Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of ...Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.展开更多
BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignan...BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.展开更多
AIM:To evaluate the clinical characteristics,demographics,and visual outcomes of patients with ocular syphilis at an urban hospital to increase awareness and assist in earlier diagnosis and treatment of the resurgent ...AIM:To evaluate the clinical characteristics,demographics,and visual outcomes of patients with ocular syphilis at an urban hospital to increase awareness and assist in earlier diagnosis and treatment of the resurgent disease.METHODS:A retrospective chart review was performed on patients with ICD-9 and ICD-10 diagnosis codes correlating with syphilis or syphilis-related ocular diseases between 2010 and 2019.Variables evaluated included age,gender,race,vision,ocular findings,human immunodeficiency virus(HIV)status and men who have sex with men status,recreational drug and alcohol use.RESULTS:Ocular syphilis was diagnosed in 40 patients(53 eyes)of a total of 229 patients who tested positive for syphilis via serum and/or cerebrospinal fluid treponemal testing from 2010-2019.Among patients with ocular syphilis,most patients were males,aged 45 or above and Black,and had no diagnosed HIV infection.Approximately 50%patients had 20/40 vision or better.Nearly 50%had nongranulomatous anterior uveitis as their initial presentation,and 49%of patients had involvement of the posterior segment.Neovascular glaucoma(5.7%),papillitis(7.5%),vasculitis(5.7%),and retinal detachment(5.7%)were rarer presentations of the disease and were associated with a poorer visual prognosis.CONCLUSION:Given the increased prevalence and protean manifestations of syphilis,early diagnosis and treatment are paramount.More studies on ocular syphilis are warranted to understand this resurging disease.展开更多
BACKGROUND One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners.The disease causes serious repercussions in inf...BACKGROUND One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners.The disease causes serious repercussions in infected newborns.AIM To evaluate the prevalence and factors associated with the therapeutic adhesion among partners of pregnant women with syphilis in a county in Northeastern Brazil.METHODS This is a descriptive,analytic,quantitative,cross-sectional study that was carried out through interviews with 46 pregnant women diagnosed with syphilis between 2017 and 2018 as well as with their partners.The interviews aimed at collecting data regarding sociodemographic characteristics,obstetric variables and information about syphilis,and partners’related variables.RESULTS Our results showed that 73.91%of the partners did not undergo appropriate treatments,and obtaining negative results in syphilis tests was the main reason for the absence of therapies.The following factors were significantly associated with the lack of treatment among partners:Being a partner that is not the current mate of the pregnant woman,having a level of schooling inferior to 8 years[oddsratio(OR)=10.28],and the pregnant woman undergoing up to two syphilis tests during the prenatal care(OR=8.6).The study found a higher odds of absent treatment among partners if the pregnant woman is not white(OR=13.88)or if the partner has less than 8 years of schooling(OR=21.00)or has a monthly income of less than half the minimum wage(OR=13.93).CONCLUSION The findings of this study show a high prevalence of partners that are not adequately treated for syphilis,a phenomenon that is strongly associated with socioeconomic factors.展开更多
Normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a...Normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a 79-year-old male was admitted for investigation of a dementia syndrome. The patient presented with clinical features and neuroimaging compatible with NPH. Syphilis serology was reactive and compatible with active disease. The patient was treated with crystalline penicillin (4 million units every 4 hours for 21 days) and was assessed again after three months, when his cognition and gait had improved and the urinary incontinence had resolved. According to this information, we describe a case of syphilis mimicking normal pressure hydrocephalus, making clear the importance of the investigation of sexually transmitted diseases in the differential diagnosis of dementia, even in patients without established risk supposedly.展开更多
BACKGROUND:Rapid plasma regain positive and/or treponema pallidum hemagglutination negative [RPR(+)/TPHA(-)] results were designated as biologic false-positive (BFP).There are limited data about BFP reactions against ...BACKGROUND:Rapid plasma regain positive and/or treponema 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 (P<0.001).A significantly increased prevalence shown by false-positive tests for syphilis was observed in elderly HCV-seropositive patients.BFP-HCV positive group had a higher prevalence of eosinophilia.The eosinophil abnormality was compared between the patients and controls (66.7% vs 21.4%,P=0.0043).No significant results were observed in antinuclear antibodies,antiphospholipid and complement (C3,C4) (P>0.05).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.展开更多
Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a pa...Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a patient who had an underlying primary peritoneal serous carcinoma (PPSC).The patient was diagnosed with PPSC and achieved a complete remission of PPSC following six cycles of platinum-based chemotherapy.Two hepatic nodules developed during the follow-up period and were initially labeled as hepatic metastases from the underlying PPSC,based on radiological findings.A resection of hepatic nodules was performed for therapeutic and diagnostic purposes,because there were no other metastatic foci except in the liver.Unex-pectedly,serology and histology confirmed tertiary sy philis.This rare case emphasizes the importance of including tertiary syphilis in the differential diagnosis of a space-occupying lesion,even with an existing diagn osis of underlying cancer.展开更多
Dear Editor,Syphilis is a spirochaetal bacterial sexually transmitted disease(STD) caused by Treponema pallidum. Outbreaks of syphilis have been described in Western communities, especially in men who have sex with me...Dear Editor,Syphilis is a spirochaetal bacterial sexually transmitted disease(STD) caused by Treponema pallidum. Outbreaks of syphilis have been described in Western communities, especially in men who have sex with men(MSM) and people infected with human immunodeficiency virus(HIV)^([1]). Reports of the condition from Asian countries remains limited, this展开更多
Mother-to-child transmission(MTCT)of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries.In 2007,World Health Orgernization launched the global elimination of MTCT(EMTC...Mother-to-child transmission(MTCT)of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries.In 2007,World Health Orgernization launched the global elimination of MTCT(EMTCT)of syphilis.Given the high burden of congenital syphilis,China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis.The congenital syphilis incidence rate per 100,000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019.However,due to the global pandemic of COVID-19,the current measures for eliminating MTCT of syphilis are greatly challenged.In this article,we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years,the remarkable achievements by the policy support under the leadership of the government.In the context of COVID-19 pandemics,strengthening emergency response to the regional outbreaks of COVID-19,adopting safe,rapid,early and high-quality clinical care for 100%of pregnant women to receive prenatal syphilis testing services,ensuring the availability of Benzathine penicillin for the treatment,and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are the key measures to determine the effectiveness of MTCT for syphilis.Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.展开更多
The methods and strategies used to screen for syphilis and to confirm initially reactive results can vary significantly across clinical laboratories.While the performance characteristics of these different approaches ...The methods and strategies used to screen for syphilis and to confirm initially reactive results can vary significantly across clinical laboratories.While the performance characteristics of these different approaches have been evaluated by multiple studies,there is not,as of yet,a single,universally recommende dalgorithm for syphilis testing.To clarify the currently available options for syphilis testing,this update will summarize the clinical challenges to diagnosis,review the specific performance characteristics of treponemal and non-treponemal tests,and finally,summarize select studies published over the past decade which have evaluated these approaches.Specifically,this review will discuss the traditional and reverse sequence syphilis screening algorithms commonly used in the United States,alongside a discussion of the European Centre for Disease Prevention and Control syphilis algorithm.Ultimately,in the United States,the decision of which algorithm to use is largely dependent on laboratory resources,the local incidence of syphilis and patient demographics.展开更多
Objective:To explore the feasibility of using grey model GM(1,1)model to predict syphilis,and to provide a theoretical basis for the health sector to develop corresponding strategies.Methods:GM(1,1)model was used to c...Objective:To explore the feasibility of using grey model GM(1,1)model to predict syphilis,and to provide a theoretical basis for the health sector to develop corresponding strategies.Methods:GM(1,1)model was used to construct and simulate the incident rate and case number of syphilis in China from 2009 to 2018 to predict the change trend.Results:The GM(1,1)prediction model of syphilis incident rate was x^(1)(k+1)=929.367901 e(0.029413k)-906.297901.The GM(1,1)prediction model for the number of syphilis patients was x^(1)(k+1)=1060.278025 e(0.034280k)-1029.639925.For syphilis incidence model,the posterior difference ratio was 0.19819 and the probability of small error was 1.For the syphilis incident number model,the posterior difference ratio was 0.18450 and the probability of small error was 1.The above models have good fitting accuracy with excellent grade level and can be predicted by extrapolation and predicted that the syphilis incidence in 2019-2021 may be 36.15 per 100,000,37.23 per 100,000 and 38.34 per 100,000,respectively.From 2019 to 2021,the number of incident syphilis cases in China may be 503,406,520,962 and 539,130,respectively.Conclusion:The GM(1,1)model can well fit and predict the change trend of syphilis incidence in time series.The prediction model showed that the incidence of syphilis may continue to increase and the number of syphilis cases per year may continue to increase substantially.More effort is needed to strengthen the prevention and treatment of venereal disease,reduce venereal harm to the population and improve the early detection rate of syphilis.展开更多
BACKGROUND Anti-N-methyl-D-aspartate-receptor(NMDAR)encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations.The pathogenesis of the disease ...BACKGROUND Anti-N-methyl-D-aspartate-receptor(NMDAR)encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations.The pathogenesis of the disease is unclear.Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms.There are few reports of anti-NMDAR encephalitis with syphilis,and the association between them is unknown;both diseases are related to immune system damage.We report a case of anti-NMDAR encephalitis with syphilis.CASE SUMMARY A 32-year-old man was admitted to our hospital with complaints of cognitive decline,diplopia,and walking instability during the previous 6 mo.He developed dysarthria,difficulty swallowing,and involuntary shaking of his head,neck,and limbs during the month prior to presentation.Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons,midbrain,and bilateral basal ganglia,and inflammatory demyelination was considered.The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test.He was given anti-syphilis treatment,but the above symptoms gradually worsened.Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum.Due to the cerebrospinal fluid findings,anti-NMDAR encephalitis was a consideration.According to the patient’s weight,he was treated with intravenous methylprednisolone 1 g QD for 5 d,with the dose gradually decreased for 6 mo,and immunoglobulin 25 g QD for 5 d;his symptoms improved after treatment.CONCLUSION This case shows that anti-NMDAR encephalitis may be combined with syphilis,which should be recognized to avoid misdiagnosis and treatment delay.展开更多
BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions s...BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week,which was aggravated for two days.The patient had been sexually active with the same male partner for the past years,but her partner was promiscuous.Abdominal contrastenhanced computed tomography(CT)and positron emission tomography/CT suggested gastric cancer.The gastroscopy revealed an antral gastric ulcer with gastric retention,and also suggested gastric cancer.But no cancer cells were found in the biopsies taken during the two gastroscopies.Treponema pallidum(T.pallidum)antibodies:ELISA positive,rapid plasma reagin titer 1:16.Hematoxylin and eosin(HE)stain showed macrophage infiltration in the lamina propria.Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T.pallidum.The patient was finally diagnosed with gastric syphilis.CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer.Penicillin can relieve symptoms of gastric syphilis.展开更多
BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of...BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.展开更多
BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman pr...BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman presented with blurred vision due to cataracts.Slit-lamp microscopy revealed bilateral hyaline scrolls with a dichotomous branching pattern extending to the anterior chamber or rods attaching to the rough posterior surface of the cornea.The patient was positive for syphilis-specific antibodies,with no ocular or systemic evidence of congenital or acquired syphilis.Binocular cataract,retrocorneal scroll,and corneal endothelial gutta were considered.The scroll of the right eye was removed during cataract surgery and further observed using hematoxylin–eosin staining and scanning electron microscopy.The cornea of the right eye remained transparent,and the residual scroll seemed stable,however,the corneal endothelial density declined at 13 mo after surgery.In vivo confocal microscopy revealed coalescence of corneal guttae at the level of the corneal endothelium or adhesion to the posterior surface of the endothelium,with enlarged endothelial cells in both eyes.Activated keratocytes in the stroma and a highly reflective acellular structure at the level of the Descemet’s membrane were observed.The removed scroll had a cartilage-like hardness and a circularly arranged fiber-like acellular structure.CONCLUSION Occult congenital syphilis could induce corneal endothelial gutta and theformation of retrocorneal scrolls without other signs of ocular syphilis.展开更多
A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both e...A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.展开更多
Migrant workers, particularly gold mining workers, have been identified as a group at risk for HIV and sexually transmitted infections (STI). A cross-sectional study was undertaken on the correlates of human immunodef...Migrant workers, particularly gold mining workers, have been identified as a group at risk for HIV and sexually transmitted infections (STI). A cross-sectional study was undertaken on the correlates of human immunodeficiency virus (HIV) and syphilis infections in a sample of migrants (Ghanaian citizens [156] and non-Ghanaian citizens [8]) working in a gold mining centres in Konongo, Ghana. The study was conducted between the months of January 2013 to December 2013. Of a total of 600 eligible migrant workers, only 164 (27.33%;males 114, females 50) of the eligible migrants took part in the study. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimen for testing for the presence of antibodies to HIV and Treponema pallidum, the causative agent of syphilis. These data were analyzed using both univariate and multivariate techniques. The median age of the participants was 29.0 years (range 18 - 62 years). Of the 164 migrant workers tested, HIV and syphilis seroprevalence were 6.7% and 3.7% respectively. On multivariate analysis, the independent determinants for HIV infection were being female [odds ratio (OR) 2.94;95% confidence interval (95% CI 0.86 - 10.0);unmarried (OR 10.13;95% CI 1.2 - 81.09);drug use (OR 3.76;95% CI 0.38 - 36.3);and blood transfusion (OR 2.45;95% CI 0.27 - 22.37). Similarly, on multivariate analysis, the independent determinants for syphilis infection were having concurrent sexual partners (OR 2.16;95% CI 0.38 - 12.12);and blood transfusion (OR 5.07;95% CI 0.51 - 50.37). Consistent with similar studies worldwide, our results suggest high prevalence of HIV and syphilis infections among migrant workers who work in gold mining centres in Ghana.展开更多
Diagnosis of sexually transmitted infections is very important considering the spread of HIV and the extensive use of highly active antiretroviral therapy worldwide. This will assist in planning of treatment schedule ...Diagnosis of sexually transmitted infections is very important considering the spread of HIV and the extensive use of highly active antiretroviral therapy worldwide. This will assist in planning of treatment schedule in controlling these infections. The study therefore aimed at determining the prevalence of syphilis in HIV positive antiretroviral therapy naive patients in Cape Coast and the associated risk factors involved in infection. A cross-sectional study was carried out using initial HIV rapid and confirmation tests, and then Venereal Disease Research Laboratory test with the Ultra Rapid Test Kits for syphilis. Demographic data, risky sexual behaviours capable of co-transmission of both HIV and Syphilis, were also collected through the use of questionnaires. In all, 150 HIV positive antiretroviral naive subjects were studied and 15 (10%) were positive for VDRL test, with females (6.00%) and males (4.00%), who were mainly within the age group of 20 - 39 years. A significant number of males (p = 0.019) and females (p = 0.015) participants were not smoking with a fewer number of the females (p = 0.002) having multiple sexual partners. Also a smaller number of those who were infected with the bacteria (p = 0.004) did not support the control of sexually transmitted infection (p = 0.022). The result showed that co-infection of Syphilis in HIV positive antiretroviral therapy naive patients persists in the Cape Coast Metropolis, which is an indication of prominence of STIs that require further study on a larger scale to ascertain the extent of co-infection and to formulate policy for treatment to help minimize the rate of infection.展开更多
First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is ...First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.展开更多
文摘Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.
基金Supported by the National Natural Science Foundation of China,No.81773337the Shandong Traditional Chinese Medicine Science and Technology Development Plans,China,No.2017-415+1 种基金the Medical and Health Science Technology Project of Shandong Province,China,No.2017WS345the Natural Science Foundation of Shandong Province,China,No.ZR2015HL127
文摘BACKGROUND Syphilis is a common sexually transmitted disease caused by the Treponema pallidum (T.pallidum).Malignant syphilis is a rare presentation of secondary syphilis.Here,we present a case diagnosed with malignant syphilis accompanied with neurosyphilis.CASE SUMMARY A 56-year-old man present with a 2-mo history of spreading ulcerous and necrotic papules and nodules covered with thick crusts over the face,trunk,extremities,and genitalia.The patient was diagnosed with malignant syphilis accompanied by neurosyphilis based on the characteristic morphology of the lesions,positive serological and cerebrospinal fluid tests for syphilis,brain magnetic resonance imaging,and histopathology,along with resolution of the lesions following the institution of penicillin therapy.The lesions and neurological condition successfully resolved after a course of treatment with penicillin.CONCLUSION We suggest that neurosyphilis should be considered whenever people have psychiatric symptoms without cutaneous lesions or human immunodeficiency virus.
文摘AIM:To evaluate the clinical characteristics,demographics,and visual outcomes of patients with ocular syphilis at an urban hospital to increase awareness and assist in earlier diagnosis and treatment of the resurgent disease.METHODS:A retrospective chart review was performed on patients with ICD-9 and ICD-10 diagnosis codes correlating with syphilis or syphilis-related ocular diseases between 2010 and 2019.Variables evaluated included age,gender,race,vision,ocular findings,human immunodeficiency virus(HIV)status and men who have sex with men status,recreational drug and alcohol use.RESULTS:Ocular syphilis was diagnosed in 40 patients(53 eyes)of a total of 229 patients who tested positive for syphilis via serum and/or cerebrospinal fluid treponemal testing from 2010-2019.Among patients with ocular syphilis,most patients were males,aged 45 or above and Black,and had no diagnosed HIV infection.Approximately 50%patients had 20/40 vision or better.Nearly 50%had nongranulomatous anterior uveitis as their initial presentation,and 49%of patients had involvement of the posterior segment.Neovascular glaucoma(5.7%),papillitis(7.5%),vasculitis(5.7%),and retinal detachment(5.7%)were rarer presentations of the disease and were associated with a poorer visual prognosis.CONCLUSION:Given the increased prevalence and protean manifestations of syphilis,early diagnosis and treatment are paramount.More studies on ocular syphilis are warranted to understand this resurging disease.
文摘BACKGROUND One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners.The disease causes serious repercussions in infected newborns.AIM To evaluate the prevalence and factors associated with the therapeutic adhesion among partners of pregnant women with syphilis in a county in Northeastern Brazil.METHODS This is a descriptive,analytic,quantitative,cross-sectional study that was carried out through interviews with 46 pregnant women diagnosed with syphilis between 2017 and 2018 as well as with their partners.The interviews aimed at collecting data regarding sociodemographic characteristics,obstetric variables and information about syphilis,and partners’related variables.RESULTS Our results showed that 73.91%of the partners did not undergo appropriate treatments,and obtaining negative results in syphilis tests was the main reason for the absence of therapies.The following factors were significantly associated with the lack of treatment among partners:Being a partner that is not the current mate of the pregnant woman,having a level of schooling inferior to 8 years[oddsratio(OR)=10.28],and the pregnant woman undergoing up to two syphilis tests during the prenatal care(OR=8.6).The study found a higher odds of absent treatment among partners if the pregnant woman is not white(OR=13.88)or if the partner has less than 8 years of schooling(OR=21.00)or has a monthly income of less than half the minimum wage(OR=13.93).CONCLUSION The findings of this study show a high prevalence of partners that are not adequately treated for syphilis,a phenomenon that is strongly associated with socioeconomic factors.
文摘Normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a 79-year-old male was admitted for investigation of a dementia syndrome. The patient presented with clinical features and neuroimaging compatible with NPH. Syphilis serology was reactive and compatible with active disease. The patient was treated with crystalline penicillin (4 million units every 4 hours for 21 days) and was assessed again after three months, when his cognition and gait had improved and the urinary incontinence had resolved. According to this information, we describe a case of syphilis mimicking normal pressure hydrocephalus, making clear the importance of the investigation of sexually transmitted diseases in the differential diagnosis of dementia, even in patients without established risk supposedly.
文摘BACKGROUND:Rapid plasma regain positive and/or treponema 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 (P<0.001).A significantly increased prevalence shown by false-positive tests for syphilis was observed in elderly HCV-seropositive patients.BFP-HCV positive group had a higher prevalence of eosinophilia.The eosinophil abnormality was compared between the patients and controls (66.7% vs 21.4%,P=0.0043).No significant results were observed in antinuclear antibodies,antiphospholipid and complement (C3,C4) (P>0.05).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.
文摘Tertiary syphilis,especially in cases involving visceral gummatous disease,can be confused with cancer of the solid organs.We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a patient who had an underlying primary peritoneal serous carcinoma (PPSC).The patient was diagnosed with PPSC and achieved a complete remission of PPSC following six cycles of platinum-based chemotherapy.Two hepatic nodules developed during the follow-up period and were initially labeled as hepatic metastases from the underlying PPSC,based on radiological findings.A resection of hepatic nodules was performed for therapeutic and diagnostic purposes,because there were no other metastatic foci except in the liver.Unex-pectedly,serology and histology confirmed tertiary sy philis.This rare case emphasizes the importance of including tertiary syphilis in the differential diagnosis of a space-occupying lesion,even with an existing diagn osis of underlying cancer.
文摘Dear Editor,Syphilis is a spirochaetal bacterial sexually transmitted disease(STD) caused by Treponema pallidum. Outbreaks of syphilis have been described in Western communities, especially in men who have sex with men(MSM) and people infected with human immunodeficiency virus(HIV)^([1]). Reports of the condition from Asian countries remains limited, this
基金National Natural Science Foundation of China(81772209 and 81601804).
文摘Mother-to-child transmission(MTCT)of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries.In 2007,World Health Orgernization launched the global elimination of MTCT(EMTCT)of syphilis.Given the high burden of congenital syphilis,China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis.The congenital syphilis incidence rate per 100,000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019.However,due to the global pandemic of COVID-19,the current measures for eliminating MTCT of syphilis are greatly challenged.In this article,we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years,the remarkable achievements by the policy support under the leadership of the government.In the context of COVID-19 pandemics,strengthening emergency response to the regional outbreaks of COVID-19,adopting safe,rapid,early and high-quality clinical care for 100%of pregnant women to receive prenatal syphilis testing services,ensuring the availability of Benzathine penicillin for the treatment,and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are the key measures to determine the effectiveness of MTCT for syphilis.Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.
文摘The methods and strategies used to screen for syphilis and to confirm initially reactive results can vary significantly across clinical laboratories.While the performance characteristics of these different approaches have been evaluated by multiple studies,there is not,as of yet,a single,universally recommende dalgorithm for syphilis testing.To clarify the currently available options for syphilis testing,this update will summarize the clinical challenges to diagnosis,review the specific performance characteristics of treponemal and non-treponemal tests,and finally,summarize select studies published over the past decade which have evaluated these approaches.Specifically,this review will discuss the traditional and reverse sequence syphilis screening algorithms commonly used in the United States,alongside a discussion of the European Centre for Disease Prevention and Control syphilis algorithm.Ultimately,in the United States,the decision of which algorithm to use is largely dependent on laboratory resources,the local incidence of syphilis and patient demographics.
文摘Objective:To explore the feasibility of using grey model GM(1,1)model to predict syphilis,and to provide a theoretical basis for the health sector to develop corresponding strategies.Methods:GM(1,1)model was used to construct and simulate the incident rate and case number of syphilis in China from 2009 to 2018 to predict the change trend.Results:The GM(1,1)prediction model of syphilis incident rate was x^(1)(k+1)=929.367901 e(0.029413k)-906.297901.The GM(1,1)prediction model for the number of syphilis patients was x^(1)(k+1)=1060.278025 e(0.034280k)-1029.639925.For syphilis incidence model,the posterior difference ratio was 0.19819 and the probability of small error was 1.For the syphilis incident number model,the posterior difference ratio was 0.18450 and the probability of small error was 1.The above models have good fitting accuracy with excellent grade level and can be predicted by extrapolation and predicted that the syphilis incidence in 2019-2021 may be 36.15 per 100,000,37.23 per 100,000 and 38.34 per 100,000,respectively.From 2019 to 2021,the number of incident syphilis cases in China may be 503,406,520,962 and 539,130,respectively.Conclusion:The GM(1,1)model can well fit and predict the change trend of syphilis incidence in time series.The prediction model showed that the incidence of syphilis may continue to increase and the number of syphilis cases per year may continue to increase substantially.More effort is needed to strengthen the prevention and treatment of venereal disease,reduce venereal harm to the population and improve the early detection rate of syphilis.
基金Supported by the National Natural Science Foundation of China,No.81571057Tianjin Science and Technology Project,No.16ZXMJSY00010
文摘BACKGROUND Anti-N-methyl-D-aspartate-receptor(NMDAR)encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations.The pathogenesis of the disease is unclear.Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms.There are few reports of anti-NMDAR encephalitis with syphilis,and the association between them is unknown;both diseases are related to immune system damage.We report a case of anti-NMDAR encephalitis with syphilis.CASE SUMMARY A 32-year-old man was admitted to our hospital with complaints of cognitive decline,diplopia,and walking instability during the previous 6 mo.He developed dysarthria,difficulty swallowing,and involuntary shaking of his head,neck,and limbs during the month prior to presentation.Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons,midbrain,and bilateral basal ganglia,and inflammatory demyelination was considered.The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test.He was given anti-syphilis treatment,but the above symptoms gradually worsened.Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum.Due to the cerebrospinal fluid findings,anti-NMDAR encephalitis was a consideration.According to the patient’s weight,he was treated with intravenous methylprednisolone 1 g QD for 5 d,with the dose gradually decreased for 6 mo,and immunoglobulin 25 g QD for 5 d;his symptoms improved after treatment.CONCLUSION This case shows that anti-NMDAR encephalitis may be combined with syphilis,which should be recognized to avoid misdiagnosis and treatment delay.
基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2020ZH080.
文摘BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week,which was aggravated for two days.The patient had been sexually active with the same male partner for the past years,but her partner was promiscuous.Abdominal contrastenhanced computed tomography(CT)and positron emission tomography/CT suggested gastric cancer.The gastroscopy revealed an antral gastric ulcer with gastric retention,and also suggested gastric cancer.But no cancer cells were found in the biopsies taken during the two gastroscopies.Treponema pallidum(T.pallidum)antibodies:ELISA positive,rapid plasma reagin titer 1:16.Hematoxylin and eosin(HE)stain showed macrophage infiltration in the lamina propria.Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T.pallidum.The patient was finally diagnosed with gastric syphilis.CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer.Penicillin can relieve symptoms of gastric syphilis.
基金Supported by Science and Technology Innovation Joint Fund Project of Fujian Province,No.2018Y9116.
文摘BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.
基金Zhejiang Provincial Medical and Health Technology Project,No.2020KY215.
文摘BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman presented with blurred vision due to cataracts.Slit-lamp microscopy revealed bilateral hyaline scrolls with a dichotomous branching pattern extending to the anterior chamber or rods attaching to the rough posterior surface of the cornea.The patient was positive for syphilis-specific antibodies,with no ocular or systemic evidence of congenital or acquired syphilis.Binocular cataract,retrocorneal scroll,and corneal endothelial gutta were considered.The scroll of the right eye was removed during cataract surgery and further observed using hematoxylin–eosin staining and scanning electron microscopy.The cornea of the right eye remained transparent,and the residual scroll seemed stable,however,the corneal endothelial density declined at 13 mo after surgery.In vivo confocal microscopy revealed coalescence of corneal guttae at the level of the corneal endothelium or adhesion to the posterior surface of the endothelium,with enlarged endothelial cells in both eyes.Activated keratocytes in the stroma and a highly reflective acellular structure at the level of the Descemet’s membrane were observed.The removed scroll had a cartilage-like hardness and a circularly arranged fiber-like acellular structure.CONCLUSION Occult congenital syphilis could induce corneal endothelial gutta and theformation of retrocorneal scrolls without other signs of ocular syphilis.
文摘A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.
文摘Migrant workers, particularly gold mining workers, have been identified as a group at risk for HIV and sexually transmitted infections (STI). A cross-sectional study was undertaken on the correlates of human immunodeficiency virus (HIV) and syphilis infections in a sample of migrants (Ghanaian citizens [156] and non-Ghanaian citizens [8]) working in a gold mining centres in Konongo, Ghana. The study was conducted between the months of January 2013 to December 2013. Of a total of 600 eligible migrant workers, only 164 (27.33%;males 114, females 50) of the eligible migrants took part in the study. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimen for testing for the presence of antibodies to HIV and Treponema pallidum, the causative agent of syphilis. These data were analyzed using both univariate and multivariate techniques. The median age of the participants was 29.0 years (range 18 - 62 years). Of the 164 migrant workers tested, HIV and syphilis seroprevalence were 6.7% and 3.7% respectively. On multivariate analysis, the independent determinants for HIV infection were being female [odds ratio (OR) 2.94;95% confidence interval (95% CI 0.86 - 10.0);unmarried (OR 10.13;95% CI 1.2 - 81.09);drug use (OR 3.76;95% CI 0.38 - 36.3);and blood transfusion (OR 2.45;95% CI 0.27 - 22.37). Similarly, on multivariate analysis, the independent determinants for syphilis infection were having concurrent sexual partners (OR 2.16;95% CI 0.38 - 12.12);and blood transfusion (OR 5.07;95% CI 0.51 - 50.37). Consistent with similar studies worldwide, our results suggest high prevalence of HIV and syphilis infections among migrant workers who work in gold mining centres in Ghana.
文摘Diagnosis of sexually transmitted infections is very important considering the spread of HIV and the extensive use of highly active antiretroviral therapy worldwide. This will assist in planning of treatment schedule in controlling these infections. The study therefore aimed at determining the prevalence of syphilis in HIV positive antiretroviral therapy naive patients in Cape Coast and the associated risk factors involved in infection. A cross-sectional study was carried out using initial HIV rapid and confirmation tests, and then Venereal Disease Research Laboratory test with the Ultra Rapid Test Kits for syphilis. Demographic data, risky sexual behaviours capable of co-transmission of both HIV and Syphilis, were also collected through the use of questionnaires. In all, 150 HIV positive antiretroviral naive subjects were studied and 15 (10%) were positive for VDRL test, with females (6.00%) and males (4.00%), who were mainly within the age group of 20 - 39 years. A significant number of males (p = 0.019) and females (p = 0.015) participants were not smoking with a fewer number of the females (p = 0.002) having multiple sexual partners. Also a smaller number of those who were infected with the bacteria (p = 0.004) did not support the control of sexually transmitted infection (p = 0.022). The result showed that co-infection of Syphilis in HIV positive antiretroviral therapy naive patients persists in the Cape Coast Metropolis, which is an indication of prominence of STIs that require further study on a larger scale to ascertain the extent of co-infection and to formulate policy for treatment to help minimize the rate of infection.
文摘First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.
