It is described as a sexually transmissible infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum.
Syphilis, deadly and decimating disease has a major route of transmission which is through sex with an
infected partner and could also be transmitted from mother to the fetus during pregnancy or during delivery thus medically referred to as congenital syphilis.
The result of a 2008 study by the World Health Organisation (WHO) carried out in 97 countries and released in the week revealed that across the world Syphilis infection remains one which affects large numbers of pregnant women, yet it is never diagnosed early enough to commence treatment.
The WHO noted that if every pregnant woman was tested on her first antenatal visit, the onset of infection would have been diagnosed and appropriate treatment given to prevent mother to child transmission.
The study estimated the percentage of pregnant women tested for syphilis and adequately treated, ranges from 30 per cent for Africa and the Mediterranean region to 70 per cent for Europe.
According to the international researchers who conducted the study reported in PLOS Medicine, large numbers of pregnant women got infected worldwide, causing serious health problems and even death to their babies.
In 2008, 1.4 million pregnant women around the world were estimated to have been infected with syphilis, 80 per cent of whom had attended antenatal care services.
The researchers reached this figure by using information on the number of syphilis infections from 97 countries and on antenatal clinic attendance from 147 countries and then inputted this information into a model.
In consultation with experts, the authors used a realistic scenario to estimate the percentage of pregnant women tested for syphilis and adequately treated, ranging from 30 per cent for Africa and the Mediterranean region to 70 per cent for Europe. Based on this scenario, the authors estimate that in 2008, syphilis infections in pregnant women caused approximately 520,000 harmful outcomes, including 215,000 stillbirths, 90,000 neonatal (baby) deaths, 65,000 preterm or low birth-weight babies, and 150,000 babies with congenital infections.
Syphilis continues to be an important cause of adverse outcomes of pregnancy, including substantial numbers of perinatal deaths and disabilities
The authors estimate that in 2008, testing and treating pregnant women for syphilis prevented a quarter of such harmful outcomes but worryingly, the authors found that about two-thirds of these harmful effects occurred in women who had attended antenatal care but were not treated or tested for syphilis.
They continue: “Countries also need to ensure that quality-assured syphilis testing is available in all antenatal clinic settings, now possible even in remote care settings with the introduction of rapid point-of-care diagnostics.
“In addition, efforts are needed to ensure universal access to early antenatal care, as well as improved quality of antenatal care so that all pregnant women receive an essential package of services that includes routine and early access to point-of-care testing and adequate treatment for syphilis if seropositive”, the researchers stated.
The signs and symptoms of syphilis vary depending in which of the four stages it presents -primary, secondary, latent, and tertiary.
The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration). It is typically acquired by direct sexual contact with the infectious lesions of another person.
The secondary stage presents with a diffuse rash which frequently involves the palms of the hands and soles of the feet and occurs approximately four to ten weeks after the primary infection.
Latent syphilis often presents with little to no symptoms hence it is defined as having serologic proof of infection without symptoms of disease as it may take up to a year before it manifests.
The tertiary syphilis shows with gummas, neurological, or cardiac symptoms. Tertiary syphilis may occur approximately 3 to 15 years after the initial infection, and may be divided into three different forms: gummatous syphilis (15%), late neurosyphilis (6.5%), and cardiovascular syphilis (10%).Without treatment, a third of infected people develop tertiary disease however; people with tertiary syphilis are not infectious.
Nonetheless, the spirochaete is able to pass through intact mucous membranes or compromised skin. It is thus transmissible by kissing near a lesion, as well as oral, vaginal, and anal sex.
Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.
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