EMERGING TREND OF SYPHILIS IN STD CLINIC ATTENDEES IN A TERTIARY CARE HOSPITAL IN NORTH-EAST INDIA.
Main Article Content
Keywords
RPR, Syphilis, Seroprevalence, STI clinic, TPHA.
Abstract
Background: Syphilis is a sexually transmitted disease (STD), caused by Treponema pallidum subsp. pallidum. Increasing trend of syphilis infection has been observed in North-East India in recent years.
Aim: To study the prevalence of syphilis infection among the STD clinic attendees.
Settings and Design: This retrospective study was conducted in Gauhati Medical College & Hospital, a tertiary care hospital from April 2020 to September 2021 considering the OPD attendees of STD clinic, Department of Dermatology.
Material and Method: Blood samples received from STD clinic attendees were analysed for the study. The serum samples were subjected to qualitative RPR test followed by quantitative RPR and TPHA using standard procedure. Samples which were reactive by both quantitative RPR and TPHA were considered as seropositive for syphilis.
Statistical Analysis: Carried out with Microsoft Office Excel.
Results: The seroprevalence of syphilis was found to be 10.61%. Higher seroprevalence was noted among the sexually active age groups (21-40 yrs). Males showed higher seroprevalence indicating high risk behaviour (MSM) and unsafe sexual practices.
Conclusion: Prevalence of syphilis is quite high amongst the STI clinic attendees in our hospital which can be reduced by behaviour modification, promoting safe sexual practices, enhanced case detection, treatment and follow up.
References
2. Ruxrungtham K, Brown T, Phanuphak P. HIV/AIDS in Asia. Lancet 2004;364(9428):69-82.
3. Garg R, Yu D, Narain JP. Epidemiology and transmission dynamics. In: Narain JP, editor. Three decades of HIV/AIDS in Asia. New Delhi: Sage Publications; 2012.
4. Steen R, Zhao P, Wi TE, Punchihewa N, Abeyewickreme I, Lo Y-R. Halting and reversing HIV epidemics in Asia by interrupting transmission in sex work: experience and outcomes from ten countries. Expert Rev Anti Infect Ther 2013;11(10):999-1015.
5. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS ONE 2015;10(12): e0143304.
6. Jain VK, Dayal S, Aggarwal K, Jain S. Changing trends of sexually transmitted diseases at Rohtak. Indian J Sex Trans Dis 2008;29:23–5.
7. Ray K, Bala M, Gupta SM, Khunger N, Puri P, Muralidhar S, et al. Changing trends in sexually transmitted disease in a regional STD centre in north India. Indian J Med Res 2006;124:559–68.
8. Schumacher CM, Ellen J, Rompalo AM. Changes in demographics and risk behaviors of person with early syphilis depending on epidemic phase. Sex Transm Dis 2008;35:190–6.
9. Nishal PK, Kapoor A, Jain VK, Dayal S, Aggarwal K. Changing trends in acquired syphilis at a Tertiary Care Center of North India. Indian J Sex Transm Dis 2015;36:149-53.
10. Maity S, Bhunia SC, Biswas S, Saha MK. Syphilis seroprevalence among patients attending a sexually transmitted disease clinic in West Bengal, India. Japanese Journal of Infectious Diseases 2011;64(6):506-8.
11.Patwardhan VV, Bhattar S, Bhalla P, Rawat D. Seroprevalence of syphilis by VDRL test and biological false positive reactions in different patient populations: Is it alarming? Our experience from a tertiary care center in India. Indian J Sex Transm Dis 2020;41:43-6.
12. Patton ME, Su JR, Nelson R, Weinstock H. Centers for Disease Control and Prevention (CDC). Primary and secondary syphilis United States, 2005-2013. MMWR Morb Mortal Wkly Rep 2014;63(18):402-6.
13.Shaw SY, Deering KN, Reza-Paul S, Isac S, Ramesh BM, Washington R, et al. Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study. BMC Public Health 2011;11(Suppl 6): S4.
14. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2016. Atlanta: U.S. Department of Health and Human Services [internet]. 2017. Available from: https://www.cdc.gov/std/stats.
15.Tao XH, Jiang T, Shao D, Xue W, Ye FS, Wang M, et al. High prevalence of syphilis among street-based female sex workers in Nanchang, China. Indian Dermatol Online J 2014;5:449-55.
16. Mehta SD, Ghanem KG, Rompalo AM, Erbelding EJ. HIV seroconversion among public sexually transmitted disease clinic patients: analysis of risks to facilitate early identification. J Acquir Immune Defic Syndr 2006;42:116–22.
17. Baeten JM, Overbaugh J. Measuring the infectiousness of persons with HIV-1: opportunities for preventing sexual HIV-1 transmission. Curr HIV Res 2003;1:69–86.
18. Devi SA, Vetrichevvel TP, Pise GA, Thappa DM. Pattern of sexually transmitted infections in a tertiary care centre at Puducherry. Indian J Dermatol 2009;54(4):347-9.
19. Barot, Jigna P; Solanki, Avanita D; Patel, Neela M; Modi, Khushboo R; Bodar, Miral B. A Retrospective Study of the Pattern of Sexually Transmitted Diseases in Teenagers Attending Sexually Transmitted Disease Clinic during a 7-Year Period at a Tertiary Care Centre. Indian Journal of Paediatric Dermatology 2018;19(3):220-3.
20. Sethi S, Mewara A, Hallur V, Prasad A, Sharma K, Raj A. Rising trends of syphilis in a tertiary care center in North India. Indian J Sex Transm Dis AIDS 2015;36(2):140-3.
21. Khan S, Menezes GA, Dhodapkar R, Harish BN. Seroprevalence of syphilis in patients attending a tertiary care hospital in Southern India. Asian Pacific Journal of Tropical Biomedicine 2014;4(12):995-7.
22. Bala M, Singh V, Muralidhar S, Ramesh V. Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/ indoor patients of a tertiary care centre and peripheral health clinic attendees. Indian J Med Microbiol 2013;31:275-9.
23. Chopra S, Garg A, Chopra M, Ghosh A, Sreenivas V, Sood S, Kapil A, Das BK. Declining trends of Syphilis seroprevalence among antenatal clinic cases and STD clinic cases in a tertiary care centre: From January 2002 to December 2012. Indian J Med Microbiol 2015;33:126-8.
24. Punia P, Singh D, Bala K, Aparna, Chaudhary U, Griwan A. Recent Trends of Sero-Prevalence of Syphilis in Patients Attending a Tertiary Care Centre in North India. Int.J.Curr.Microbiol.App.Sci 2017;6(11):882-6.
25. Prajakta S, Barde, Neelima S. Seroprevalence of Syphilis in AnteNatal Cases in Central India. International Journal of Medical Science and Clinical Inventions 2017;4(8):3143-5.
26. Archana BR, Prasad SR, Beena PM, Okade R, Sheela SR, Beeregowda YC. Maternal and congenital syphilis in Karnataka, India. Southeast Asian J Trop Med Public Health 2014;45(2):430-4.
27. Mehta KD, Antala S, Mistry M, Goswami Y. Seropositivity of hepatitis B, hepatitis C, syphilis, and HIV in antenatal women in India. J Infect Dev Ctries 2013;7(11):832-7.
28. Sgaier SK, Mony P, Jayakumar S, McLaughlin C, Arora P, Kumar R, Bhatia P, Jha P. Prevalence and correlates of Herpes Simplex Virus-2 and syphilis infections in the general population in India. Sexually Transmitted Infections 2011;87:94-100.
29. Marra CM, Maxwell CL, Smith SL, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis 2004; 189:369–76.
30. Levine DK, Scott KC, Klausner JD. Online syphilis testing—confidential and convenient. Sexually transmitted diseases 2005;32(2):139-41.
