of 3 paretic patients. Because of this he was awarded with the nobel prize. Since 1922 bismuth was used, but then it was substituted by the sulphamidas of difficult application. The most important therapeutical advance happened in 1943

  10. Serological screening for sexually transmitted infections in pregnancy: is there any value in re-screening for HIV and syphilis at the time of delivery?

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    Qolohle, D C; Hoosen, A A; Moodley, J; Smith, A N; Mlisana, K P

    1995-01-01

    OBJECTIVE--The aim of this study was to assess the prevalence of syphilis, human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections in women at the time of delivery, and to determine the seroconversion rates for syphilis and HIV infections from initial booking visit to delivery. SETTING--The labour ward of a typical tertiary hospital in a developing country and serving an indigent African population. METHOD--Four hundred and eighteen women presenting in labour were randomly selected and informed consent obtained for serological testing for syphilis and HBV infections in umbilical cord blood samples. The specimens were then given a study number, the gestational ages recorded and anonymously tested for HIV infection. RESULTS--Of the 191 women who had antenatal care, 13 (6.8%) were HIV antibody positive at the initial "booking" visit. An additional 4 were found to be HIV antibody positive at the time of delivery resulting in a seroconversion rate of 2.2%. The seroconversion rate for syphilis at the time of delivery was 2.7%. Hepatitis B surface antigens were detected in only 2 women, one of whom was antigen positive. CONCLUSION--The high seroconversion rates for both syphilis and HIV infection in pregnancy justifies re-screening for these conditions in endemic areas such as ours. PMID:7744414

  11. 联合检测方法检测梅毒的效果评价%Evaluation on the Value of Combination of Syphilis Detection Methods

    Institute of Scientific and Technical Information of China (English)

    张会平

    2012-01-01

    目的 探讨联合检测方法在梅毒检测中的应用价值. 方法 采用联合检测方法TRUST+ ELISA、TRUST+ SYP、TRUST+ RPR、RPR+ ELISA分别检测献血者血液标本,对4种联合检测方法进行比较. 结果 TRUST+ELISA组阳性率分别与各组比较:TRUST+ SYP(P>0.05),TRUST+ RPR(P< 0.01),RPR+ ELISA(P >0.05). 结论 TRUST+ ELISA联合检测方法能确保梅毒检测的灵敏度、准确性,且成本不高,可作为血站较为合适的梅毒血清学筛查方法.%Objective To explore the value of combination of syphilis detection methods. Methods Syphilis in the blood of the voluntary blood donors was detected by combination methods, TRUST + ELISA, TRUST + SYP, TRUST + RPR, and RPR+ ELISA. The results of the four combinations were compared. Results The positive rate of syphilis detected by TRUST + ELISA combination was significantly higher than that by TRUST + RPR (P0.05). Conclusions TRUST + ELISA combination can ensure the sensitivity and accuracy of syphilis detection. It is cheap and suitable for syphilis screening in blood donors in blood stations.

  12. 梅毒引起视力下降案例分析%Case analysis of impaired vision caused by syphilis

    Institute of Scientific and Technical Information of China (English)

    陈亦洋

    2016-01-01

    梅毒是由苍白螺旋体感染的一种慢性、全身性的性传播疾病,以眼部视力下降为主述的梅毒损害比较少见,可能导致误诊。本文就收治的梅毒引起视力下降的病例1例进行分析、总结。%Syphilis is a chronic,systemic sexually transmitted disease that is infected by the spirochaeta pallid.The decline of ocular visual acuity as the main syphilis damage is relatively rare,which may lead to misdiagnosis.In this paper,we analyzed and summarized 1 case with impaired vision caused by syphilis.

  13. High frequency of the 23S rRNA A2058G mutation of Treponema pallidum in Shanghai is associated with a current strategy for the treatment of syphilis.

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    Lu, Haikong; Li, Kang; Gong, Weimin; Yan, Limeng; Gu, Xin; Chai, Ze; Guan, Zhifang; Zhou, Pingyu

    2015-02-01

    The preferred drugs for the treatment of syphilis, benzathine and procaine penicillin, have not been available in Shanghai for many years, and currently, the incidence of syphilis is increasing. Alternative antibiotics for patients with syphilis during the benzathine and procaine penicillin shortage include macrolides. The failure of macrolide treatment in syphilis patients has been reported in Shanghai, but the reason for this treatment failure remains unclear. We used polymerase chain reaction technology to detect a 23S rRNA A2058G mutation in Treponema pallidum in 109 specimens from syphilis patients. The use of azithromycin/erythromycin in the syphilis patients and the physicians' prescription habits were also assessed based on two questionnaires regarding the use of macrolides. A total of 104 specimens (95.4%) were positive for the A2058G mutation in both copies of the 23S rRNA gene, indicating macrolide resistance. A questionnaire provided to 122 dermatologists showed that during the penicillin shortage, they prescribed erythromycin and azithromycin for 8.24±13.95% and 3.21±6.37% of their patients, respectively, and in the case of penicillin allergy, erythromycin and azithromycin were prescribed 15.24±22.89% and 7.23±16.60% of the time, respectively. A second questionnaire provided to the syphilis patients showed that 150 (33.7%), 106 (23.8%) and 34 (7.6%) individuals had used azithromycin, erythromycin or both, respectively, although the majority did not use the drugs for syphilis treatment. Our findings suggest that macrolide resistance in Treponema pallidum is widespread in Shanghai. More than half of the syphilis patients had a history of macrolide use for other treatment purposes, which may have led to the high prevalence of macrolide resistance. Physicians in China are advised to not use azithromycin for early syphilis.

  14. Home-based counseling and testing for HIV and syphilis - an evaluation of acceptability and quality control, in remote Amazonas State, Brazil.

    Science.gov (United States)

    Ribeiro, Luciana Viana da Costa; Sabidó, Meritxell; Galbán, Enrique; Guerra, Jorge Augusto de Oliveira; Mabey, David; Peeling, Rosanna W; Benzaken, Adele Schwartz

    2015-03-01

    Home-based, voluntary counselling and testing (HBCT) can help scale up early diagnosis. We aimed to evaluate the acceptance of HBCT for HIV and syphilis, estimate the prevalence among home-tested individuals and assess the performance of point-of-care testing by health staff using dried tube specimens (DTS) in a remote municipality of the Amazon region. Community health teams conducted door-to-door outreach in the urban area of São Gabriel da Cachoeira, Amazonas. HBCT for HIV and syphilis was offered to all residents aged ≥15 years. To provide an external quality assurance (EQA) of the healthcare workers' (HCW') ability to perform testing, DTS panels of reference samples were reconstituted and tested by the workers. HBCT was offered to 1752 individuals and accepted by 1501 (85.6%). Those tested had a median age 32.0 years, 64.4% were women and 85.1% were indigenous; none were previously tested using a rapid test. The prevalence of HIV was 0.37% in men and 0.0% in women; the prevalence of syphilis was 1.12% in men and 2.69% in women. Eleven HCW tested 44 DTS samples for HIV and 44 for syphilis. EQA testing revealed that workers interpreted 55.8% and 90.7% of HIV and syphilis reference samples correctly. HBCT was acceptable and successful in reaching untested individuals. However, there were concerns with the quality of test performance, highlighting the need for continual evaluation and retraining of community HCW. As Brazil scales up HIV and syphilis testing, our findings highlight how HBCT can maximise coverage in similar remote areas and improve knowledge about prevalence of these infections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Advances in the diagnosis and treatment of syphilis in pregnant women%妊娠期梅毒的诊疗进展

    Institute of Scientific and Technical Information of China (English)

    郝丽丽; 季必华

    2008-01-01

    Treponema pallidum in pregnant women could pass through the placenta and cause abortion, fetal death, premature birth, and congenital syphilis. Neonatal death and stillbirth are the most severe adverse pregnancy outcomes. So it is especially important to routinely screen syphilis in pregnant women during perinatal period. In regions with high prevalence of syphilis and among high risk population, syphilis should be screened twice in the first 28 weeks of pregnancy and at the time of birth. Once the diagnosis of pregnant syphilis is confirmed, early treatment with regular and adequate doses of penicillin as well as a close follow up of neonates are warranted. Effective treatment with penicillin during pregnancy may lead to a decrease in perinatai mortality and incidence of congenital syphilis.%梅毒螺旋体能通过胎盘引起胎儿宫内感染,造成流产、死产、早产或分娩胎传梅毒儿.死胎和新生儿死亡是最严重的妊娠不良结局.因此,围产期应常规开展妊娠期梅毒血清学的产前筛查工作.在梅毒高流行区或高危人群,尚需在孕28周和分娩时作2次血清学检查.一旦确诊,应尽早、足量、正规给予青霉素治疗,并加强新生儿随防.孕期有效的青霉素治疗,将降低围产期死亡率及胎传梅毒的发生.

  16. Multiple primary syphilis on the lip, nipple-areola and penis: An immunohistochemical examination of Treponema pallidum localization using an anti-T. pallidum antibody.

    Science.gov (United States)

    Fukuda, Hidetsugu; Takahashi, Misaki; Kato, Keiichi; Oharaseki, Toshiaki; Mukai, Hideki

    2015-05-01

    Primary syphilis caused by Treponema pallidum usually develops after sexual contact as an initial solitary sclerosis or hard chancre in the genital region. We describe a case of primary syphilis at three sites in genital and extragenital regions of a man who had sex with men. A 29-year-old man visited our hospital for skin lesions on his lower lip, nipple-areola and penis. A positive syphilis serological test for rapid plasma reagin had a titer of 1:16; the patient also tested positive for specific antibodies against T. pallidum, with a cut-off index of 39.0. Histopathological examination of a nipple-areola biopsy specimen revealed a thickened epidermis and dense infiltration of inflammatory cells extending from the upper dermal layers to the deep dermis. The inflammatory cells were composed of abundant lymphocytes, plasma cells, histiocytes and neutrophils. Immunohistochemical staining for T. pallidum using an anti-T. pallidum antibody showed numerous spirochetes in the lower portion of the epidermis, scattered inside inflammatory cell infiltrate and perivascular sites throughout the dermis. Based on these findings, the patient was diagnosed with primary syphilis. Treatment with oral amoxicillin hydrate was started. Five days after starting treatment, a diffuse maculopapular rash (syphilitic roseola) occurred on his trunk and extremities. Perivascular cuffing due to T. pallidum was present throughout the dermis in the biopsy specimen of a localized lesion of primary syphilis. Moreover, syphilitic roseola, which indicates generalized dissemination of T. pallidum, developed during the course of treatment for primary syphilis. Therefore, we considered perivascular cuffing to be indicative of the dissemination phase.

  17. Conventional systemic treatments associated with therapeutic sites of local lesions of secondary syphilis in the oral cavity in patients with AIDS

    Directory of Open Access Journals (Sweden)

    Elcio Magdalena Giovani

    2012-01-01

    Full Text Available Patients with HIV infection may develop common diseases with atypical clinical features. HIV infection can change the classic clinical course of syphilis and increase the incidence of malignant syphilis. Malignant syphilis is a rare subtype of secondary syphilis that presents special clinical and histological features and has been associated with several processes characterized by variable degrees of immunosuppression. It is necessary to consider the possibility of this entity in the differential diagnoses in HIV-infected patients with cutaneous lesions. The dental surgeon (or oral surgeon is vital to the medical team for promoting the health and improving the quality of life of syphilis patients. A patient with HIV infection was referred to us for complaints of a white patch on the tongue, stinging and burning sensation on the tongue, loss of taste, and dryness of the mouth. On clinical examination, the patient was found to have a tabetic gait (the Prussian soldier gait associated with Charcot arthropathy. We also identified bilateral lesions with ulceration and exposure of the tissue that were tender, characterized by discrete necrosis. The treatment that was initiated at that time involved cleaning the area with gauze to remove all the white patches, followed by rinsing with bicarbonate in water (one teaspoon of baking soda dissolved in half a glass of water four times a day. Additionally, fluconazole (100 mg/day for 7 days was prescribed. We diagnosed secondary malignant syphilis of approximately 5 days duration. As an adjunctive therapy, we performed low-intensity laser treatment using a GaAsAl (gallium-aluminum arsenide laser at 790 nm. With this treatment there was progressive resolution of the lesions.

  18. Factors associated with serological cure and the serofast state of HIV-negative patients with primary, secondary, latent, and tertiary syphilis.

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    Man-Li Tong

    Full Text Available BACKGROUND: Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response. METHODS: We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,327 HIV-negative patients with primary, secondary, latent, and tertiary syphilis were enrolled. Bivariate and multivariate analyses were utilised to identify factors associated with a serological cure and serofast state in syphilis patients one year after therapy. Chi-square tests were used to determine the differences in the serological cure rate across different therapy time points. RESULTS: One year after the recommended therapy, 870 patients achieved a serological cure, and 457 patients (34.4% remained in the serofast state. The serological cure rate increased only within the first 6 months. The bivariate analysis indicated that male or younger patients had a higher likelihood of a serological cure than female or older patients. Having a baseline titre ≤ 1∶2 or ≥ 1∶64 was associated with an increased likelihood of a serological cure. The serological cure rate decreased for the different disease stages in the order of primary, secondary, latent, and tertiary syphilis. A distinction should be drawn between early and late syphilis. The multivariate analysis indicated that a serological cure was significantly associated with the disease phase, gender, age, and baseline rapid plasma reagin (RPR titre. CONCLUSIONS: The serofast state is common in clinical work. After one year of the recommended therapy, quite a few syphilis patients remained RPR positive. The primary endpoint of the study indicated that disease phase, gender, age and baseline RPR titre were crucial factors associated with a serological cure.

  19. Canadian Public Health Laboratory Network laboratory Guidelines for the Use of Serological Tests (excluding point-of-care tests for the Diagnosis of Syphilis in Canada

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    Paul N Levett

    2015-01-01

    Full Text Available Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum, is an infection recognized since antiquity. It was first reported at the end of the 15th century in Europe. Infections may be sexually transmitted as well as spread from an infected mother to her fetus or through blood transfusions. The laboratory diagnosis of syphilis infection is complex. Because this organism cannot be cultured, serology is used as the principal diagnostic method. Some of the issues related to serological diagnoses are that antibodies take time to appear after infection, and serology screening tests require several secondary confirmatory tests that can produce complex results needing interpretation by experts in the field. Traditionally, syphilis screening was performed using either rapid plasma reagin or Venereal Disease Research Laboratory tests, and confirmed by treponemal tests such as MHA-TP, TPPA or FTA-Abs. Currently, that trend is reversed, ie, most of the laboratories in Canada now screen for syphilis using treponemal enzyme immunoassays and confirm the status of infection using rapid plasma reagin or Venereal Disease Research Laboratory tests; this approach is often referred to as the reverse algorithm. This chapter reviews guidelines for specimen types and sample collection, treponemal and non-treponemal tests utilized in Canada, the current status of serological tests for syphilis in Canada, the complexity of serological diagnosis of syphilis infection and serological testing algorithms. Both traditional and reverse sequence algorithms are recommended and the algorithm used should be based on a combination of local disease epidemiology, test volumes, performance of the proposed assays and available resources.

  20. Canadian Public Health Laboratory Network laboratory guidelines for the use of serological tests (excluding point-of-care tests) for the diagnosis of syphilis in Canada.

    Science.gov (United States)

    Levett, Paul N; Fonseca, Kevin; Tsang, Raymond Sw; Kadkhoda, Kamran; Serhir, Bouchra; Radons, Sandra M; Morshed, Muhammad

    2015-01-01

    Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum, is an infection recognized since antiquity. It was first reported at the end of the 15th century in Europe. Infections may be sexually transmitted as well as spread from an infected mother to her fetus or through blood transfusions. The laboratory diagnosis of syphilis infection is complex. Because this organism cannot be cultured, serology is used as the principal diagnostic method. Some of the issues related to serological diagnoses are that antibodies take time to appear after infection, and serology screening tests require several secondary confirmatory tests that can produce complex results needing interpretation by experts in the field. Traditionally, syphilis screening was performed using either rapid plasma reagin or Venereal Disease Research Laboratory tests, and confirmed by treponemal tests such as MHA-TP, TPPA or FTA-Abs. Currently, that trend is reversed, ie, most of the laboratories in Canada now screen for syphilis using treponemal enzyme immunoassays and confirm the status of infection using rapid plasma reagin or Venereal Disease Research Laboratory tests; this approach is often referred to as the reverse algorithm. This chapter reviews guidelines for specimen types and sample collection, treponemal and non-treponemal tests utilized in Canada, the current status of serological tests for syphilis in Canada, the complexity of serological diagnosis of syphilis infection and serological testing algorithms. Both traditional and reverse sequence algorithms are recommended and the algorithm used should be based on a combination of local disease epidemiology, test volumes, performance of the proposed assays and available resources.

  1. Cerebrospinal fluid abnormalities in HIV-negative patients with secondary and early latent syphilis and serum VDRL ≥ 1:32

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    Maciej Pastuszczak

    2013-01-01

    Full Text Available Background : Syphilis is caused by a spirochete Treponema pallidum. Invasion of the central nervous system (CNS by T. pallidum may appear early during the course of disease. The diagnosis of confirmed neurosyphilis is based on the reactive Venereal Disease Research Laboratory (VDRL in cerebrospinal fluid (CSF. Recent studies indicated that serum RPR ≥ 1:32 are associated with higher risk of reactivity of CSF VDRL. Aims : The main aim of the current study was to assess cerebrospinal fluid serological and biochemical abnormalities in HIV negative subjects with secondary and early latent syphilis and serum VDRL ≥ 1:32. Materials and Methods : Clinical and laboratory data of 33 HIV-negative patients with secondary and early latent syphilis, with the serum VDRL titer ≥ 1:32, who underwent a lumbar puncture and were treated in Department of Dermatology at Jagiellonian University School of Medicine in Cracow, were collected. Results : Clinical examination revealed no symptoms of CNS involvement in all patients. 18% ( n = 6 of patients met the criteria of confirmed neurosyphilis (reactive CSF-VDRL. In 14 (42% patients CSF WBC count ≥ 5/ul was found, and in 13 (39% subjects there was elevated CSF protein concentration (≥ 45 mg/dL. 10 patients had CSF WBC count ≥ 5/ul and/or elevated CSF protein concentration (≥ 45 mg/dL but CSF-VDRL was not reactive. Conclusions : Indications for CSF examination in HIV-negative patients with early syphilis are the subject of discussion. It seems that all patients with syphilis and with CSF abnormalities (reactive serological tests, elevated CSF WBC count, elevated protein concentration should be treated according to protocols for neurosyphilis. But there is a need for identification of biomarkes in order to identify a group of patients with syphilis, in whom risk of such abnormalities is high.

  2. Cerebrospinal Fluid Abnormalities in HIV-Negative Patients with Secondary and Early Latent Syphilis and Serum VDRL ≥ 1:32.

    Science.gov (United States)

    Pastuszczak, Maciej; Zeman, Jacek; Jaworek, Andrzej K; Wojas-Pelc, Anna

    2013-07-01

    Syphilis is caused by a spirochete Treponema pallidum. Invasion of the central nervous system (CNS) by T. pallidum may appear early during the course of disease. The diagnosis of confirmed neurosyphilis is based on the reactive Venereal Disease Research Laboratory (VDRL) in cerebrospinal fluid (CSF). Recent studies indicated that serum RPR ≥ 1:32 are associated with higher risk of reactivity of CSF VDRL. The main aim of the current study was to assess cerebrospinal fluid serological and biochemical abnormalities in HIV negative subjects with secondary and early latent syphilis and serum VDRL ≥ 1:32. Clinical and laboratory data of 33 HIV-negative patients with secondary and early latent syphilis, with the serum VDRL titer ≥ 1:32, who underwent a lumbar puncture and were treated in Department of Dermatology at Jagiellonian University School of Medicine in Cracow, were collected. Clinical examination revealed no symptoms of CNS involvement in all patients. 18% (n = 6) of patients met the criteria of confirmed neurosyphilis (reactive CSF-VDRL). In 14 (42%) patients CSF WBC count ≥ 5/ul was found, and in 13 (39%) subjects there was elevated CSF protein concentration (≥ 45 mg/dL). 10 patients had CSF WBC count ≥ 5/ul and/or elevated CSF protein concentration (≥ 45 mg/dL) but CSF-VDRL was not reactive. Indications for CSF examination in HIV-negative patients with early syphilis are the subject of discussion. It seems that all patients with syphilis and with CSF abnormalities (reactive serological tests, elevated CSF WBC count, elevated protein concentration) should be treated according to protocols for neurosyphilis. But there is a need for identification of biomarkes in order to identify a group of patients with syphilis, in whom risk of such abnormalities is high.

  3. Seroprevalence and correlates of HIV, syphilis, and hepatitis B and C virus among intrapartum patients in Kabul, Afghanistan

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    Ghazanfar Syed

    2008-09-01

    Full Text Available Abstract Background Little current information is available for prevalence of vertically-transmitted infections among the Afghan population. The purpose of this study is to determine prevalence and correlates of human immunodeficiency virus (HIV, syphilis, and hepatitis B and C infection among obstetric patients and model hepatitis B vaccination approaches in Kabul, Afghanistan. Methods This cross-sectional study was conducted at three government maternity hospitals in Kabul, Afghanistan from June through September, 2006. Consecutively-enrolled participants completed an interviewer-administered survey and whole blood rapid testing with serum confirmation for antibodies to HIV, T. pallidum, and HCV, and HBsAg. Descriptive data and prevalence of infection were calculated, with logistic regression used to identify correlates of HBV infection. Modeling was performed to determine impact of current and birth dose vaccination strategies on HBV morbidity and mortality. Results Among 4452 women, prevalence of HBsAg was 1.53% (95% CI: 1.18 – 1.94 and anti-HCV was 0.31% (95% CI: 0.17 – 0.53. No cases of HIV or syphilis were detected. In univariate analysis, HBsAg was associated with husband's level of education (OR = 1.13, 95% CI: 1.01 – 1.26. Modeling indicated that introduction of birth dose vaccination would not significantly reduce hepatitis-related morbidity or mortality for the measured HBsAg prevalence. Conclusion Intrapartum whole blood rapid testing for HIV, syphilis, HBV, and HCV was acceptable to patients in Afghanistan. Though HBsAg prevalence is relatively low, periodic assessments should be performed to determine birth dose vaccination recommendations for this setting.

  4. Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret, Kenya

    Institute of Scientific and Technical Information of China (English)

    Lydia B.Nyamwamu; Michael M.Gicheru; Rekha R.Sharma; Albert Kimutai; Willy K.Tonui

    2009-01-01

    Objective: This study compared the performance of the immunochromatographic strip (ICS) to the Venereal Disease Research Laboratory (VDRL) test and Treponema pallidum haemagglutination assay (TPHA) at a primary health care setting. Methods: The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared. Results: The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test (P > 0.05). The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value (NPV) and positive predictive value (PPV) were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%. Conclusion: The diagnostic accuracy of the ICS compared favorably with theVDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.

  5. Molecular subtyping of Treponema pallidum during a local syphilis epidemic in men who have sex with men in Melbourne, Australia.

    Science.gov (United States)

    Azzato, Francesca; Ryan, Norbert; Fyfe, Janet; Leslie, David E

    2012-06-01

    Treponema pallidum is the causative agent of syphilis, a sexually transmitted infection of significant public health importance. Since 2000 there has been a marked increase in the number of cases of syphilis infections notified in Victoria, Australia, with the majority of cases occurring in men who have sex with men (MSM) and the highest incidence being in HIV-infected MSM. The molecular subtyping method described by Pillay et al. (A. Pillay et al., Sex. Transm. Dis. 25:408-414, 1998) has been used in this study to determine the diversity of T. pallidum subtypes circulating locally and to look for any relationship between T. pallidum subtypes and HIV status over a 6-year period (2004 to 2009). Treponema pallidum DNA was detected in 303 patient specimens (n = 3,652), and full subtyping profiles were obtained from 90 of these (from 88 patients). A total of 11 T. pallidum subtypes were identified: types 14e (28, 31.1%), 14d (15, 16.7%), 14k (13, 14.4%), 14p (12, 13.3%), 14i (7, 7.8%) 14b (6, 6.7%), 14l (5, 5.6%), and 12i, 13b, 13i, and 13e (1 each, 1.1%). This study showed a similar level of variation among circulating T. pallidum strains compared with that in other studies using the same methodology. A different mix of strains and different predominating strains have been found at each geographical study location, with type 14e emerging as the predominant local strain in Victoria. There was no detectable trend between T. pallidum subtypes and the specimen collection site or stage of syphilis (where known), nor was there any relationship between particular strains and HIV status.

  6. High-risk factors for congenital syphilis%胎传梅毒相关高危因素

    Institute of Scientific and Technical Information of China (English)

    蒋增琼; 李扬; 张学军

    2015-01-01

    胎传梅毒是由妊娠母体内苍白密螺旋体通过胎盘感染胎儿引起的先天性全身疾病.妊娠梅毒的分期、产前非梅毒血清学滴度高低、治疗的情况、产前检查次数及父方因素,如梅毒病史不明等相关高危因素均可能与胎传梅毒的发病率相关.胎传梅毒可导致胎儿死产、早产等严重不良后果,给孕妇、家庭甚至社会带来严重影响,因此,了解胎传梅毒相关的高危因素,可进一步指导临床诊治,减少胎传梅毒的患病率.%Congenital syphilis (CS) is a systemic disease caused by mother-to-child transplacental transmission of Treponema pallidum (TP) infection.The incidence of CS is associated with the stage of syphilis in pregnancy,antepartum nontreponemal antibody titers,treatment of the mother,frequency of prenatal examination and paternal factors such as unknown history of syphilis.CS can lead to fetal stillbirth,premature birth and other serious adverse consequences,and severely impact gravida,family and even society.Therefore,realizing high-risk factors for CS may provide further guide to its clinical diagnosis and treatment,and facilitate the reduction in its prevalence.

  7. Evaluation of different confirmatory algorithms using seven treponemal tests on Architect Syphilis TP-positive/RPR-negative sera.

    Science.gov (United States)

    Jonckheere, S; Berth, M; Van Esbroeck, M; Blomme, S; Lagrou, K; Padalko, E

    2015-10-01

    The Architect Syphilis TP is considered to be a suitable screening test due to its high sensitivity and full automation. According to the International Union against Sexually Transmitted Infections (IUSTI) 2014 guidelines, however, positive screening tests need confirmation with Treponema pallidum particle agglutination (TP.PA). Among Architect-positive results, samples with a negative non-treponemal test present the major diagnostic challenge. In this multicenter study, we investigated if other, preferable less labor-intensive treponemal tests could replace TP.PA. A total of 178 rapid plasma reagin (RPR)-negative sera with an Architect value between 1 and 15 S/CO were prospectively selected in three centers. These sera were analyzed with TP.PA and six alternative treponemal tests: three immunoblots and three tests on random-access analyzers. The diagnostic performance of the treponemal tests differed substantially, with the overall agreement between the six alternative tests ranging from 44.6 to 82.0%. Based on TP.PA as the gold standard, the INNO-LIA IgG blot, the BioPlex 2200 IgG, and the Syphilis TPA showed a high sensitivity, while the EUROLINE-WB IgG blot, recomLine Treponema IgG blot, and the Chorus Syphilis screen showed a high specificity. However, an Architect cut-off of 5.6 S/CO can serve as an alternative for these confirmatory treponemal tests in case of an RPR-negative result. Treponemal tests show poor agreement in this challenging group of Architect-positive/RPR-negative sera. The most optimal algorithm is obtained by assigning sera with an Architect value >5.6 S/CO as true-positives and sera with a value between 1 and 5.6 S/CO as undetermined, requiring further testing with TP.PA.

  8. Evaluation of positive and false-positive results in syphilis screening of blood donors in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Sandes, V S; Silva, S G C; Motta, I J F; Velarde, L G C; de Castilho, S R

    2017-06-01

    We propose to analyse the positive and false-positive results of treponemal and nontreponemal tests in blood donors from Brazil and to evaluate possible factors associated with the results of treponemal tests. Treponemal tests have been used widely for syphilis screening in blood banks. The introduction of these tests in donor screening has caused an impact and a loss of donors who need to be assessed. This was a retrospective cross-sectional study of syphilis screening and confirmatory test results of blood donors that were obtained before and after adopting a chemiluminescent immunoassay (CLIA). A comparative analysis was performed using a second sample drawn from positive donors. The possible factors associated with CLIA-positive or CLIA-false-positive results were investigated in a subgroup. Statistical tests were used to compare the proportions and adjusted estimates of association. The reactivity rate increased from 1·01% (N = 28 158) to 2·66% (N = 25 577) after introducing the new test. Among Venereal Disease Research Laboratory (VDRL)- and CLIA-confirmed results, the false-positive rates were 40·5% (N = 180) and 37·4% (N = 359), respectively (P = 0·5266). Older donors (OR = 1·04; P = 0·0010) and donors with lower education levels (OR = 6·59; P = 0·0029) were associated with a higher risk of positivity for syphilis. CLIA represents an improvement in blood bank serological screening. However, its use in a healthy population appears to result in high rates of false positives. Identifying which characteristics can predict false positives, however, remains a challenge. © 2017 British Blood Transfusion Society.

  9. Expression of CXCL2 in the serum and cerebrospinal fluid of patients with HIV and syphilis or neurosyphilis.

    Science.gov (United States)

    Tsai, Hung-Chin; Ye, Shin-Yu; Lee, Susan Shin-Jung; Wann, Shue-Ren; Chen, Yao-Shen

    2014-06-01

    The potential mechanisms for blood-brain barrier damage and the diagnosis of neurosyphilis in HIV patients co-infected with syphilis (HIV-S) are unclear. The aim of the study was to determine the expression of CXCL2 in the serum and cerebrospinal fluid (CSF) of HIV-S patients. A total of 34 HIV patients and 7 controls were enrolled in a HIV clinical cohort for diagnosis of neurosyphilis in Taiwan. Serum and CSF concentrations of CXCL2 were determined by ELISA. Neurosyphilis was defined as a CSF white blood cell count of ≧20 cells/μl or a reactive CSF Venereal Disease Research Laboratory (VDRL). Demographics and medical histories were collected. All the patients with HIV-S were males. Most (80%) had sex with men (MSM) and serum rapid plasma reagin (RPR) titers of ≧1:32. The medium age was 37 (range 21-68) years. The medium CD4 T cell counts at the time of the diagnosis of syphilis were 299 (range 92-434) cells/μl. Eight patients (24%) had neurosyphilis based on a reactive CSF VDRL test (n = 5) or increased CSF white blood cell counts of ≧20 cells/μl (n = 3). The concentrations of CSF CXCL2 were significantly higher in patients with HIV and neurosyphilis as compared to HIV with syphilis, HIV, and controls (p = 0.012). There were no significant differences in serum concentrations between the four groups. There was a correlation between CSF CXCL2 concentrations with neurosyphilis (p = 0.017), CSF white blood cell count (p = 0.001), and CSF protein levels (p = 0.005). The CSF level of CXCL2 can be used to distinguish those with or without neurosyphilis in HIV infected patients.

  10. Demographic, risk factors and motivations among blood donors with reactive serologic tests for syphilis in São Paulo, Brazil.

    Science.gov (United States)

    Ferreira, S C; de Almeida-Neto, C; Nishiya, A S; Oliveira, C D L; Ferreira, J E; Alencar, C S; Levi, J E; Salles, N A; Mendrone, A; Sabino, E C

    2014-06-01

    To identify the demographic characteristics, risk factors and motivations for donating among blood donors with reactive serologic tests for syphilis. Post-donation interviews with syphilis seropositive blood donors improve recruitment and screening strategies. This case-control study compares 75 Venereal Disease Research Laboratory (VDRL) > 8, EIA+ (enzyme immunoassay) and FTA-ABS+ (fluorescent treponemal antibody); 80 VDRL-, EIA+ and FTA-ABS+; and 34 VDRL- and EIA- donors between 2004 and 2009. Donors were assessed by their demographic characteristics, sexual behaviour, history of alcohol and illicit drugs use, and motivations to donate. Donors with VDRL > 8 were more likely to be divorced [AOR = 12·53; 95% confidence interval (CI) 1·30-120·81], to have had more than six sexual partners (AOR=7·1; 95% CI 1·12-44·62) and to report male-male-sex in the past 12 months (AOR=8·18; 95% CI 1·78-37·60). Donors with VDRL-, EIA+ and FTA-ABS+ were less likely to be female (AOR=0·26; 95% CI 0·07-0·96), more likely to be older (AOR=10·2; 95% CI 2·45-42·58 ≥ 39 and VDRL > 8) and 12·5% (VDRL-, EIA+ and FTA-ABS+) of donors reported that they had been at risk for HIV infection (P = 0·004). One-third of donors came to the blood bank to help a friend or a relative who needed blood. Although donors exposed to syphilis reported and recognised some high risk behaviour, most were motivated by direct appeal to donate blood. Monitoring the risk profile of blood donors can benefit public health and improve blood safety. © 2014 The Authors. Transfusion Medicine © 2014 British Blood Transfusion Society.

  11. Effective use of an audit tool devised to optimize the management of syphilis in an integrated sexual health clinic.

    Science.gov (United States)

    Knapper, C; Furness, L; Collett, M; Lomax, N; Browning, M

    2011-05-01

    The objective of this study was to audit the management of syphilis in our integrated sexual health clinic according to the British Association for Sexual Health and HIV (BASHH) guideline using the 'Treponemal Infection Care' (TIC) audit tool devised by our clinic. The case notes of patients diagnosed with all stages of syphilis during an 18-month period were reviewed. At the time of diagnosis, the departmental TIC proforma was filled in: this proforma details BASHH auditable outcomes. The case notes of 83 patients diagnosed with syphilis during the audit period were reviewed. The majority of patients were men (76), men who had sex with men (69), HIV-negative (59) and were British (68). In line with current guidance all patients had a baseline Venereal Disease Research Laboratory (VDRL) titre at the start of treatment (target: 100%) and 97% of diagnosed patients completed treatment (target: 95%). A 'response to treatment' according to the decrease in VDRL was demonstrated in 50 (60%) patients with two (2%) patients failing to respond according to these criteria. However, 19 (23%) patients failed to return for their VDRL tests before demonstrating an adequate response to treatment, despite repeated attempts to contact them by letter and telephone. Fifty-four patients had at least 50% of their partners documented as traceable. Of those who were contactable, 100% attended for screening or treatment (target: 60%). In conclusion, our department performed well against BASHH auditable outcome targets. The introduction of the TIC proforma greatly facilitated the ease of audit and is a valuable tool within our clinic setting, which may have positively influenced our audit outcomes. Further action is required to highlight the importance of follow-up VDRLs to patients.

  12. Improving the screening of blood donors with syphilis rapid diagnostic test (RDT) and rapid plasma reagin (RPR) in low- and middle-income countries (LMIC)

    DEFF Research Database (Denmark)

    Sarkodie, F.; Hassall, O.; Owusu-Dabo, E.

    2017-01-01

    BACKGROUND: Syphilis testing conventionally relies on a combination of non-treponemal and treponemal tests. The primary objective of this study was to describe the positive predictive value (PPV) of a screening algorithm in a combination of a treponemal rapid diagnostic test (RDT) and rapid plasm...... of blood donors by combining syphilis RDT and RPR with relatively good PPV may provide a reasonable technology for LMIC that has a limited capacity for testing and can contribute to the improvement of blood safety with a minimal loss of donors....

  13. [Juan Marin Rojas M.D., First Professor of History of Medicine at Universidad de Chile and his "Essay about the origin of syphilis"].

    Science.gov (United States)

    Laval, Enrique

    2014-06-01

    Dr. Juan Marín Rojas, M.D., was the first Professor of History of Medicine at Universidad de Chile, navy doctor, diplomat, writer and literary critic. Member of the International Society of History of Medicine, and Correspondent Member for Chile of the "Office de Documentation de Médecine et Pharmacie Militaire", Liege, Belgium, from which his "Essay about the origin of syphilis" is transcribed with interesting historical facts and little known arguments that affirm the non-american origin of syphilis, but "aspire to leave a doubt, given not a contrary conviction".

  14. Laboratory Evaluation of a Dual-Path Platform Assay for Rapid Point-of-Care HIV and Syphilis Testing.

    Science.gov (United States)

    Leon, S R; Ramos, L B; Vargas, S K; Kojima, N; Perez, D G; Caceres, C F; Klausner, J D

    2016-02-01

    We assessed the laboratory performance of the Chembio dual-path platform HIV-syphilis rapid immunodiagnostic test and electronic reader for detection of HIV and Treponema pallidum antibodies in 450 previously characterized serum specimens. For visual or electronic reader HIV antibody detection, the sensitivity was 100% and the specificity was 98.7%. For visual T. pallidum antibody detection, the test sensitivity was 94.7% and the specificity was 100.0%; with the electronic reader, the sensitivity was 94.7% and the specificity was 99.7%. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  15. Sífilis secundaria en cavidad oral: Reporte de dos casos Oral secondary syphilis: Two cases report

    Directory of Open Access Journals (Sweden)

    M G Díaz

    2008-12-01

    Full Text Available La sífilis es una enfermedad infecciosa humana causada por una bacteria: el Treponema pallidum. La enfermedad es transmitida por contacto directo a través de lesiones durante el estadio primario y secundario, por vía transplacentaria intrauterina o a través del canal uterino; puede afectar cualquier órgano de la economía causando un número infinito de presentaciones clínicas. La sífilis secundaria cursa con manifestaciones mucocutáneas características y eventual sintomatología general. La presentación clínica de nuestros dos pacientes es singular ya que solo poseían lesiones en la cavidad oral. La respuesta al tratamiento instaurado fue buena.Syphilis is a human infectious disease caused by the bacterium Treponema pallidum. The disease is transmitted by direct contact with a lesion during the primary or secondary stages, in utero by the transplacental route, or during delivery as the baby passes through an infected canal. The bacterium may infect any organ, causing an infinite number of clinical presentations. Secondary syphilis is characterized by mucocutaneous lesions, a flulike syndrome, and generalized adenopathy. Hepatosplenomegaly may be present. The oral mucosa is the second most frequent site of luetic lesions; the genital areas are the most frequent. In the oral cavity, the most characteristic lesion is a whitish mucosal patch, normally located on the lips, tongue, or palate, which is extremely contagious. The differential diagnosis of this lesion may include oral squamous carcinoma, leukoplakia, candidosis, lichen planus, and hairy oral leukoplakia. Definitive diagnosis is based on clinical information and completed by laboratory examinations even the biopsy can help us. With the diagnosis of secondary syphilis treatment with penicillin G benzathine must be started. We present two cases of secondary syphilis with oral lesions only; the first one, a man with macule covered with a whitish membrane on palate mucosa and a

  16. Treponema pallidum (syphilis) antigen TpF1 induces angiogenesis through the activation of the IL-8 pathway.

    Science.gov (United States)

    Pozzobon, Tommaso; Facchinello, Nicola; Bossi, Fleur; Capitani, Nagaja; Benagiano, Marisa; Di Benedetto, Giulietta; Zennaro, Cristina; West, Nicole; Codolo, Gaia; Bernardini, Marialina; Baldari, Cosima Tatiana; D'Elios, Mario Milco; Pellegrini, Luca; Argenton, Francesco; de Bernard, Marina

    2016-01-05

    Over 10 million people every year become infected by Treponema pallidum and develop syphilis, a disease with broad symptomatology that, due to the difficulty to eradicate the pathogen from the highly vascularized secondary sites of infection, is still treated with injections of penicillin. Unlike most other bacterial pathogens, T. pallidum infection produces indeed a strong angiogenic response whose mechanism of activation, however, remains unknown. Here, we report that one of the major antigen of T. pallidum, the TpF1 protein, has growth factor-like activity on primary cultures of human endothelial cells and activates specific T cells able to promote tissue factor production. The growth factor-like activity is mediated by the secretion of IL-8 but not of VEGF, two known angiogenic factors. The pathogen's factor signals IL-8 secretion through the activation of the CREB/NF-κB signalling pathway. These findings are recapitulated in an animal model, zebrafish, where we observed that TpF1 injection stimulates angiogenesis and IL-8, but not VEGF, secretion. This study suggests that the angiogenic response observed during secondary syphilis is triggered by TpF1 and that pharmacological therapies directed to inhibit IL-8 response in patients should be explored to treat this disease.

  17. Treponema pallidum putative novel drug target identification and validation: rethinking syphilis therapeutics with plant-derived terpenoids.

    Science.gov (United States)

    Dwivedi, Upendra N; Tiwari, Sameeksha; Singh, Priyanka; Singh, Swati; Awasthi, Manika; Pandey, Veda P

    2015-02-01

    Syphilis, a slow progressive and the third most common sexually transmitted disease found worldwide, is caused by a spirochete gram negative bacteria Treponema pallidum. Emergence of antibiotic resistant T. pallidum has led to a search for novel drugs and their targets. Subtractive genomics analyses of pathogen T. pallidum and host Homo sapiens resulted in identification of 126 proteins essential for survival and viability of the pathogen. Metabolic pathway analyses of these essential proteins led to discovery of nineteen proteins distributed among six metabolic pathways unique to T. pallidum. One hundred plant-derived terpenoids, as potential therapeutic molecules against T. pallidum, were screened for their drug likeness and ADMET (absorption, distribution, metabolism, and toxicity) properties. Subsequently the resulting nine terpenoids were docked with five unique T. pallidum targets through molecular modeling approaches. Out of five targets analyzed, D-alanine:D-alanine ligase was found to be the most promising target, while terpenoid salvicine was the most potent inhibitor. A comparison of the inhibitory potential of the best docked readily available natural compound, namely pomiferin (flavonoid) with that of the best docked terpenoid salvicine, revealed that salvicine was a more potent inhibitor than that of pomiferin. To the best of our knowledge, this is the first report of a terpenoid as a potential therapeutic molecule against T. pallidum with D-alanine:D-alanine ligase as a novel target. Further studies are warranted to evaluate and explore the potential clinical ramifications of these findings in relation to syphilis that has public health importance worldwide.

  18. Comparison of a recombinant-antigen enzyme immunoassay with Treponema pallidum hemagglutination test for serological confirmation of syphilis.

    Science.gov (United States)

    Rodríguez, Islay; Alvarez, Elvio L; Fernández, Carmen; Miranda, Alina

    2002-04-01

    A recombinant-antigen enzyme immunoassay (EIA), BioSCREEN anti-Treponema pallidum, was compared favorably with the T. pallidum hemagglutination test, in the detection of specific antibodies in different groups of sera from patients with primary (n = 38), secondary (n = 10), early latent (n = 28) and congenital syphilis (n = 2), patients with leptospirosis ( n= 8), infectious mononucleosis (n = 7), hepatitis (n = 9), diabetes mellitus (n = 11), rheumatoid arthritis (n = 13), leprosy (n = 11), tuberculosis (n = 9), HIV/Aids ( n= 12), systemic lupus erythematosus (n = 4), rheumatic fever (n = 3), old-persons (n = 9), pregnant women (n = 29) and blood donors (n = 164). The coincidence between them was 95.1%. The sensitivity and specificity of the EIA were 93.3% and 95.5%, respectively. Fifteen serum specimens belonging to old-persons, pregnant women, blood donors, and patients with human leptospirosis, hepatitis, diabetes mellitus, tuberculosis and rheumatic fever gave false-positive results by Venereal Disease Research Laboratory and/or Rapid Plasma Reagin. The EIA can be used as alternative method for the serological confirmation of syphilis.

  19. Comparison of a Recombinant-antigen Enzyme Immunoassay with Treponema pallidum Hemagglutination Test for Serological Confirmation of Syphilis

    Directory of Open Access Journals (Sweden)

    Islay Rodríguez

    2002-04-01

    Full Text Available A recombinant-antigen enzyme immunoassay (EIA, BioSCREEN TM anti-Treponema pallidum, was compared favorably with the T. pallidum hemagglutination test, in the detection of specific antibodies in different groups of sera from patients with primary (n = 38, secondary (n = 10, early latent (n = 28 and congenital syphilis (n = 2, patients with leptospirosis ( n= 8, infectious mononucleosis (n = 7, hepatitis (n = 9, diabetes mellitus (n = 11, rheumatoid arthritis (n = 13, leprosy (n = 11, tuberculosis (n = 9, HIV/Aids ( n= 12, systemic lupus erythematosus (n = 4, rheumatic fever (n = 3, old-persons (n = 9, pregnant women (n = 29 and blood donors (n = 164. The coincidence between them was 95.1%. The sensitivity and specificity of the EIA were 93.3% and 95.5%, respectively. Fifteen serum specimens belonging to old-persons, pregnant women, blood donors, and patients with human leptospirosis, hepatitis, diabetes mellitus, tuberculosis and rheumatic fever gave false-positive results by Venereal Disease Research Laboratory and/or Rapid Plasma Reagin. The EIA can be used as alternative method for the serological confirmation of syphilis.

  20. Usefulness in clinical practice of a point-of-care rapid test for simultaneous detection of nontreponemal and Treponema pallidum-specific antibodies in patients suffering from documented syphilis.

    Science.gov (United States)

    Guinard, Jérôme; Prazuck, Thierry; Péré, Hélène; Poirier, Claire; LeGoff, Jérôme; Boedec, Erwan; Guigon, Aurélie; Day, Nesrine; Bélec, Laurent

    2013-12-01

    The usefulness of a point-of-care immunochromatographic dual test for the simultaneous detection of both nontreponemal and Treponema pallidum-specific antibodies (Chembio Diagnostics Systems Inc., Medford, NY, USA) was assessed in various situations related to syphilis, by reference to conventional syphilis serology. Thawed sera were obtained from 100 adults including 36 primary syphilis, 6 secondary syphilis, 6 re-infection, 9 recently-treated syphilis, and 43 old syphilis. Doubtful reactivities for the treponemal line were considered positive; doubtful reactivities for the nontreponemal line were considered positive only when the treponemal line was present. The sensitivity, the specificity, and its concordance to gold standard serology of treponemal line were high, around 90%. The sensitivity of nontreponemal line was 96.3%, its specificity 76.7%, and its concordance 83.4%. In conclusion, the dual rapid test from Chembio Diagnostics Systems Inc. is useful for rapid point-of-care diagnosis in the various situations encountered with patients suffering from syphilis.

  1. Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey

    Directory of Open Access Journals (Sweden)

    Tiange P. Zhang

    2017-01-01

    Conclusions: HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting testing in China and should be considered in intervention development and delivery. Further research is needed to better understand the role of LMIC community engagement in HIV interventions.

  2. An evaluation of the relative sensitivities of the venereal disease research laboratory test and the Treponema pallidum particle agglutination test among patients diagnosed with primary syphilis.

    Science.gov (United States)

    Creegan, Linda; Bauer, Heidi M; Samuel, Michael C; Klausner, Jeffrey; Liska, Sally; Bolan, Gail

    2007-12-01

    Because definitive methods for diagnosing primary syphilis are limited, it is important to optimize the sensitivity of serodiagnosis. To determine the most sensitive testing approach to the diagnosis of primary syphilis, using the commonly available serologic tests: the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum particle agglutination (TP-PA) test. Sensitivities of 2 serologic testing strategies for primary syphilis were compared among 106 darkfield-confirmed cases treated in San Francisco from January 2002 through December 2004. The sensitivity of the diagnostic strategy using VDRL confirmed by TP-PA was 71% (95% CI, 61%-79%). Substituting Rapid Plasma Reagin test for VDRL in a subset of 51 patients produced the same sensitivity (71%; 95% CI, 56%-83%). The sensitivity of TP-PA as the first-line diagnostic test was 86% (95% CI, 78%-92%). The sensitivity of the former approach was significantly lower among HIV-positive patients, compared with HIV-negative patients (55% vs. 77%, P = 0.05). The TP-PA test as the first-line diagnostic test yielded higher sensitivity for primary syphilis than did the use of the currently recommended strategy.

  3. A case-control study evaluating the role of internet meet-up sites and mobile telephone applications in influencing a syphilis outbreak: Multnomah County, Oregon, USA 2014.

    Science.gov (United States)

    DeSilva, Malini; Hedberg, Katrina; Robinson, Byron; Toevs, Kim; Neblett-Fanfair, Robyn; Petrosky, Emiko; Hariri, Susan; Schafer, Sean

    2016-08-01

    Early syphilis in Multnomah County, Oregon, USA, increased 16-fold during 2007-2013. Cases predominantly occurred among men who have sex with men (MSM); 55% were HIV coinfected. We conducted a case-control study to evaluate the association between meeting sex partners online and early syphilis. Cases subjects (cases) were Multnomah County resident, English speaking, MSM, aged ≥18 years with laboratory-confirmed early syphilis reported 1 January to 31 December 2013. We recruited two MSM controls subjects (controls) per case, frequency matched by HIV status and age. Participants completed self-administered questionnaires. We performed multivariable logistic regression. Seventy per cent (40/57) of cases and 42% (50/119) of controls met partners online (ponline (adjusted OR (aOR)=3.0; 95% CI 1.2 to 6.7), controlling for presumptive confounders. Cases reported more partners than controls (medians 5, 2; ponline. We believe this association may be related to number of sex partners acting as an intermediate variable between use of online resources to meet sex partners and early syphilis. Online meet-up sites might represent areas for public health interventions targeting at-risk individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. 头晕起病的神经梅毒1例临床分析%Clinical Analysis of One Case with Neural Syphilis Caused by Dizzy

    Institute of Scientific and Technical Information of China (English)

    赵清石

    2012-01-01

    目的研究排除各种病因的头晕患者患有神经梅毒的可能性.方法对1名排除了各种病因的头晕患者行输血3项检查显示:TPPA阳性,进而行TRUST(梅毒血清学试验)检查.结果患者输血3项提示:TPPA及TRUST(梅毒血清学试验)阳性.考虑此患者为神经梅毒.结论临床如遇此类患者应进一步行脑脊液及血清VIA—ABS等相关检查.%Objective Explicitly excluding the various causes of dizziness patients may have nerve syphilis. Methods For a dizziness patient was done a blood transfusion, three tests show TPPA:positive, and then was inspected TRUST (syphilis serologic test) examination. Results The patiem blood transfusion presents TPPA and TRUST (syphilis serologic test) :positive. Considering the patient is neural syphilis. Conclusion Clinical case should be further do cerebrospinal fluid and serum FTA-ABS and related inspection.

  5. Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Robert Ali

    2016-01-01

    Full Text Available Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV, syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of “malignant” syphilis. CD4 count was 57 cells/μL. RPR was elevated with 1 : 64 titer and positive confirmatory TP-PA. Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy. The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy. He was subsequently treated with doxycycline 100 mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains. Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging. Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy. Doxycycline with/without azithromycin is other options worth considering.

  6. Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

    Directory of Open Access Journals (Sweden)

    Christoph Schweikardt

    2016-09-01

    Full Text Available Background: The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs, and to examine opportunities and limits of the Intego database in this regard. Methods: Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results: A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI 9.6; 14.7 per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5, respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4 and 7.0 (CI: 6.7, 7.3, respectively. Conclusion: In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP.

  7. Characterizing the Syphilis-Causing Treponema pallidum ssp. pallidum Proteome Using Complementary Mass Spectrometry

    Science.gov (United States)

    Houston, Simon; Lithgow, Karen V.; Meehan, Conor J.; Strouhal, Michal; Šmajs, David; Cameron, Caroline E.; Van Ostade, Xaveer; Kenyon, Chris R.; Van Raemdonck, Geert A.

    2016-01-01

    Background The spirochete bacterium Treponema pallidum ssp. pallidum is the etiological agent of syphilis, a chronic multistage disease. Little is known about the global T. pallidum proteome, therefore mass spectrometry studies are needed to bring insights into pathogenicity and protein expression profiles during infection. Methodology/Principal Findings To better understand the T. pallidum proteome profile during infection, we studied T. pallidum ssp. pallidum DAL-1 strain bacteria isolated from rabbits using complementary mass spectrometry techniques, including multidimensional peptide separation and protein identification via matrix-assisted laser desorption ionization-time of flight (MALDI-TOF/TOF) and electrospray ionization (ESI-LTQ-Orbitrap) tandem mass spectrometry. A total of 6033 peptides were detected, corresponding to 557 unique T. pallidum proteins at a high level of confidence, representing 54% of the predicted proteome. A previous gel-based T. pallidum MS proteome study detected 58 of these proteins. One hundred fourteen of the detected proteins were previously annotated as hypothetical or uncharacterized proteins; this is the first account of 106 of these proteins at the protein level. Detected proteins were characterized according to their predicted biological function and localization; half were allocated into a wide range of functional categories. Proteins annotated as potential membrane proteins and proteins with unclear functional annotations were subjected to an additional bioinformatics pipeline analysis to facilitate further characterization. A total of 116 potential membrane proteins were identified, of which 16 have evidence supporting outer membrane localization. We found 8/12 proteins related to the paralogous tpr gene family: TprB, TprC/D, TprE, TprG, TprH, TprI and TprJ. Protein abundance was semi-quantified using label-free spectral counting methods. A low correlation (r = 0.26) was found between previous microarray signal data and

  8. 抗梅毒治疗对妊娠结局及新生儿预后的影响%Effect of anti-syphilis treatment on perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis

    Institute of Scientific and Technical Information of China (English)

    周敏; 陈竹; 曾义岚; 何克静; 祝昭惠; 黄海霞

    2013-01-01

    目的 探讨不同抗梅毒治疗方法对妊娠梅毒患者的妊娠结局及新生儿预后的影响.方法 选择2010年1月至2012年1月成都市传染病医院收治的妊娠合并梅毒患者198例.根据孕期治疗情况,将患者分为规范治疗组(98例)、未规范治疗组(59例)和未治疗组(41例).采用Pearsonx2和卡方分割法比较各组的妊娠结局、新生儿预后及快速血浆反应环状卡片试验(RPR)转阴率等情况.结果 流产、早产、死胎、死产、新生儿畸形等不良妊娠结局的发生率在规范治疗组、未规范治疗组及未治疗组分别为4.08%,27.12%和63.41%.先天梅毒儿、低体重儿、窒息儿、新生儿死亡等发生率在规范治疗组、未规范治疗组及未治疗组中逐渐升高,其中先天梅毒儿的发生率分别为2.06%,18.75%和35.29%.RPR高滴度(≥1∶8)的梅毒孕妇所产新生儿RPR滴度进行比较,规范治疗组较未规范治疗组和未治疗组明显下降,其差异具有统计学意义(x2=37.122,P<0.01).新生儿RPR转阴率在规范治疗组、未规范治疗组及未治疗组中分别为100.00%,59.26%和25.00%,差异有统计学意义(x2=18.839,P<0.01).结论 规范的抗梅毒治疗是改善妊娠结局、新生儿预后及降低先天梅毒发生率的关键.%Objective To investigate the effect of anti-syphilis treatment on the perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis.Methods One hundred and ninety eight pregnant women complicated with syphilis were collected from Chengdu Hospital of Infectious Diseases during January 2010 and January 2012,including 98 cases received standard treatment,59 cases received nonstandard treatment and 41 cases did not receive treatment.Pearson x2 and partition of chi-square were used for the comparison of pregnant outcomes,neonatal prognosis and negative rates of rapid plasma circle card test (RPR) among 3 groups.Results The incidence of adverse pregnancy

  9. Sífilis materna y congénita en cuatro provincias de Bolivia Maternal and congenital syphilis in four provinces in Bolivia

    Directory of Open Access Journals (Sweden)

    Rita Revollo

    2007-12-01

    Full Text Available OBJETIVO: Calcular las frecuencias de sífilis materna y congénita, transmisión del agente etiológico de la madre al recién nacido, y variables asociadas con la enfermedad, en seis hospitales públicos en Bolivia. MATERIAL Y MÉTODOS: Se realizó un estudio transversal de mayo a septiembre de 2004. Se administró la prueba rápida para sífilis Determine-TP y RPR cuantitativo a mujeres postparto sin RPR previo. Se incluyeron antecedentes demográficos y de atención prenatal de embarazos previos. A los recién nacidos de madres con sífilis se les practicó Western Blot IgM p47 y ELISA IgM. Las pruebas serológicas se procesaron en el Laboratorio Nacional de Referencia (INLASA. Se realizó un análisis estadístico bivariado y multivariado para establecer asociaciones con el diagnóstico positivo a T. pallidum. RESULTADOS: La prevalencia de sífilis entre 1 594 mujeres postparto fue de 7.2%, con una proporción de transmisión de infección de madres a recién nacidos de 15.7 por ciento. La prevalencia de sífilis congénita por serología fue de 1.1%; 94% de estos neonatos no presentaron sintomatología. A pesar de una cobertura de control prenatal de 70.5% en Bolivia, aún existen mujeres que acuden directamente al parto institucional sin contar con tamizaje previo para sífilis con pruebas de rutina. El bajo nivel de instrucción formal (OBJECTIVE: Assess frequencies of maternal and congenital syphilis, mother-child transmission and variables associated with syphilis in six urban hospitals in Bolivia. MATERIAL AND METHODS: A cross-sectional study was performed between May and September 2004. We administered the Abbot Determine-TP rapid test and quantitative RPR to postpartum women without prior RPR. Sociodemographic variables and prior prenatal care visits were studied. Newborns of syphilis positive mothers were studied with Western Blot IgM p47 and ELISA IgM. Serum samples were analyzed at the Central Reference Laboratory (INLASA

  10. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation

    Science.gov (United States)

    Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Mumba, Grace Tembo; Gill, Michelle M.; Strasser, Susan; Peeling, Rosanna W.; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider’s perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in

  11. A Dual Point-of-Care Test Shows Good Performance in Simultaneously Detecting Nontreponemal and Treponemal Antibodies in Patients With Syphilis: A Multisite Evaluation Study in China

    Science.gov (United States)

    Yin, Yue-Ping; Chen, Xiang-Sheng; Wei, Wan-Hui; Gong, Kuang-Long; Cao, Wen-Ling; Yong, Gang; Feng, Liang; Huang, Shu-Jie; Wang, Dong-Mei; Han, Yan; Chen, Shao-Chun; Mabey, David; Peeling, Rosanna W.

    2013-01-01

    Background. Rapid point-of-care (POC) syphilis tests based on simultaneous detection of treponemal and nontreponemal antibodies (dual POC tests) offer the opportunity to increase coverage of syphilis screening and treatment. This study aimed to conduct a multisite performance evaluation of a dual POC syphilis test in China. Methods. Participants were recruited from patients at sexually transmitted infection clinics and high-risk groups in outreach settings in 6 sites in China. Three kinds of specimens (whole blood [WB], fingerprick blood [FB], and blood plasma [BP]) were used for evaluating sensitivity and specificity of the Dual Path Platform (DPP) Syphilis Screen and Confirm test using its treponemal and nontreponemal lines to compare Treponema pallidum particle agglutination (TPPA) assay and toluidine red unheated serum test (TRUST) as reference standards. Results. A total of 3134 specimens (WB 1323, FB 488, and BP 1323) from 1323 individuals were collected. The sensitivities as compared with TPPA were 96.7% for WB, 96.4% for FB, and 94.6% for BP, and the specificities were 99.3%, 99.1%, and 99.6%, respectively. The sensitivities as compared with TRUST were 87.2% for WB, 85.8% for FB, and 88.4% for BP, and the specificities were 94.4%, 96.1%, and 95.0%, respectively. For specimens with a TRUST titer of 1:4 or higher, the sensitivities were 100.0% for WB, 97.8% for FB, and 99.6% for BP. Conclusions. DPP test shows good sensitivity and specificity in detecting treponemal and nontreponemal antibodies in 3 kinds of specimens. It is hoped that this assay can be considered as an alternative in the diagnosis of syphilis, particularly in resource-limited areas. PMID:23132172

  12. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Directory of Open Access Journals (Sweden)

    Katharine D Shelley

    Full Text Available Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015 elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16 was more than triple the pilot unit cost ($3.19. While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into

  13. Domestic and overseas research progress in co-infection of HIV and Syphilis%HIV/梅毒共感染国内外研究进展

    Institute of Scientific and Technical Information of China (English)

    李璇; 王辉

    2011-01-01

    梅毒是一种复杂的性传播疾病,在世界范围内其发病率正在上升.同时,作为一个公共健康问题,艾滋病病毒(HIV)感染也为世界各国所重视.梅毒和HIV的感染人群和传播途径相似,其共同感染也日渐增多.二者相互影响,梅毒能显著提高HIV感染的风险,而HIV可以改变梅毒的自然病程.文章综述了国内外近年来关于这两种疾病共同感染的研究进展,包括流行病学特征、共感染的表现、相互作用,以及针对HIV/梅毒共感染病人的诊断和治疗等.%Syphilis is a kind of complicated sexually transmitted disease, and its morbidity rate is climbing globally. In the meantime, as a public health issue, HIV infection is being given serious attention by all countries over the world. Syphilis and HIV have similar infected population and transmission route, and therefore have caused increasing number of co-infection cases. As mutual effect , syphilis can dramatically increase the infection risk of HIV , on the other hand, HIV can change the natural course of syphilis. This article reviews the recent domestic and overseas research progress in the co-infection of these two diseases , including epidemiological characteristics, manifestations and interaction of the co-infection, and the diagnosis and the treatment of HIV/syphilis co-infected patients.

  14. RPR和TPPA在梅毒血清测定中的比较研究%The determination with RPR and TPPA for serum syphilis

    Institute of Scientific and Technical Information of China (English)

    白艳丽

    2015-01-01

    目的:探讨RPR和TPPA在梅毒血清学测定中的临床价值。方法选择确诊梅毒患者600例,确诊排除梅毒者600例,RPR组使用RPR测定法,TPPA组使用TPPA测定法,比较两组不同阶段梅毒检查阳性率,并分析特异性和敏感性。结果TPPA组对Ⅰ期、Ⅱ期和Ⅲ期梅毒检查阳性率均显著高于RPR组(P<0.05), TPPA组特异性和敏感性均超过95.0%,显著高于RPR组(P<0.05)。结论 RPR测定其特异性和敏感性低于TPPA检测适用于普查,TPPA检测则可作为确诊方法运用于临床。%Objective To explore the clinical value of Rpr and tppa for serum syphilis. Methods 600 cases confirmed with syphilis patients and 600 cases of confirmed without syphilis were choosed, RPR group were used RPR,the TPPA group were used TPPA,then different stage syphilis positive rate of examination and specificity and sensitivity were compared in the two groups. Results TPPA group with stageⅠ, Ⅱ and Ⅲ check syphilis positive rate were significantly higher than RPR group (P<0.05), specificity and sensitivity with TPPA group were more than 95.0%,they were higher than RPR group(P<0.05). Conclusion The detection of RPR measure with specificity and sensitivity are lower than the TPPA,it is suitable for the census,and TPPA test can be applied to clinical diagnosis method.

  15. Neurosyphilis Increases HIV-associated Central Nervous System Inflammation but Does Not Explain Cognitive Impairment in HIV-infected Individuals with Syphilis.

    Science.gov (United States)

    Ho, Emily L; Maxwell, Clare L; Dunaway, Shelia B; Sahi, Sharon K; Tantalo, Lauren C; Lukehart, Sheila A; Marra, Christina M

    2017-05-19

    HIV-infected individuals with previous syphilis have cognitive impairment. We tested the hypothesis that neurosyphilis causes cognitive impairment in HIV by amplifying HIV-related CNS inflammation. 132 HIV-infected participants enrolled in a study of CSF abnormalities in syphilis underwent the mental alternation test (MAT), venipuncture and lumbar puncture. CSF concentrations of chemokine (C-X-C motif) ligand 10 (CXCL10), chemokine (C-C motif) ligand 2 (CCL2) and neurofilament light (NFL) were determined by commercial assays. The proportion of peripheral blood mononuclear cells (PBMCs) and of CSF white blood cells (WBCs) that were activated monocytes (CD14+CD16+) was determined by flow cytometry. Neurosyphilis was defined as detection of T. pallidum 16S RNA in CSF or CSF white blood cells (WBCs) >20/ul or a reactive CSF-Venereal Disease Research Laboratory (VDRL) test; uncomplicated syphilis was defined as undetectable CSF T. pallidum, CSF WBCs ≤5/ul and nonreactive CSF-VDRL. MAT <18 was considered low. Median proportion of PBMCs that were activated monocytes (16.6 vs. 5.3), and median CSF CXCL10 (10,658 vs. 2,530 units), CCL2 (519 vs. 337 units) and HIV RNA (727 vs. 50 c/ml) were higher in neurosyphilis than in uncomplicated syphilis (P≤0.001 for all comparisons). Neurosyphilis was not related to low MAT scores. Participants with low MAT scores had higher median CSF CXCL10 (10,299 vs.3,650 units, P=0.008) and CCL2 (519 vs. 365 units, P=0.04) concentrations than those with high MAT scores. Neurosyphilis may augment HIV-associated CNS inflammation, but it does not explain cognitive impairment in HIV-infected individuals with syphilis.

  16. Seroprevalencia de sífilis en mujeres embarazadas en San Luis Potosí Seroprevalence of syphilis in pregnant women in San Luis Potosí

    Directory of Open Access Journals (Sweden)

    Daniel E Noyola

    2006-04-01

    Full Text Available OBJETIVO: Determinar la seroprevalencia de sífilis en mujeres embarazadas. MATERIAL Y MÉTODOS: Encuesta seroepidemiológica en 1 857 mujeres que acudieron para la atención del parto a un hospital general de la ciudad de San Luis Potosí. RESULTADOS: Se diagnosticó sífilis en cinco (0.27% mujeres al momento del parto. Los factores maternos asociados con una probabilidad superior de presentar sífilis incluyeron mayor edad materna, mayor número de embarazos previos y vivir en unión libre con su pareja. CONCLUSIONES: El número de recién nacidos expuestos a sífilis durante el embarazo, en la ciudad de San Luis Potosí, está subestimado. Los resultados de este estudio sustentan la necesidad de identificar, al momento del parto, a madres infectadas con sífilis.OBJECTIVE: To determine the seroprevalence of syphilis in pregnant women. METHODS: A seroepidemiologic survey was conducted in 1 857 women giving birth at a general hospital in the city of San Luis Potosi, Mexico. RESULTS: Five women (0.27 % were diagnosed with syphilis at the time of delivery. Maternal factors associated with a greater likelihood of syphilis included older age, a higher number of pregnancies and living out of wedlock. CONCLUSIONS: The number of new borns exposed to syphilis during pregnancy in San Luis Potosi is underestimated. The results of this study support the need to identify syphilis in infected mothers at the time of delivery.

  17. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    Science.gov (United States)

    Shelley, Katharine D; Ansbro, Éimhín M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic s