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Aktas, G., H. Young, A. Moyes, and S. Badur. "Evaluation of the Serodia Treponema pallidum particle agglutination, the Murex Syphilis ICE and the Enzywell TP tests for serodiagnosis of syphilis." International Journal of STD & AIDS 16, no. 4 (2005): 294–98. http://dx.doi.org/10.1258/0956462053654195.
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We evaluated the Treponema pallidum haemagglutination assay (TPHA), a treponemal test, with three other treponemal tests, the Serodia T. pallidum particle agglutination assay, the Murex Syphilis ICE IgG + IgM enzyme immunoassay (EIA) and the Enzywell TP IgG + M EIA (a new rapid EIA) for use in conjunction with the rapid plasma reagin test (RPR), a non-treponemal test, for serodiagnosis of syphilis. In all, 124 serum samples were found reactive with RPR and/or TPHA after testing by the routine laboratory protocol. Twenty-three (18.5%) of them were positive only by RPR test and were evaluated as biologically false-positive, 16 were positive only by the TPHA and 84 by both the RPR and TPHA tests; one sample was non-specific (heterophile reaction) in the TPHA. Agreements of the TPHA with the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP tests were 96.7%, 100% and 99.1%, respectively. We conclude that each one of the tests, the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP, is an appropriate substitute for screening for serodiagnosis of syphilis.
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Dogra, Avantika, Mudit Tyagi, Hrishikesh Kaza, and Avinash Pathengay. "Syphilitic chorioretinitis presenting as a choroidal granuloma." BMJ Case Reports 13, no. 4 (2020): e234022. http://dx.doi.org/10.1136/bcr-2019-234022.
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A rare case of syphilitic uveitis presenting as a choroidal granuloma is described in this case report. The clinical picture resembled that of a tubercular choroidal granuloma. However, the patient was positive for treponemal (treponema pallidum hemagglutination assay) as well as non-treponemal tests (venereal disease research laboratory test) for syphilis. Therefore, the patient was treated for ocular syphilis and responded to antisyphilitic therapy. There was a complete resolution of the lesion at the end of 14 days of treatment.
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Golušin, Zoran, Marina Jovanović, Milan Matić, Ljuba Vujanović, Tatjana Roš, and Biljana Jeremić. "Serological Tests for Acquired Syphilis in Immuno-competent Patients." Serbian Journal of Dermatology and Venereology 8, no. 2 (2016): 79–87. http://dx.doi.org/10.1515/sjdv-2016-0007.
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AbstractSerological tests represent a valuable tool for the diagnosis and monitoring the syphilis treatment. Non-treponemal antibodies are nonspecific to detect the infection, but antibody titers are used to monitor the effects of syphilis treatment. A definitive diagnosis of syphilis is made using treponemal tests, because they detect specific antibodies to the treponemal strains or treponemal fragments, which cause syphilis. These tests may remain reactive for years, sometimes for life, regardless of the therapy outcome. Even after successful treatment, approximately 85% of patients remain positive for treponemal antibodies for the rest of their lives. However, treponemal tests cannot differentiate past infections from a current infection. Therefore, we use a combination of specific and non-specific tests, the two most frequently used diagnostic algorithms. The traditional algorithm begins with a non-treponemal assay, and if it is positive, the treponemal test is done. A positive treponemal test indicates syphilis. The reverse serology algorithm detects early, primary, and treated syphilis that may be missed with traditional screening. However, non-treponemal test is necessary to detect patients with active syphilis.
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Ison, C. "S11.3 Performing a treponemal test to confirm a reactive EIA test: before or after the non-treponemal test?" Sexually Transmitted Infections 87, Suppl 1 (2011): A13. http://dx.doi.org/10.1136/sextrans-2011-050102.46.
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Fortin, C. "S11.2 Which algorithm performs better, screening with a non-treponemal or treponemal test?" Sexually Transmitted Infections 87, Suppl 1 (2011): A13. http://dx.doi.org/10.1136/sextrans-2011-050102.45.
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Pastro, Déboranh De Oliveira Togneri, Bruna Pereira Farias, Otávio Augusto Gurgel Garcia, Bianca Da Silva Gambichler, Dionatas Ulises De Oliveira Meneguetti, and Rita do Socorro Uchôa da Silva. "Prenatal quality and clinical conditions of newborns exposed to syphilis." Journal of Human Growth and Development 29, no. 2 (2019): 249–56. http://dx.doi.org/10.7322/jhgd.v29.9429.
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Introduction: Syphilis is a sexually transmitted disease caused by Treponema pallidum, and results in considerable morbidity and mortality. Congenital syphilis can lead to miscarriage, prematurity, bone deformities, hearing loss and other important clinical changes. Objective: To analyze prenatal quality and clinical conditions of newborns exposed to syphilis in a public maternity hospital in Rio Branco-Acre. Method: This is a cross-sectional study that included 92 mothers diagnosed with syphilis during pregnancy, attended from July to December 2017. Two pregnant women had fetal death, and the final sample consisted of 90 newborns exposed to syphilis. An interview with the postpartum woman was used, analysis of the pregnant woman's card and search for information from the pregnant woman's records and newborns. It was considered confirmed case of syphilis in pregnant woman: a) All pregnant women who presented non-treponemal reagent test with any titration and reagent treponemal test performed during prenatal care; b) Pregnant woman with reagent treponemal test and nonreactive or unreacted nontreponemal test, without previous treatment record. To characterize congenital syphilis we considered: a) newborn whose mother was not diagnosed with syphilis during pregnancy and who presented a nontreponemal test reactive with any titration at the time of delivery; b) child whose mother was not diagnosed with syphilis during pregnancy and had a non-treponemal test reagent at the time of delivery; c) newborns whose mother presented a reactive treponemal test and a nonreactive non-treponemal test at the moment of delivery, without previous treatment record. Results: Most newborns were born in normal delivery (65.5%), 17.8% had acute fetal distress and 11.2% required resuscitation maneuvers. Prematurity occurred in 10% of births and 12.2% of them were small for gestational age. Complete prenatal care was performed by 29.5% of the mothers, following the recommendations of the Ministry of Health of seven visits to the Health Unit and or Health Professional. From the 90 pregnant women, 79 had a reactive treponemal test when admitted to the maternity ward. 29.3% of them performed the treatment properly. In the analysis about the treatment of the sexual partner, it was reported that 58% did not adhere to syphilis treatment. Conclusion: The prenatal quality of pregnant women with syphilis was lower than that recommended by the Brazilian Ministry of Health, although there are few cases of syphilis as the primary outcome in newborns with childbirth with mothers diagnosed with syphilis. Prenatal, newborn, syphilis in pregnancy, congenital syphilis.
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Rahayuningsih, Dwi, Aryati Aryati, and Budi Arifah. "Evaluation of immunochromatography test using Tp17 antigen for detection of treponemal antibody in blood donors." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 26, no. 1 (2019): 81. http://dx.doi.org/10.24293/ijcpml.v26i1.1349.
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Syphilis transmission through blood transfusion urged WHO recommend examination of treponemal antibody in blood donors. Treponemal antibody was identified to be formed against the membrane of lipoprotein antigen Tp15, Tp17, and Tp47 of T.pallidum. Tp17 antigen may have important role in the pathogenesis of syphilis. Evaluation of CLIA method using Tp17 antigen showed a good diagnostic value. Currently immunochromatography test using Tp17 antigen was available but the diagnostic value has not been widely published. The aim of this study was to determine the diagnostic value of immunochromatography test using Tp17 antigen for treponemal antibody detection in blood donors. Total 100 serum samples with reactive (n=66) and non-reactive (n=34) treponemal antibody screened with ELISA and CLIA methods in blood transfusion unit of Surabaya, Mojokerto, and Sidoarjo Indonesian Red Cross from May 2018-August 2018 were examined for treponemal antibody with immunochromatography test using Tp17 antigen (StandardTM Q Syphilis Ab, Standard Biosensor) and Fluorescent Treponemal Antibody Absorption /FTA-ABS (EUROIMMUN, AG) as gold standard. Kappa Cohen analysis showed the concordance of immunochromatography test using Tp17 antigen was moderate and significant with IgG anti-treponemal FTA-ABS (k = 0.477 p: 0.000). The IgM anti-treponemal was non-reactive in all samples. The sensitivity was 69.8% with 81% of specificity. The sensitivity was not high may be due to the use of a single antigen (Tp17) while the treponemal antibody was formed by Tp15, Tp17, and Tp47 antigen predominantly, the others possbilities were decreased of IgG anti-Tp17 in donors after syphilis treatment, and differences of gold standard with other studies (FTA-ABS vs TPHA). Further study was needed with TPHA that was routinely used as a confirmation test, Western Blot to determine the antibody others than anti-Tp17, and non-treponemal test to determine the disease activity.
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Shukla, Mayur R., John W. Deutsch, Lara E. Pereira, Ellen N. Kersh, and Yetunde F. Fakile. "Development of a novel magnetic particle-based agglutination immunoassay for anticardiolipin antibody detection in syphilis." Sexually Transmitted Infections 96, no. 6 (2020): 411–16. http://dx.doi.org/10.1136/sextrans-2020-054437.
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ObjectivesSerological tests of non-treponemal and treponemal types are the most frequently used for syphilis diagnosis. Treponemal tests are available in wide variety of assay formats; however, limited advances have been made for the improvement of conventional non-treponemal tests. The objective of this work was to develop a novel non-treponemal magnetic particle-based agglutination assay (NT-MAA) and evaluate its feasibility for syphilis testing.MethodsCardiolipin was modified and coupled to magnetic microbeads. Serum diluted in phosphate-buffered saline was mixed with cardiolipin-coupled beads and incubated in a round bottom microplate for 90–120 min followed by visual inspection. A panel of reported syphilis (n=127) and non-reactive (n=244) specimens was prepared to evaluate the NT-MAA performance in comparison to conventional rapid plasma reagin (RPR). Treponema pallidum particle agglutination (TP-PA) assay and enzyme immunoassay (EIA) were included. Analytical sensitivity and reproducibility of NT-MAA were also determined.ResultsThe non-treponemal NT-MAA and RPR showed sensitivity of 90.6% and 88.2% and specificity of 96.7% and 100%, respectively. The treponemal TP-PA and EIA yielded sensitivity of 100% and 99.2%, respectively, and 100% specificity by both assays. The per cent agreement between NT-MAA and RPR was 97% (kappa=0.931, 95% CI 0.891 to 0.971). Analytical sensitivity determined with IgM anticardiolipin antibody (ACA) was 2.6 µg/mL for both NT-MAA and RPR, while IgG ACA yielded 0.9 µg/mL and 1.7 µg/mL for NT-MAA and RPR, respectively. Qualitative results of intra-assay and interassay reproducibility revealed 100% consistency for NT-MAA.ConclusionPreliminary evaluation of the novel NT-MAA validated proof of concept using laboratory-characterised syphilis sera and demonstrated performance comparable to RPR. Further validation of NT-MAA using additional specimens with better clinical staging may broaden the scope of developed test for syphilis diagnosis.
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Shukla, Mayur R. "Can a Duplex Non-treponemal and Treponemal Serological Test Help in Improving Syphilis Testing?" International Journal of Current Microbiology and Applied Sciences 5, no. 6 (2016): 338–44. http://dx.doi.org/10.20546/ijcmas.2016.506.038.
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Katz, Alan R., Alan Y. Komeya, and Juval E. Tomas. "False-negative syphilis treponemal enzyme immunoassay results in an HIV-infected case-patient." International Journal of STD & AIDS 28, no. 7 (2016): 735–37. http://dx.doi.org/10.1177/0956462416684426.
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We present a case report of a false-negative syphilis treponemal enzyme immunoassay test result in an HIV-infected male. While treponemal tests are widely considered to be more sensitive and specific than non-treponemal tests, our findings point to potential challenges using the reverse sequence syphilis screening algorithm.
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Joesoef, M. R., M. Gultom, I. D. Irana, et al. "High rates of sexually transmitted diseases among male transvestites in Jakarta, Indonesia." International Journal of STD & AIDS 14, no. 9 (2003): 609–13. http://dx.doi.org/10.1258/095646203322301068.
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Many male transvestites ( waria) in Jakarta, Indonesia engage in unprotected receptive anal and oral intercourse with homosexual and bisexual men for pay. Although this behaviour clearly puts them at risk of sexually transmitted diseases (STDs), including HIV infection, little is known about the prevalence of STD among them. To learn the STD prevalence and its risk factors, we conducted an STD prevalence survey among waria in North Jakarta, Indonesia. From August to December 1999 we offered screening for rectal and pharyngeal infections with Neisseria gonorrhoeae (Ng), Chlamydia trachomatis (Ct) by DNA probe (GenProbe PACE 2) and for Treponema pallidum (Tp) by non-treponemal and treponemal serological tests. Of 296 participants (median age 28 years), 93% reported having been paid for sex. A total of 96% reported having had oral sex (median five times/week) and/or anal sex (median three times/week) in the last week. Ng was found in the rectum of 12.8% and the pharynx of 4.2%; Ct was found in 3.8% and 2.4%, respectively. A total of 43.6% had reactive non-treponemal and treponemal tests. Of the 129 with positive treponemal tests, 42.6% had non-treponemal test titres greater than 1:8. In the logistic regression model, waria who were younger (≥25 years old) had a significantly 3.5 times risk of Ng and/or Ct infections than older waria (>25 years old). Because only 12% of waria stated that they consistently used condoms during any sex act, it is important to warn them that STD/HIV transmission can occur with either anal or oral sex and that the risk of either anal or oral transmission can be reduced by condom use. In addition, high rates of asymptomatic syphilis and rectal gonorrhoea warrant a periodic screening and treatment for these infections in this population. Because waria have the highest rates of HIV and their clients consist of homosexual and bisexual men, successful prevention efforts in waria could help curb the spread of the epidemic.
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Maan, Irfaan, David S. Lawrence, Nametso Tlhako, et al. "Using a dual antibody point-of-care test with visual and digital reads to diagnose syphilis among people living with HIV in Botswana." International Journal of STD & AIDS 32, no. 5 (2021): 453–61. http://dx.doi.org/10.1177/0956462420975639.
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Syphilis data from low- and middle-income countries are lacking due to limited testing. Point-of-care tests (POCTs) have been promoted to expand testing but previously only included treponemal tests, which cannot distinguish active from past infection. We aimed to assess the feasibility of using a combined treponemal and non-treponemal POCT in HIV clinic patients in Gaborone, Botswana, and estimate syphilis prevalence in our clinic sample using this approach. We recruited 390 non-pregnant patients. Participants underwent a combined treponemal and non-treponemal POCT (Dual Path Platform (DPP®) Syphilis Screen and Confirm Assay (Chembio Diagnostic Systems)) on finger-prick blood sample and a questionnaire. Median age 45 years, 30% men, median CD4 count 565 cells/μL, and 91% had an HIV viral load <400 copies/mL. Five participants had active syphilis (1.3%, 95% CI 0.5–3.0%) and 64 had previous syphilis (16.4%, 95% CI 13.0–20.4%) using the DPP POCT. There was a reasonable level of agreement between digital and visual reading of the POCT (kappa statistic of 0.81); however, visual reading missed three active infections (60%). The level of active syphilis was similar to local antenatal data. The DPP POCT led to five participants with active syphilis being diagnosed and starting same-day treatment. The digital reader should be used.
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Madi, Deepak, Basavaprabhu Achappa, Poonam Vernakar, Unnikrishnan Bhaskaran, John T. Ramapuram, and Soundarya Mahalingam. "Prevalence of Syphilis among People living with HIV (PLHIV) attending a tertiary care hospital in coastal south India." Asian Journal of Medical Sciences 6, no. 6 (2015): 77–79. http://dx.doi.org/10.3126/ajms.v6i6.11623.
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Background: Syphilis and HIV are both transmitted sexually so people can be infected with both diseases. Co-infection of syphilis and HIV alters the course of both the diseases. Venereal disease research laboratory (VDRL) test is a non-treponemal test, used commonly in Antiretroviral Therapy Centres (ART) in India to detect syphilis. The aim of our study was to determine the prevalence of syphilis in HIV-infected patients attending a tertiary care hospital using VDRL test. Materials and Methods: Using a cross-sectional study design 113 HIV positive patients were included. VDRL test was used to screen for syphilis. The collected data was analyzed using SPSS version 11.5. Results: Among the 113 patients screened 69(61%) were males and 44(39%) were females. Majority of the patients had acquired the disease through heterosexual transmission (92.9%). VDRL test was negative in all 113 patients. Conclusion: The seroprevalence of syphilis in coastal South India using VDRL is very less. Specific tests like Fluorescent Treponemal Antibody Absorption test (FTA-ABS) or Treponema pallidum hemagglutination Assay (TPHA) would be beneficial to detect asymptomatic syphilis in ART centers.DOI: http://dx.doi.org/10.3126/ajms.v6i6.11623 Asian Journal of Medical Sciences Vol.6(6) 2015 77-79
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Naidu, NarinderKaur, ZS Bharucha, Vandana Sonawane, and Imran Ahmed. "Comparative study of Treponemal and non-Treponemal test for screening of blood donated at a blood center." Asian Journal of Transfusion Science 6, no. 1 (2012): 32. http://dx.doi.org/10.4103/0973-6247.95048.
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Langendorf, Céline, Céline Lastrucci, Isabelle Sanou-Bicaba, Kara Blackburn, Marie-Hortense Koudika, and Tania Crucitti. "Dual screen and confirm rapid test does not reduce overtreatment of syphilis in pregnant women living in a non-venereal treponematoses endemic region: a field evaluation among antenatal care attendees in Burkina Faso." Sexually Transmitted Infections 95, no. 6 (2018): 402–4. http://dx.doi.org/10.1136/sextrans-2018-053722.
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ObjectivesIn resource-limited settings, screening pregnant women for syphilis using rapid diagnostic tests (RDTs) is a key tool in the prevention of congenital syphilis. However, most syphilis RDTs detect only treponemal antibodies (T-RDT), meaning antibiotics may be provided unnecessarily to previously treated pregnant women, particularly in non-venereal treponematoses endemic regions. We estimated the potential reduction in overtreatment when comparing T-RDT (SD Bioline) to a newer rapid test (Dual Path Platform (DPP) Screen and Confirm Assay, Chembio) detecting both treponemal and non-treponemal antibodies.MethodsPregnant women in Déou, Burkina Faso, screened for syphilis during antenatal care (ANC) visits were prospectively enrolled in the study after providing consent. DPP and T-RDT tests were performed on whole blood specimens. Plasma was tested in an international reference laboratory by Treponema pallidum passive particle agglutination (TPPA) and quantitative rapid plasma reagin (RPR). Presumptive active syphilis was defined as a result that was both TPPA and RPR reactive.ResultsOf the 242 pregnant women included in the study, 91 (37.6%) had presumptive active syphilis and 19.0% had RPR titres ≥8. DPP testing did not reduce the number of pregnant women who would have been overtreated compared with T-RDT (0.0% vs 2.5%; p=0.218) and had a higher proportion of underdiagnosis (48.4% vs 2.2%; p<0.001). Seven women with high RPR titres ≥8 would not have received treatment had only DPP testing been used.ConclusionIn the first evaluation comparing DPP with traditional screening methods in pregnant women, we saw no reduction in unnecessarily treated syphilis and an underestimation of those needing treatment. High seroprevalence in the population may indicate the presence of other treponemal infections in the area, and further study of DPP in a variety of Sahelian and other contexts is warranted.
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Wahab, Asrul Abdul, and Norhazlin Mustafa. "Uveitis Presented as a Case of Ocular Syphilis – A Rare Presentation." Journal of Medicine 20, no. 1 (2019): 52–54. http://dx.doi.org/10.3329/jom.v20i1.38841.
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Ocular syphilis is one of the clinical presentation or complication of syphilis. Uveitis is the most common ocular diagnosis of the condition but any component of the eyes can be affected. Serology test that include both treponemal and non-treponemal antibody detections play an important role for supporting the diagnosis. This condition is considered as part of neurosyphilis and the recommended treatment follows the treatment for neurosyphilis.
 We reported a 47-year-old man presented with chronic episode of blurring of vision associated with floaters involving both eyes. Both eyes showed abnormal visual acuity with involvement of optic disc on the left eye. Serology tests for non-treponemal antibody and treponemal antibody test were positive. He was diagnosed as a case of bilateral posterior uveitis with left eye neuroretinitis. He was successfully treated with intravenous aqueous crystalline penicillin 3 million unit every four hour daily for 14 days.
 J MEDICINE JUL 2019; 20 (1) : 52-54
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Young, H., P. J. Walker, D. Merry, and A. Mifsud. "A Preliminary Evaluation of a Prototype Western Blot Confirmatory Test Kit for Syphilis." International Journal of STD & AIDS 5, no. 6 (1994): 409–14. http://dx.doi.org/10.1177/095646249400500606.
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A prototype Western blot kit was evaluated as a confirmatory test for syphilis using 131 sera characterized by other serological tests for syphilis. There were 114 treponemal sera (including 94 cases of early syphilis, 83 of which were untreated) and 17 non-treponemal problem sera (11 gave false positive reactions on screening with the TmpA recombinant antigen enzyme immunoassay (EIA), 3 gave false positive fluorescent treponemal antibody absorbed (FTA-abs) tests, and 3 false positive Captia Syphilis G EIA results). Based on the manufacturer's criteria of reactivity in multiple bands for designating a positive result the Western blot test gave a sensitivity of 99.1% (113/114) and a specificity of 88.2% (15/17) when indeterminate reactions were scored positive and 98.2% (112/114) and 100% (17/17) when indeterminate reactions were scored negative. Sensitivity was high in both treated and untreated infection. Corresponding sensitivities for the TPHA and FTA-abs when equivocal reactions were scored negative were 97.5% (111/114) and 99.1% (113/114). The high sensitivity of the FTA-abs in this study is probably due to the large number of untreated primary infections. Our results with the Western blot, confirm earlier studies using ‘in-house’ test systems and, support a role for a commercial Western blot test in the confirmatory diagnosis of syphilis. Further studies are required to confirm the high specificity and sensitivity of the kit in a larger series including a wider variety of non-treponemal cases as well as patients with untreated and treated infection.
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Pastuszczak, Maciej, Agnieszka Kotnis-Gąska, Bernadetta Jakubowicz, Iwona Martyka, Monika Bociaga-Jasik, and Anna Wojas-Pelc. "Utility of antitreponemal IgM testing in the diagnosis of early and repeat syphilis among HIV-infected and non-infected patients." International Journal of STD & AIDS 29, no. 9 (2018): 890–94. http://dx.doi.org/10.1177/0956462418762849.
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Until now only non-treponemal tests (e.g. rapid plasma reagin [RPR]) have been used to monitor syphilis activity (e.g. distinguishing between treated, untreated and repeat disease) and efficacy of treatment. However, they usually require manual operation and are less specific than treponemal tests. The aim of the current study was to evaluate the use of the antitreponemal IgM testing in the diagnosis of early and repeat syphilis in HIV-infected and non-infected patients. One hundred and seventeen patients with early syphilis were included in this prospective study. RPR and anti- Treponema pallidum-IgM (TP-IgM) tests were conducted at onset and at three-month intervals during 24-month follow-up after initial treatment. In 31 of 117 syphilitic patients the co-occurrence of HIV infection was diagnosed. A positive TP-IgM test was present in 78.6% of patients with newly-diagnosed primary syphilis, 95.8% with secondary and 57.9% with early latent syphilis, but only in 38.5% patients with syphilis reinfection. There was a significant correlation between primary and secondary syphilis, higher baseline RPR titre and the pre-treatment IgM test reactivity. Regardless of the syphilis stage, HIV-seropositive individuals were more frequently positive for TP-IgM, both during the first onset of the disease (90.3%), and reinfection (71.4%), as compared to the HIV-seronegative group (71.4% and 0%, respectively, P < 0.03). TP-IgM seroreversion was observed in 115 out of 117 patients studied (98.3%) during follow-up (mean time to seroreversion 6.9 months). The time to TP-IgM seroreversion after treatment was significantly shorter in patients with early symptomatic syphilis (mean 4.9 months) when compared to early latent syphilis (7.7 months, P < 0.05). A negative TP-IgM test was found in approximately 20% and 40% of individuals with primary and early latent syphilis, respectively. The value of IgM testing in the diagnosis of syphilis reinfection is doubtful.
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Owusu-Edusei, Kwame, Thomas L. Gift, and Ronald C. Ballard. "Cost-Effectiveness of a Dual Non-Treponemal/Treponemal Syphilis Point-of-Care Test to Prevent Adverse Pregnancy Outcomes in Sub-Saharan Africa." Sexually Transmitted Diseases 38, no. 11 (2011): 997–1003. http://dx.doi.org/10.1097/olq.0b013e3182260987.
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Sahota, Somanpreet Kaur, Barun Kumar Shakya, Deepak Arora, and Neeraj Jindal. "Biological false positive rapid plasma reagin tests in pregnant females in North India." International Journal Of Community Medicine And Public Health 8, no. 3 (2021): 1217. http://dx.doi.org/10.18203/2394-6040.ijcmph20210803.
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Background: Syphilis, a sexually transmitted disease seriously complicate pregnancy and produce harmful results in fetus. Screening of pregnant females in early pregnancy with non-treponemal tests such as RPR and VDRL is a cost effective strategy for diagnosis of syphilis. However, these tests could produce BFP reaction in pregnancy. The prevalence of which may be different in different populations and at different times. The current prevalence of the biological false positive rapid plasma regain tests in pregnant females of North India was there for assessed and being reported.Methods: A total 500 consecutive pregnant females who presented to our tertiary care center for the first time were screened for syphilis by RPR (a non-treponemal test) and Hi-Quik (a treponemal test) after obtaining their written consent.Results: Of the 500 females 21 (4.2%) were RPR positive and only one (0.2%) was Hi-Quik positive. Thus the prevalence of biological false positive rapid plasma regain tests in pregnant females of North India was 4% (20/500). In semi quantitative RPR, these tests were positive in ≤1:4 dilution and were not found to be related to any particular age, geographical distribution, literacy status, occupation or period of gestation (p value >0.05) and were transient in nature.Conclusions: Our study concludes that although RPR is a good, cost effective test for mass screening of pregnant females, but it produces BFP reactions in considerable percentage (4%) in pregnant females of North India.
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Levett, Paul N., Kevin Fonseca, Raymond SW Tsang, et al. "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." Canadian Journal of Infectious Diseases and Medical Microbiology 26, supplement a (2015): 6A—12A. http://dx.doi.org/10.1155/2015/983425.
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Syphilis, caused by the bacteriumTreponema pallidumsubsp.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.
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Shannon, Chelsea, Claire Bristow, Sasha Herbst De Cortina, Jennifer Chang, and Jeffrey Klausner. "Use of Oral Fluid in a Rapid Syphilis Test Assay." Open Forum Infectious Diseases 4, suppl_1 (2017): S107—S108. http://dx.doi.org/10.1093/ofid/ofx163.107.
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Abstract Background From 2014 to 2015, the syphilis rate in the United States increased by 19%, reaching its highest rate since 1994. Currently, point-of-care syphilis assays use fingerstick or venipuncture whole blood to identify Treponema pallidum (TP) antibodies by qualitative immunoassay. However, patients and providers prefer oral fluid testing to whole blood testing. In this study, we aimed to determine whether a rapid syphilis test intended for use on whole blood could be used to detect TP antibodies in oral fluid. Methods Oral fluid was collected from 72 participants using the Super•SAL™ Oral Fluid Collection Device (Oasis Diagnostics®, Vancouver, WA). The device uses an absorbent cylindrical pad to collect and filter ~1 mlml of oral fluid. Oral fluid filtrate was tested using the SD Bioline Syphilis 3.0 rapid test (Alere Diagnostics, MA) following manufacturer directions for whole blood. TP particle agglutination (TPPA) and rapid plasma reagin (RPR) results derived from participants’ medical records were used as reference values. We used three different definitions as comparators: 1: TPPA reactive; 2: TPPA and RPR reactive and 3: TPPA reactive and RPR titer &gt;1:4. Those with non-reactive TPPA and RPR results were considered seronegative. We calculated the sensitivity and specificity for definition 1 and sensitivity for definitions 2 and 3. We used the exact binomial method to determine 95% confidence intervals (CI). Results With definitions 1, 2, and 3, respectively, sensitivity was 83.3% (CI: 67.2, 93.6), 86.4% (CI: 65.1, 97.1), and 100% (CI: 71.5, 100). Specificity was 47.2% (CI: 36.5, 75.5). Conclusion The high sensitivity of the SD Bioline Syphilis 3.0 test using oral fluid suggests a strong potential for the development of accurate rapid oral syphilis tests. Sensitivity increased with higher RPR titer. False positive results may be due to the presence of non-venereal treponemal antibodies in oral fluid. Further research and development are needed to optimize specificity. Disclosures All authors: No reported disclosures.
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Runina, A. V., M. V. Shpilevaya, M. A. Filippova, G. L. Katunin, and A. A. Kubanov. "DIAGNOSTIC IMMINOARRAY ASSAY FOR CHARACTERIZATION OF IMMUNOGLOBULIN IGG AND IGM LEVEL IN SYPHILIS PATIENTS SERUM TOWARDS 12 RECOMBINANT ANTIGENS OF T. PALLIDUM BEFORE AND AFTER THE THERAPY." Russian Clinical Laboratory Diagnostics 64, no. 9 (2019): 546–52. http://dx.doi.org/10.18821/0869-2084-2019-64-9-546-552.
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The aim of the study was to characterize the dynamics of immunoglobulin IgG and IgM level in syphilis patients serum at different stages of the disease before and after the therapy towards 12 diagnostic antigens of T. pallidum in an microarray assay and to evaluate these data as possible prognostic markers. The dynamics of immunoglobulin IgG and IgM level was measured in the reaction of indirect immunofluorescence using microarray and compared to the results of non-treponemal RPR test and treponemal tests as EIA and reaction of passive hemagglutination. In microarray assay diagnostically high level of IgM in patients with primary, secondary and early latent and late latent syphilis decreased dramatically to zero after the successful therapy. Continuously high level of IgM after the therapy proposes the persistence of infection agents in the organism and points out the need of additional antimicrobial treatment. In most of the cases anti-treponemal IgG level also declined after the successful therapy and this confirms the appropriate treatment. The results of microarray assay coincide with the results of other mentioned laboratory tests for syphilis diagnostics. Microarray assay with the recombinant T. pallidum antigens gives the perspective for creating methods with wider spectrum of diagnostic and therapy control options using the IgM immunoglobulin level as a marker for successful syphilis treatment.
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Dev, Rubee, Shambhu P. Adhikari, Anjana Dongol, et al. "Prevalence assessment of sexually transmitted infections among pregnant women visiting an antenatal care center of Nepal: Pilot of the World Health Organization’s standard protocol for conducting STI prevalence surveys among pregnant women." PLOS ONE 16, no. 4 (2021): e0250361. http://dx.doi.org/10.1371/journal.pone.0250361.
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Introduction Sexually transmitted infections (STIs) are common during pregnancy and can result in adverse delivery and birth outcomes. The purpose of this study was to estimate the prevalence of STIs; Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (syphilis), Trichomonas vaginalis (trichomoniasis), and Human Immunodeficiency Virus (HIV) among pregnant women visiting an antenatal care center in Nepal. Materials and methods We adapted and piloted the WHO standard protocol for conducting a prevalence survey of STIs among pregnant women visiting antenatal care center of Dhulikhel Hospital, Nepal. Patient recruitment, data collection, and specimen testing took place between November 2019-March 2020. First catch urine sample was collected from each eligible woman. GeneXpert platform was used for CT and NG testing. Wet-mount microscopy of urine sample was used for detection of trichomoniasis. Serological test for HIV was done by rapid and enzyme-linked immunosorbent assay tests. Serological test for syphilis was done using “nonspecific non-treponemal” and “specific treponemal” antibody tests. Tests for CT, NG and trichomoniasis were done as part of the prevalence study while tests for syphilis and HIV were done as part of the routine antenatal testing. Results 672 women were approached to participate in the study, out of which 591 (87.9%) met the eligibility criteria and consented to participate. The overall prevalence of any STIs was 8.6% (51/591, 95% CI: 6.3–10.8); 1.5% (95% CI: 0.5–2.5) for CT and 7.1% (95% CI: 5.0–9.2) for trichomoniasis infection. None of the samples tested positive for NG, HIV or syphilis. Prevalence of any STI was not significantly different among women, age ≤ 24 years (10%, 25/229) compared to women age ≥25 years (7.1%, 26/362) (p = 0.08). Conclusions The prevalence of trichomoniasis among pregnant women in this sub-urban population of Nepal was high compared to few cases of CT and no cases of NG, syphilis, and HIV. The WHO standard protocol provided a valuable framework for conducting STI surveillance that can be adapted for other countries and populations.
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Wong, S. S., D. L. T. Teo, and R. K. W. Chan. "Confirmatory serological testing of blood donors positive on TPHA screening in Singapore." International Journal of STD & AIDS 8, no. 12 (1997): 760–63. http://dx.doi.org/10.1258/0956462971919237.
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Summary: Seventy-two blood donors who were tested positive by the Singapore Blood Transfusion Service (SBTS) for Treponema pallidum haemagglutination (TPHA) test, were evaluated at the Department of Sexually Transmitted Diseases Clinic (DSC) between November 1994 to December 1996. All underwent syphilis serological testing, including rapid plasma reagin test (RPR), TPHA test and fluorescent treponemal antibody-absorption (FTA-Abs) test. All except one (98.6%) were confirmed TPHA positive by the DSC. Of the 71 TPHA-confirmed-positive donors, 53 (74.6%) were subsequently tested positive for FTA-Abs and 18 (25.4%) were tested negative for FTA-Abs. Twenty-two (31%) of the 71 TPHA-positive blood donors had reactive RPR and 49 (69%) had non-reactive RPR. Of the 22 TPHA-positive donors who had reactive RPR, 19 (86%) had positive FTA-Abs (13 late latent syphilis, 4 serological scar, one late congenital syphilis, one secondary syphilis), and 3 (14%) had negative FTA-Abs (all late latent syphilis). Of the 49 TPHA-positive donors who had non-reactive RPR, 34 (69%) had positive FTA-Abs (24 late latent syphilis, 9 serological scar, one late congenital syphilis) and 15 (31%) had negative FTA-Abs (12 late latent syphilis, 2 serological scar, one false-positive TPHA). Only one TPHA-positive donor referred by the SBTS subsequently turned out to have negative syphilis serology at the DSC. Overall, 68 (95.8%) TPHApositive donors who had a past history of sexual exposure were managed as treated or untreated syphilis, regardless of their RPR or FTA-Abs results. However, FTAAbs was found to be useful in the management of 3 (4.2%) TPHA-positive blood donors in the absence of a history of sexual exposures.
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Jhirwal, Manisha, Charu Sharma, Shashank Shekhar, Apoorva Tak, and Poonam Elhance. "Syphilis in pregnancy: The menace continues to haunt." Indian Journal of Obstetrics and Gynecology Research 8, no. 3 (2021): 434–36. http://dx.doi.org/10.18231/j.ijogr.2021.091.
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Syphilis in pregnancy remains an important medical condition due to its adverse perinatal consequences and potential to cause congenital syphilis. The cases of congenital syphilis have been reported worldwide as there is increase in cases of syphilis in women. We hereby present a case of 34-year-old multigravida who was diagnosed with syphilis during her first antenatal visit in second trimester and managed. The baby did not show any signs of congenital syphilis. This report highlights the diagnostic workup, management and possible complications of syphilis in pregnancy. Universal screening of all pregnant women at first antenatal visit with a non-treponemal test should be used for screening for syphilis in pregnancy.
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Parkes-Ratanshi, Rosalind, Joshua Mbazira Kimeze, Edith Nakku-Joloba, et al. "Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes: the Syphilis Treatment of Partners (STOP) randomised control trial." Sexual Health 17, no. 3 (2020): 214. http://dx.doi.org/10.1071/sh19092.
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Background Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. Methods: Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1:1:1 to receive either notification slips (NS; standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. Results: Between 2015 and 2016, 17130 pregnant women were screened; 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3%; 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up; there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75; 95% confidence interval 2.36–3.21; P &lt; 0.001). Conclusions: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
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Henning, Maria P., Christa Kruger, and Lizelle Fletcher. "Syphilis sero-positivity in recently admitted and long-term psychiatric inpatients: Screening, prevalence and diagnostic profile." South African Journal of Psychiatry 18, no. 4 (2012): 5. http://dx.doi.org/10.4102/sajpsychiatry.v18i4.358.
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<p><strong>Background.</strong> Syphilis research has neglected the prevalence of the disease among psychiatric patients, and traditional syphilis screening has been reported as inadequate.</p><p><strong>Objectives.</strong> (i) To assess the syphilis prevalence among psychiatric patients; (ii) to compare psychiatric diagnoses of syphilis-infected and -uninfected patients; (iii) to assess self-reported high-risk sexual behaviour; (iv) to establish syphilis/HIV co-morbidity; and (v) to investigate the performance of the rapid plasma reagin (RPR) test in syphilis screening, compared with the Treponema pallidum haemagglutination (TPHA) test.</p><p><strong>Methods.</strong> Psychiatric inpatients at Weskoppies Hospital, Pretoria, who consented to participate in the study (N=195) were categorised according to gender and length of admission (long-term or recent). Non-treponemal RPR, confirmatory TPHA, HIV-rapid and HIV enzyme-linked immunosorbent assay (ELISA) tests were performed. A reactive TPHA test was used to diagnose syphilis.</p><p><strong> Results.</strong> The estimated prevalence of syphilis was 11.7%. There was no significant association between TPHA sero-positivity and primary psychiatric diagnosis or self-reported high-risk sexual behaviour. Significant co-morbidity existed between syphilis and HIV (p=0.012). Compared with the TPHA test, the RPR test performed poorly, identifying only 2/23 patients who had a sero-positive TPHA test (8.7% sensitivity and 100% specificity).</p><p><strong>Conclusions.</strong> The prevalence of syphilis was higher than anticipated, supporting the need for routine testing. The significant co-morbidity and alarming prevalence of HIV and syphilis warrant testing for both conditions in all psychiatric admissions. Current syphilis screening with a single RPR test is inadequate; both RPR and TPHA tests should be performed.</p>
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Farfour, Eric, Svetlane Dimi, Olivier Chassany, et al. "Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening." PLOS ONE 16, no. 6 (2021): e0250557. http://dx.doi.org/10.1371/journal.pone.0250557.
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The burden of STIs is particularly high in HIV-infected MSM patients. A recent increase in STIs prevalence has been noticed in the US and western European countries. We aim to assess trends in asymptomatic STIs following the publication of recommendations for STIs screening, i.e. Chlamydia (CT) and gonorrhea (NG). Seventeen centers located in the Paris area participated in the study. All asymptomatic HIV-infected MSM patients attending a follow up consultation were proposed to participated in the study. Asymptomatic patients were included over 2 periods: period 1 from April to December 2015 and period 2 from September to December 2017. Etiologic diagnosis of STIs including hepatitis B, C, syphilis, was performed using a serological test, including a non-treponemal titer with a confirmatory treponemal assay for syphilis. CT and NG were screened using a nucleic acid amplification test (NAATs) on 3 anatomical sites, i.e. urine, rectal and pharyngeal. Overall, 781 patients were included: 490 and 291 in periods 1 and 2 respectively. Asymptomatic CT, NG, and syphilis were diagnosed in 7.5%, 4.8% and, 4.2% respectively. The rate of patients having a multisite asymptomatic infection was 10.2% and 21.1% for CT and NG respectively. The most frequently involved anatomical sites for CT and NG asymptomatic infections were anorectal (66.1% and 55.2% respectively) and pharyngeal (47.4% and 60.5% respectively). CT and NG asymptomatic infection increased by 1.3- and 2-fold respectively between the two periods while syphilis decreased by 3 folds. Our results encourage to reconsider multisite screening for CT and NG in asymptomatic HIV positive MSM as the yield of screening urinary samples only might be low. Despite the more systematic STI screening of asymptomatic HIV positive MSM the prevalence of STI is increasing in MSM in France. Therefore, this strategy has not led to alter CT and NG transmission. The decrease of syphilis might involve self-medication by doxycycline, and the intensification of syphilis screening.
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Phang Romero Casas, Carmen, Marrissa Martyn-St James, Jean Hamilton, Daniel S. Marinho, Rodolfo Castro, and Sue Harnan. "Rapid diagnostic test for antenatal syphilis screening in low-income and middle-income countries: a systematic review and meta-analysis." BMJ Open 8, no. 2 (2018): e018132. http://dx.doi.org/10.1136/bmjopen-2017-018132.
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ObjectivesTo undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women.MethodsFive electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women. Methodological quality was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). A bivariate meta-analysis was undertaken to generate pooled estimates of diagnostic parameters. Results were presented using a coupled forest plot of sensitivity and specificity and a scatter plot.ResultsThe methodological quality of the five included studies with regards to risk of bias and applicability concern judgements was either low or unclear. One study was judged as high risk of bias for patient selection due to exclusion of pregnant women with a previous history of syphilis, and one study was judged at high risk of bias for study flow and timing as not all patients were included in the analysis. Five studies contributed to the meta-analysis, providing a pooled sensitivity and specificity for ICS of 0.85 (95% CrI: 0.73 to 0.92) and 0.98 (95% CrI: 0.95 to 0.99), respectively.ConclusionsThis review and meta-analysis observed that rapid ICS POC tests have a high sensitivity and specificity when performed in pregnant women at antenatal clinics. However, the methodological quality of the existing evidence base should be taken into consideration when interpreting these results.PROSPERO registration numberCRD42016036335.
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Farias, Rute de Oliveira, Izailza Matos Dantas Lopes, Letícia Goes Santos, and Amanda Silveira de Carvalho Dantas. "The reality of 13 years of prenatal care to pregnant women with syphilis in Sergipe state (2007-2019)." Jornal Brasileiro de Doenças Sexualmente Transmissíveis 31, no. 4 (2019): 123–30. http://dx.doi.org/10.5327/dst-2177-8264-201931404.
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Introduction: Syphilis is an infectious disease caused by Treponema pallidum, its two main routes of transmission are sexual and transplacental (vertical). The latter is of particular worrisome, since it can generate congenital syphilis and can be avoided by early maternal serological screening. Objective: To analyze the conditions of prenatal care for syphilitic pregnant women in Sergipe State between 2007 and 2019. Methods: A cross-sectional, retrospective, and descriptive study was carried out, with the collection of notified cases of gestational and congenital syphilis in the Brazilian Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN). Results: There was a considerable increase in the number of reported cases of gestational syphilis in the last 13 years. About 36% of pregnant women were identified in the 3rd trimester of pregnancy, 68.1% were brown, 56.8% had studied for up to 8 years, and 50.1% were between 20 and 29 years old. The clinical phase latent to the diagnosis was responsible for 70.3% of the cases, followed by the primary (11%) and tertiary (7.3%) phases. Of the total number of pregnant women, 20.2% did not perform the non-treponemal test, and 97.2% were treated with penicillin. Regarding the numbers of congenital syphilis, although 75% of the mothers performed prenatal care, 37.8% received the diagnosis at the time of delivery/curettage, resulting in 72.9% of infant deaths from the disease. Moreover, there was a predominance of untreated partners (77.7%) in relation to those treated (10.8%). Conclusion: Although most of them performed prenatal care, there was a predominance of diagnoses performed only in the 3rd trimester of pregnancy, mainly at the time of delivery or curettage, not respecting the minimum therapeutic interval of 30 days before delivery. Thus, in Sergipe State, the most important factor in the high prevalence of vertical transmission of syphilis is the ineffectiveness of prenatal care provided to infected pregnant women, which remains.
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McClean, Hugo, David Daniels, Chris Carne, Paul Bunting, and Rob Miller. "UK National Audit of Early Syphilis Management. Case-notes audit: contact tracing, information giving, follow-up and outcomes." International Journal of STD & AIDS 17, no. 5 (2006): 340–43. http://dx.doi.org/10.1258/095646206776790187.
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Contact tracing was provided for 683/781 (87%, regional range 57–97%) cases, and identified 997 traceable contacts of whom 511 (51%) were seen, short of the recommended standard of 60%. However, the performance range for this standard was 26–70%, with seven regions achieving 60% or more. Of 511, 215 (42%, range 3–73%) contacts had syphilis. Treatment completion was recorded for 691 (88%, range 71–100%) cases, and resolution of lesions for 348/469 (74%, range 40–96%) cases. Nationally, 419/764 (55%, range 37–70%) cases were recorded as having a two dilution (four-fold) or greater decrease in non-treponemal test titre within 3–6 months after treatment; not achieving this titre decrease was mainly attributable to non-attendance for follow-up and failure of titre levels to fall. Follow-up of infectious syphilis in UK genitourinary medicine clinics is poor and falls far short of that recommended by National Guidelines. Only 16 (2%) cases had follow-up at intervals approximating to 1, 2, 3, 6 and 12 months, and only 312 (40%, range 5–61%) cases attended at least two follow-up visits. Only 17 (7%) of all 236 oral treatments (including switches to oral treatment), and 33 (27%) of 123 cases with HIV infection were recorded as designated annual follow-up. Further work is needed to determine factors that account for the wide variation between regions in contact tracing and follow-up performance.
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Roque, Karina Bonilha, Bruna de Paula Alves, Beatriz Félix da Silva, et al. "Panorama of congenital syphilis in school hospital of the hospital of the South region of city of São Paulo." Research, Society and Development 10, no. 4 (2021): e43410413952. http://dx.doi.org/10.33448/rsd-v10i4.13952.
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Introduction: Congenital syphilis is an infectious disease that has the etiological agent Treponema pallidum. Its transmission is vertical hematogenous, transplacental, of infected pregnant untreated or inadequately treated for its concept. It divides into two periods: early to the second year of life, and after the second year of life, late. Detection during prenatal care is performed by screening the third trimester of pregnancy with preterm labor, as early as in the maternity ward. The detection of Treponema pallidum through non-treponemal test (VDRL), presents little specificity, high sensitivity, low cost and fast negativation in response to the treatment avoiding that the concept is born with sequels. Thus, prenatal care is an important tool in the control of the disease, and it is necessary to improve care quality, since 70% of the mothers in Brazil are prenatal, not all of them are diagnosed or have the appropriate treatment of syphilis. Objective: To establish an epidemiological panorama of the incidence of Congenital Syphilis in the socioeconomic and cultural context in which the School Hospital of the Southern Region of the city of São Paulo is inserted. Patients and Methods: This is an individualized, observational, cross-sectional study carried out by means of a medical records survey of the Hospital Infection Control Service of Hospital Escola da Região Sul in the city of São Paulo. The survey of data referring to the form with questions of interest to the mother and the newborns diagnosed with Congenital Syphilis in the period from 2012 to 2016 was developed. This project was submitted and approved by the Ethics Committee of the Santo Amaro University - SP (Plataforma Brasil - CAAE: 68103317.6.3001.5447). Results: A total of 183 cases of Congenital Syphilis were registered in the Hospital Infection Control Service of the São Paulo School Hospital from 2012 to 2016, and among these, 126 medical records were reinforced. Prenatal performance (p = 0.0060), schooling (p = 0.5107) and schooling (p = 0.8603) did not influence disease screening by showing insignificant statistical data. Success occurred with companion treatment (p = 0.0451), which showed the highest incidence in 2014 (48.1%) and 2016 (58.3) when compared to the others. Conclusion: In the presented scenario, it was verified that although prenatal and maternal treatment were performed, they were inefficient to prevent pregnant women from transmitting the disease. This is probably related to the inefficiency of the treatment of the companions, who although in the year 2014 and 2016 presented a higher incidence of accomplishment, coincided with the increase of notifications in those same years. There were no statistically significant differences in relation to other factores, a fact that causes concern in the field of Public Health.
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McClean, Hugo, David Daniels, Chris Carne, Paul Bunting, and Rob Miller. "UK National Audit of Early Syphilis Management. Case notes audit: diagnosis and treatment." International Journal of STD & AIDS 17, no. 5 (2006): 334–39. http://dx.doi.org/10.1258/095646206776790150.
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A national audit of 781 early syphilis cases presenting during 2002–03 in UK genitourinary medicine clinics was conducted in late 2004, organized through the Regional Audit Groups. Data were aggregated by region and National Health Service trust, allowing practice to be compared between regions, between trusts within regions, as well as to national averages and the UK National Guidelines. An enzyme immunoassay was used to diagnose 695 (89%) cases (regional range 18–100%). Use of a non-treponemal test was not recorded for 44 (6%) cases. Dark ground microscopy was used in the diagnosis of only 80 (29%) primary cases. Uptake of HIV testing was 77% (range 69–94%). Nationally, 527 (67%) treatments were parenteral, with almost equal use of benzathine penicillin G for 262 (50%, range 0–97%) cases and procaine penicillin G (PPG) for 260 cases (49%, range 3–100%). There were 14 (5%) treatments with less than the recommended 750 mg dose of PPG. One hundred and five (40%) PPG treatments were with greater than 750 mg and/or for longer than 10 days of which 76 (72%) were for early latent syphilis and/or cases with HIV infection. One hundred and ninety two (86%, range 0–100%) of all oral treatments were with doxycycline. The recommended regimen of 100 mg doxycycline twice daily for 14 days was used for 104 (53%) cases; the other 91 (47%) treatments were with a variety of regimens, mainly treatments with larger doses and/or longer treatment intervals and some combination treatments. Fourteen (2%) cases were not treated; treatment was not reported for seven (0.9%) and not known for 10 (1.3%) cases, who were treated at other centres.
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Hampson, D. J. "Slide-agglutination for rapid serological typing of Treponema hyodysenteriae." Epidemiology and Infection 106, no. 3 (1991): 541–47. http://dx.doi.org/10.1017/s0950268800067601.
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SUMMARYA slide agglutination (SA) test was developed to determine the serogroup of isolates of Treponema hyodysenteriae of serogroups A to F. Rabbit antisera which are normally used for serogrouping T. hyodysenteriae in an agarose gel doublediffusion precipitation test (AGDP) were not suitable for SA because they agglutinated isolates from more than one serogroup. The agglutination reaction was made serogroup-specific by cross-absorbing the typing sera for serogroups A to F with whole treponemes from the other 5 of these 6 serogroups of T. hyodysenteriae. The absorbed sera were reacted in slide agglutination tests with 33 isolates of T. hyodysenteriae and with four non-T. hyodysenteriae intestinal spirochaetes. None of the non-T. hyodysenteriae isolates agglutinated, but 27 of the 33 isolates of T. hyodysenteriae did. The results for 26 of the 27 agglutination reactions agreed with the serogroup as determined in AGDP. One of the 6 isolates of T. hyodysenteriae which failed to react in slide agglutination was of serogroup B, 1 of serogroup D, 1 each were from new serogroups G, H and I, and 1 was untypable in AGDP.
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Magalhaes, Mauricio, Eitan Naaman Berezin, and Abrahão Berezin. "NON TREPONEMIC AND TREPONEMIC SEROLOGIC TESTS ASSOCIATION WITH HIV SEROLOGIC TEST. CLINICAL CORRELATION. 737." Pediatric Research 41 (April 1997): 125. http://dx.doi.org/10.1203/00006450-199704001-00757.
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Baguley, S. D. K., P. J. Horner, P. A. C. Maple, and L. Stephenson. "An oral fluid test for syphilis." International Journal of STD & AIDS 16, no. 4 (2005): 299–301. http://dx.doi.org/10.1258/0956462053654302.
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We have developed a time-resolved fluorescence immunoassay to detect antibodies to Treponema pallidum recombinant antigens in oral fluid specimens. Using an 'Oracol' swab, oral fluid was collected from 34 subjects with a serological diagnosis of syphilis and 97 seronegative controls. Using a cut-off of three standard deviations over control mean, the sensitivity and specificity of the assay in all subjects with positive syphilis serology was 76.5% and 97.9%, respectively. In those with early syphilis, the sensitivity and specificity of the assay was 100% and 97.9%. In a non-outbreak situation, screening clinic attendees for syphilis using oral fluid specimens is potentially useful when collection of blood is not practicable. In addition, it may have much to offer in outreach projects and epidemiological investigations.
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Silva Pereira, Jeferson, Geice Carla Alves Anjos, Ana Fátima Souza Melo De Andrade, and Taciana Silveira Passos. "Atuação de enfermeiros da Estratégia Saúde da Família na prevenção e controle do HIV e sífilis durante o pré-natal." Revista de Saúde Coletiva da UEFS 11, no. 1 (2021): e5944. http://dx.doi.org/10.13102/rscdauefs.v11i1.5944.
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Este trabalho teve como objetivo avaliar as práticas dos enfermeiros das equipes de saúde da família durante as consultas de pré-natal, na prevenção e controle do HIV e sífilis gestacional. Estudo transversal, descritivo e exploratório, com aplicação de questionário estruturado a 27 enfermeiros atuantes em unidades de saúde da zona urbana do município de Aracaju, Sergipe, entre setembro e outubro de 2019. A distribuição das variáveis foi analisada por meio do teste de qui-quadrado de Pearson. Constatou-se que 85,2% dos enfermeiros conheciam o manual do ministério da saúde para consulta de pré-natal e 96,3% o utilizavam, porém, 25,9% solicitavam os testes rápidos no período inadequado e 18,5% conduziam erroneamente o tratamento para gestantes com teste para HIV. Houve maior proporção de conduta assertiva dos profissionais que fizeram capacitação há menos de um ano quanto aos testes rápidos de HIV (p=0,001) e sífilis (p=0,046), testes não treponêmicos solicitados no pré-natal (p=0,003), mês que devem ser solicitados o exame de VDRL e o HIV (p=0,046) e trimestre da gestação que oferece o teste de HIV (p=0,046). Evidenciou-se a importância de capacitações sobre à temática para a proporção de atuação condizente com os manuais preconizados pelos Ministério da Saúde na Estratégia de Saúde da Família. ABSTRACTThis study aimed to evaluate the practices of nurses in family health teams, during prenatal consultations, in the prevention and control of HIV and gestational syphilis. Crosssectional study, descriptive and exploratory study, with the application of a structured questionnaire, to 27 nurses working in health units in the urban area of the municipality of Aracaju, Sergipe, between September and October 2019. The distribution of variables was analyzed using Pearson’s chi-square test. It was found that 85.2% of nurses knew the Ministry of Health for prenatal consultation and 96.3% used it, however, 25.9% requested rapid tests in the wrong period and 18.5% conducted erroneously treatment for pregnant women with an HIV test. There was a greater proportion of assertive conduct among professionals who had been trained less than a year ago regarding rapid tests for HIV (p = 0.001) and syphilis (p = 0.046), non treponemal tests requested in prenatal care (p = 0.003), month that the VDRL and HIV test (p = 0.046) and trimester of pregnancy that offers the HIV test (p = 0.046) should be requested. The importance of training on the theme was evidenced for the proportion of performance consistent with the manuals recommended by the Ministry of Health in the Family Health Strategy.Keywords: HIV; Gestational syphilis; Primary care nursing; Prenatal. RESUMENEste estudio tuvo como objetivo evaluar las prácticas de los enfermeros en los equipos de salud de la familia durante las consultas prenatales, en la prevención y control del VIH y la sífilis gestacional. Estudio transversal, descriptivo y exploratorio, con la aplicación de un cuestionario estructurado a 27 enfermeros que laboran en unidades de salud del área urbana del municipio de Aracaju, Sergipe, entre septiembre y octubre de 2019. La distribución de variables se analizó mediante la prueba de Chi Cuadrado de Pearson. Se encontró que el 85,2% de las enfermeras conocía el manual del Ministerio de Salud para la consulta prenatal y el 96,3% lo usaba, sin embargo, el 25,9% solicitó pruebas rápidas en el período inadecuado y el 18,5% realizó erróneamente tratamiento a gestantes con prueba de VIH. Hubo una mayor proporción de conducta asertiva por parte de profesionales que se habían formado hace menos de un año en cuanto a pruebas rápidas de VIH (p = 0,001) y sífilis (p = 0,046), pruebas no treponémicas solicitadas en atención prenatal (p = 0,003), mes en que se debe solicitar la prueba VDRL y VIH (p = 0,046) y trimestre de embarazo que ofrece la prueba VIH (p = 0,046). Se resaltó la importancia de la capacitación en el tema por la proporción de desempeño acorde con los manuales recomendados por el Ministerio de Salud en la Estrategia Salud de la Familia.Palabras clave: Sífilis gestacional; Enfermería de atención primaria; Prenatal.
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Lakshmi, N., K. Prasanthi, P. Kamala, C. Siva Kalyani, P. Appa Rao, and B. Gowtham. "Seroprevalence of syphilis in human immunodeficiency virus patients." International Journal of Research in Medical Sciences 7, no. 7 (2019): 2578. http://dx.doi.org/10.18203/2320-6012.ijrms20192881.
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Background: Syphilis is a sexually transmitted infection caused by, Treponema pallidum. Syphilis facilitates the transmission and acquisition of human immunodeficiency virus (HIV) and causes transient increase in the viral load. Sexually transmitted infections (STI) are 3-5 times more likely to acquire HIV infection, if exposed to the virus through sexual contact. Aim of the study was to estimate the seroprevalence of Syphilis in HIV patients.Methods: A total of 920 blood samples were collected from HIV patients attending ART (Antiretroviral therapy) centre and were tested for Syphilis by using Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA). A total of 100 HIV non-reactive individuals were taken as a control group.Results: Out of 920 samples, 102 (11.1%) were positive for Syphilis. Out of 102 Syphilis seropositive patients, males (76.5%) were more commonly affected in age group of 21-40 years. Both RPR and TPHA were reactive in 46% of cases and only TPHA reactive in 53.9% of cases. Out of 100 HIV non-reactive patients, 5% of patients are reactive for Syphilis.Conclusions: In the present study, prevalence of Syphilis was more in HIV patients compared to HIV non-reactive persons. Persons with HIV infection acquired through sexual route should be screened for Syphilis by one nonspecific test along with specific test to confirm the diagnosis. This will help in proper management of the patients having Syphilis and HIV co-infection.
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Addai-Mensah, O., PA Bashiru, and EE Dogbe. "Safety of Family Replacement Donors vs. Voluntary Non-Remunerated Donors in Komfo Anokye Teaching Hospital, Ghana: A Comparative Study." Journal of Medical and Biomedical Sciences 4, no. 1 (2015): 11–16. http://dx.doi.org/10.4314/jmbs.v4i1.2.
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Blood safety remains a challenge to many countries in sub-Saharan Africa including Ghana due to poorly planned blood donation exercises in the various communities. Blood and its products usual-ly come from two main sources; voluntary non-remunerated donors (VNRD) and family replace-ment donors (FRD). In Ghana, and in many developing countries, FRDs seem to be the major source of blood supply whilst in developed countries VNRDs are the major source. This study de-termined and compared the prevalence of four transfusion transmissible infections (TTIs); HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema palladium (TP) among FRDs and VNRDs at the Komfo Anokye Teaching Hospital to compare the safety of blood from these two groups. This cross-sectional study was undertaken at the transfusion medicine unit (TMU) of the Komfo Anokye Teaching Hospital between March and May 2014. A total of 400 blood donors (200 FRDs and 200 VNRDs) were enrolled in this study after obtaining written informed consent. Blood samples from each of the donors were then tested for HIV, hepatitis B and C, and syphilis using rapid test kits. ABO and Rhesus blood groups were also determined for all the samples. Prev-alence of TTIs was higher among FRDs (23.5%) than in VNRDs (3.5%) with males (47) been more infected than females (7). Age group 21- 30 years was the most infected, followed by age groups 31- 40 years, 11- 20 years, 41- 50 years and 51- 60 years respectively. FRDs among the younger age group, 17- 30 years, were also more infected than their VNRD counterparts. Repeat blood donors among the VNRD group, were found to be safer than their first-time counterparts. Overall, TTIs were significantly higher in the FRD group than in the VNRD group. The prevalence rates of all the infections tested were higher in the FRD group compared to the VNRD group. FRDs were the higher risk population for TTIs in comparison to VNRDs. VNRDs should therefore be encouraged to donate blood regularly.Keywords: Transfusion Transmissible Infections, HBsAg, HCV, HIV, Treponema pallidum
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v, Suneetha Devi Chappidi, Sowmya Srirama, and Syam Sundar Junapudi. "Serological Profile of Syphilis in Patients Attending the STI / RTI Clinic at Government General Hospital, Guntur, Andhra Pradesh – A Cross Sectional Study." Journal of Evidence Based Medicine and Healthcare 8, no. 17 (2021): 1122–26. http://dx.doi.org/10.18410/jebmh/2021/217.
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BACKGROUND Sexually transmitted infections (STI) are ancient and are as old as human existence. They are closely interlinked with the human sexual behaviour. Syphilis well known for its systemic complications in the pre-antibiotic era is described as the ‘great imitator’ by Sir William Osler, the father of modern medicine. In the present era of human immuno deficiency virus disease / acquired immuno deficiency syndrome, STI control has been made as first priority, because of their close association and interaction. Syphilis caused by Treponema pallidum is diagnosed most often on clinical suspicion supplemented by laboratory diagnosis, where serological tests for syphilis play a key role / main role. METHODS This study is a hospital based cross sectional study that consisted of 416 cases among which, 276 were females, 140 were males who had attended the STI / RTI clinic. The study period was from July 2011 to September 2012. Blood samples were drawn from all the patients (who were willing to be included in the study) attending the RTI / STI clinic, GGH, Guntur after taking consent. All the sera were tested by rapid plasma reagin (RPR) test and the sera was screened simultaneously for human immunodeficiency virus (HIV). Those sera which were tested reactive for RPR were further tested in dilutions to know the titres. Later the sera tested reactive for RPR were further tested by a specific test, Treponema pallidum haemagglutination (TPHA). RESULTS Of the total 19 (4.56 %) persons tested reactive for RPR, males were 10 (7.14 %), females were 9 (3.26 %), and these were further tested for TPHA. Of the 19 tested for TPHA, a total of 16 (84.21 %) were positive for TPHA of which males were 9 (90 %) and females were 7 (77.78 %). Among the 16 patients, positive for serological test for syphilis (STS), 13 (81.25 %) fall in the age group of 21 - 40, 2 (12.50 %) in the age group of ≤ 20, and 1 (6.25 %) is above 60 years of age. CONCLUSIONS In this study it was seen that out of the 16 syphilis cases, 9 were HIV reactive, 3 were non-reactive for HIV and 4 were of unknown status, showing that the rate was more among the HIV reactive group. The prevalence rate of syphilis among the 66 tested patients belonging to the high-risk group was 6.06 % and in nonhigh-risk group was 3.12 %, showing that it was more in people belonging to high risk group. KEYWORDS Serological Profile, Syphilis, Treponema pallidum, Sexually Transmitted Infections (STI), People Living with HIV / AIDS (PHLA)
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Nahlia, Nurul Laili, and Lita Setyowatie. "Overlapping Primary and Secondary Syphilis in Human Immunodeficiency Virus (HIV) Patient." Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya 4, no. 2 (2020): 265. http://dx.doi.org/10.30651/jqm.v4i2.4378.
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ABSTRACTCoinfection between syphilis and Human Immunodeficiency Virus (HIV) could have varied clinical manifestations. Overlapping of syphilis stages is accounted for 25% of cases, attributable to the defect of the cellular and humoral immune response. We reported 55 years old man who was sexually active since 25 years ago via genito-genital, genito-anal, genito-oral routes, had multiple sexual partners both male and female, seldom used condom, and always being the insertive. Dermatological examination revealed alopecia non-scarring, a painless solitary ulcer on the collum penis, also multiple erythematous macules, patches, and plaques all over the body. Spirochaeta sp. was found from the base of the ulcer with a darkfield microscope. Histopathology examination revealed secondary syphilis lesion. Venereal Disease Research Laboratory (VDRL) 1:16, Treponema Pallidum Haemagglutination test (TPHA) reactive, HIV Determine rapid test reactive, and CD4 (Cluster of Differentiation 4) T-cell count 111 cells/ µL. He was treated with a single dose of benzathine penicillin G 2,4 million units intramuscular and antiretroviral drugs. On sixth month evaluation, VDRL was non-reactive, and CD4 T-cell count 325 cells/µL. This case shows that overlapping clinical manifestations of primary and secondary syphilis on HIV patients could occur with a good general condition. Immediate treatment of antibiotics for syphilis and antiretroviral could improve the clinical and serological conditions.Keyword: primary syphilis, secondary syphilis, HIVCorrespondence: nurul.laili.nahlia@gmail.com
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Masege, S. D., and A. Karstaedt. "A rare case of a chronic syphilitic gumma in a man infected with human immunodeficiency virus." Journal of Laryngology & Otology 128, no. 6 (2014): 557–60. http://dx.doi.org/10.1017/s0022215114001200.
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AbstractObjective:This paper reports a rare case of a human immunodeficiency virus infected man with gummatous syphilis of the face.Case report:A 39-year-old man presented with an ulcer of the face which had been slowly progressive over the previous 6 years. Examination showed an ulcerative lesion of the midface involving the cheeks, and completely destroying the nose, the upper lip and part of the lower lip. The teeth and gums were exposed. The ulcer had a moist, purulent base with rolled edges. The patient had human immunodeficiency virus, with a cluster of differentiation 4 count of 641 cells per µl. The rapid plasma reagin test titre was 1:1024 and the Treponema pallidum haemagglutination assay result was positive. Biopsy showed non-necrotising granulomata with a negative Warthin–Starry silver stain. There was a dramatic response to treatment with penicillin.Conclusion:This case study is a reminder that syphilis needs to be considered in the differential diagnosis of unusual presentations involving skin and bone.
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Wanni, Nahid H. O., Reem Al Dossary, Obeid E. Obeid, et al. "Seropositivity of syphilis among individuals screened in a tertiary hospital in the Eastern Province of Saudi Arabia." Annals of Saudi Medicine 41, no. 1 (2021): 8–13. http://dx.doi.org/10.5144/0256-4947.2021.8.
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BACKGROUND: Sexually transmitted infections are a serious public health problem. Syphilis, a multistage, curable chronic disease caused by the spirochete Treponema pallidum , remains a major health problem worldwide. The disease re-emerged in the era of HIV in many countries despite the accessibility of curative therapy and continuing public health efforts to eliminate it. OBJECTIVE: Analyse the seropositivity for syphilis. DESIGN: Retrospective cross-sectional. SETTING: Tertiary hospital. PATIENTS AND METHODS: We retrospectively studied individuals who underwent screening tests for syphilis between January 2014 and December 2018. The samples that were positive by both screening and confirmatory tests were considered as confirmed positive for syphilis. MAIN OUTCOME MEASURES: Syphilis positivity identified by chemiluminescence immunoassay, the rapid plasma reagin test, and specific antibodies against Treponema pallidum . SAMPLE SIZE: 11 832. RESULTS: Of the 11 832, 54 (0.45%) were confirmed as seropositive for syphilis. Thirty-three (61.1%) were non-Saudi; 21 (38.9%) were Saudis. Thirty (55.6%) cases were males. Twenty-two (40.74%) were married and 29 (53.70%) were unmarried. Of the 54 diagnosed as syphilis positive, 28 (51.9%) were expatriate workers screened for pre-employment. The percentage of syphilis among Saudis was 0.36%. In an overall chi-square analysis, a P <.0001 indicated a difference among nationalities in the frequency of syphilis. A post-hoc analysis showed that Somalians ( P =.004) and Sudanese ( P =.005) differed significantly from other nationalities. CONCLUSION: The study showed that syphilis was low among the screened population. More than half of the syphilis positive cases in this study were household employees. Screening for syphilis assists in planning complementary services for target populations and improves syphilis control. LIMITATIONS: Retrospective design. Hospital-based findings may not be representative of the seroprevalence of syphilis in the general population. CONFLICT OF INTEREST: None.
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Setyowatie, Lita, and Noor Hidayah. "Coinfection of High-Risk and Low-Risk Human Papillomavirus in Urethra Condylomata Accuminata." Berkala Ilmu Kesehatan Kulit dan Kelamin 32, no. 3 (2020): 239. http://dx.doi.org/10.20473/bikk.v32.3.2020.239-243.
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Background: Condylomata accuminata (CA) is a sexually transmitted infection caused by the Human Papillomavirus (HPV), which has more than 40 subtypes classified into high and low risks. The incidence of coinfection involving HPVs in genitalia varies between 2%–71%. Coinfection events increase in immunosuppressed patients. Purpose: To know the types of HPV in CA lesions and the risk factors of a high and low-risk HPV coinfection. Case: A 45-year-old woman presented with genital warts appeared three weeks before. The patient had a breast cancer history and undergone chemotherapy. The examination revealed multiple papules with verrucous surface, firm borders, with whitish color around the urethra and on the vaginal wall. Acetowhite test was positive. The biopsy examination showed squamous epithelium arranged to form papils and foci suspected as koilocytes suggesting CA. The Human Immunodeficiency Virus (HIV) rapid test, VDRL (Venereal Disease Research Laboratory) and TPHA (Treponema Pallidum Haemagglutination) examinations showed non-reactive results. The HPV deoxyribonucleic acid (DNA) genotyping test showed positive results for HPV type 56 (High-Risk Genotypes) and HPV type 6 (Low-Risk Genotypes). She was treated with electrosurgery and consulted to the urology department. Discussion: Coinfection of HPVs might cause a persistent HPV infection for a longer duration, as well as the risk of developing into cancerous lesion. The mechanism of high-risk and low-risk HPV coinfection in immunosuppressed individuals might be due to faster replication of the virus or reactivation of a latent infection. Conclusion: Coinfection of 2 types of HPV could happen in immunosuppression condition such as in patient undergone chemotherapy.
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Nauclér, Anders, Paolo Albino, Agusto Paolo Da Silva, and Gunnel Biberfeld. "Sexually Transmitted Diseases and Sexual Behaviour as Risk Factors for HIV-2 Infection in Bissau, Guinea Bissau." International Journal of STD & AIDS 4, no. 4 (1993): 217–21. http://dx.doi.org/10.1177/095646249300400408.
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Patients enrolled in a hospital-based case control study ( n = 1009) and a follow-up study ( n = 130) of HIV-2 infection in Bissau were investigated with regard to sexual behaviour and sexually transmitted diseases (STD). A history of genital ulcer was more frequent in HIV-2 infected male patients (46.4%, 13 out of 28) than in seronegative male patients (17.9%, 7 out of 39) ( P = 0.05). Serological evidence of a previous syphilitic infection was significantly related to HIV-2 infection (23%, 12 out of 52, of HIV-2 seropositive patients had a positive Treponema pallidum haemagglutination test compared with 7.1%, 5 out of 70, of seronegative patients, P = 0.025) and was equally frequent in men and women. There was no significant difference in number of non-marital sexual partners and frequency of intercourse between HIV-2 seropositive and seronegative individuals. The seroprevalence of HIV-2 infection was significantly higher among patients with a monogamous marriage, 23.1% (59 out of 255) among males and 31.3% (64 out of 204) among females, than among patients with an officially polygamous marriage, 10.3% (8 out of 77) among males and 11.8% (7 out of 59) among females ( P = 0.025 for males and 0.005 for females). Infection-control measures directed at patients with STD should be promoted in Guinea-Bissau. Further research on sexual behaviour and attitudes is needed.
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Tomkins, Andrew, Shazaad Ahmad, Darren E. Cousins, Caroline M. Thng, Francisco Javier Vilar, and Stephen P. Higgins. "Screening for asymptomatic neurosyphilis in HIV patients after treatment of early syphilis: an observational study." Sexually Transmitted Infections 94, no. 5 (2017): 337–39. http://dx.doi.org/10.1136/sextrans-2016-052938.
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ObjectiveTo determine the prevalence of asymptomatic neurosyphilis (ANS) in HIV-positive individuals after treatment of early syphilis with single-dose benzathine penicillin G (BPG) or oral antibiotic alternatives.MethodsPatients at high risk of neurosyphilis (defined by serum rapid plasma reagin (RPR) titre ≥1:32 and/or peripheral blood CD4 lymphocyte count ≤350/μL) underwent lumbar puncture (LP) at a median time of 8.2 months post treatment. ANS was diagnosed by a reactive cerebrospinal fluid (CSF) RPR test or CSF white blood cells (WBC) >20/μL plus a reactive CSF Treponema pallidum particle agglutination (TPPA) ≥1:640.ResultsOf 133 eligible patients, all were men who have sex with men. Of these, 64 consented to LP. Full CSF results were available for 59 patients. Inclusion criteria were serum RPR (21/59), CD4 count (22/59) and combined RPR and CD4 (16/59). The LP patients were white British (82%), median age 40. Syphilis stages were primary (17%) secondary (43%) and early latent (41%). Syphilis was treated with BPG (47/59), doxycycline 100 mg two times per day for 14 days (10/59) and for 21 days (1/59). Azithromycin 500 mg one time per day for 10 days was given to 1/59. At the time of LP, 100% of patients had achieved serological cure, and 66% were taking antiretroviral treatment. Only 1/59 was diagnosed with ANS. The CSF showed: RPR non-reactive (59/59); TPPA non-reactive in 54/59; WBC ≤5/μL in 51/59.ConclusionsAlthough the number of patients in our study is modest, single-dose BPG appears to be highly effective even in patients at high risk of neurosyphilis.
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OHNISHI, K., and M. MURATA. "Present characteristics of symptomatic amebiasis due to Entamoeba histolytica in the east-southeast area of Tokyo." Epidemiology and Infection 119, no. 3 (1997): 363–67. http://dx.doi.org/10.1017/s0950268897008236.
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Admitted medical records, from January 1988 to December 1995, of 28 symptomatic amebic patients who lived in the east-southeast area of Tokyo were studied retrospectively, in order to find the present characteristics of symptomatic amebiasis due to Entamoeba histolytica in this area. Categorized by disease, there were 14 cases of colitis, 9 cases of liver abscess, 4 cases of colitis with liver abscess, and 1 case of liver abscess with brain abscess. Patients consisted of 26 Japanese males, 0 Japanese females, 1 non-Japanese male and 1 non-Japanese female. The mean age of colitis patients and liver abscess patients was 55·4 years old and 41·3 years old, respectively. The presumed place of contraction was Japan in 64% of the patients. Forty-eight percent of male patients indicated that they engaged in homosexual or bisexual practices, and 36% of male patients who denied such sexual practices or did not answer the question had no history of marriage. Positive rate of serum titre for Treponema pallidum hemagglutination test (TPHA) and human immunodeficiency virus antibody was 42·9% and 0%, respectively. Sixty-seven percent of TPHA-positive patients indicated that they engaged in male homosexual or bisexual practices. Zymodeme patterns of E. histolytica isolated from 4 colitis patients were XIV in 1 case and II in 3 cases. Symptomatic amebiasis in the east-southeast area of Tokyo is a disease which predominantly afflicts males, especially those in their middle age, and most patients contract the disease in Japan. The high rates of patients who engaged in male homosexual or bisexual practices and the high rates of patients with positive TPHA suggest that amebiasis is likely to be sexually transmitted disease in homosexual and bisexual men in the east-southeast area of Tokyo, and zymodeme II may be the predominant type in symptomatic amebic colitis in this area.
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Shah, Sagheer Hussain, and Agha Asad Noor. "Serodiagnostic Investigation of Syphilis in Taluka Gambat." RADS Journal of Biological Research & Applied Sciences 10, no. 2 (2020): 76–81. http://dx.doi.org/10.37962/jbas.v10i2.202.
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Background: Syphilis is a chronic and sexually transmitted infection, caused by Treponema pallidum. Taluka Gambat is an under developing rural area of District Khairpur, Sindh having higher poverty rate. This study was undertaken to assess the morbidity rate of syphilis and awareness about this disease in the population of Gambat.
 Objectives: To investigate the prevalence of syphilis in various age groups of male and female population of Taluka Gambat to review the frequency of occurrence of syphilis.
 Methodology: This work was done using conventional serological method by collecting data and laboratory diagnosis. Total 437 serum samples from different private and public health units, dispensaries and hospitals in Taluka Gambat were collected between October 2016 to March 2017 and subjected to qualitative testing by VDRL-Immune Chromatography test.
 Results: Out of 437 samples, 80 samples (18%) were reactive in adults of 30-45 years of age and one sample showed positive case in 9 months old boy indicating congenital syphilis (0.2%) whereas 373 stood non-reactive. Our results showed a 14% prevalence of syphilis in Taluka Gambat in the age group between 30-45 years of age and 0.2% congenital syphilis. It is an alarming situation due to lack of diagnostic, treatment facilities and awareness about sexually transmitted diseases (STDs).
 Conclusion: It is concluded that syphilis is found more or less in all age groups. The highest incidence is observed in population of age group between 30-40 years in Taluka Gambat. Majority infections were found in immunocompromised patients owing to drug abuse and having multiple sex partners.
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Checchi, Vittorio, and Gaia Pascolo. "Microbiological Response to Periodontal Therapy: A Retrospective Study." Open Dentistry Journal 12, no. 1 (2018): 837–45. http://dx.doi.org/10.2174/1874210601812010837.
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Background:Periodontitis is a multifactorial infection caused by a complex of pathogenic bacterial species that induce the destruction of periodontal structures.Objective:The aim of this study is to evaluate the presence and bacterial load of six periodontal pathogens bacteria, measured at initial visit and after osseous surgery in patients affected by chronic periodontitis and treated between 2005 and 2007.Methods:This cohort study was carried out on a sample of 38 consecutive patients affected by severe chronic periodontitis, diagnosed at baseline on the basis of probing depths equal to 6.68 ± 1.47 mm. On each subject, a microbiological test was performed before periodontal initial therapy and after osseous surgery (one year later). Five compromised teeth were chosen for each patient (the same teeth, before and after surgery), for a total of 190 teeth. Real-time PCR based analysis computed total bacterial load of the samples and quantified six periodontal pathogens:Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia,Treponema denticola, Fusobacterium nucleatumandPrevotella intermedia. Data collection was made consulting medical charts.Results:Pocket probing depth reduction after surgery was 4.50 ± 1.54 mm (p=0.0001). The mean number of sites with bleeding at baseline was 2.08 ± 1.17 and 0.58 ± 1.00 after surgery (p=0.001). The mean number of sites with suppuration at baseline was 0.26 ± 0.86 and 0 after surgery (p=0.02). Cell count of each pathogen and total cell count were significantly higher at baseline than after surgery. Almost all bacteria presented a mean percentage reduction equal to that of the total count, except forAaandPi,which seemed to show a greater resistance. The difference of bacterial load, both before and after surgery, between smokers and non-smokers was not statistically significant (p<0.05). A statistically significant correlation was detected between pocket probing depth variation and bleeding on probing variation before and after the surgery, controlling for age (r=0.6,p=0.001). No significant correlations were observed between pocket probing depth and bacterial loads, except forPg(r=0.5,p=0.001),Tf(r=0.6,p=0.001) andTd(r=0.4,p=0.02).Conclusions:Reduction of presence and bacterial load of the examined periodontal pathogens bacteria after osseous surgery, along with periodontal pocket reduction, appeared to be essential to achieve and maintain periodontal stability over years.