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Syphilis: A silent epidemic reawakens

Syphilis: A silent epidemic reawakens

In a recent article published within the Indian Dermatology Online Journal, researchers studied the epidemiological and clinical profile of Indian patients who visited a tertiary care center for the treatment of syphilis. Their findings indicate that though there are effective treatments for syphilis and the disease is preventable, there was a surge in cases globally over the past decade. Effective prevention and treatment are needed to be sure that untreated cases don’t result in hostile health outcomes which have implications for public health.

Study: Syphilis: Is it Back with a Bang? Image Credit: Kateryna Kon / Shutterstock

Concerning the study

On this study, researchers followed a cross-sectional observational design to evaluate the epidemiological and clinical profile of people with syphilis who received treatment at a clinic specializing in sexually transmitted infections (STI) between 2019 and 2021. Patients of all age and sex groups were included in the event that they were clinically diagnosed with syphilis, including latent, primary, secondary, tertiary, and congenital.

On the clinic, staff recorded the entire clinical history of the patients and carried out general physical, systemic, and mucocutaneous examinations. Clinical photographs were taken, and screening was performed for rapid plasma regain (RPR), treponema pallidum hemagglutination assay (TPHA), and human immunodeficiency virus (HIV).

Patients were diagnosed as having syphilis based on serology, clinical features, and history. Those that showed no clinical signs and symptoms but positive serology during screening were diagnosed as having latent syphilis. Examinations were also conducted if a patient was suspected of getting mixed venereal disease.


In total, 1,330 people sought care on the clinic, of whom 200 (144 males and 56 females) received a syphilis diagnosis. The mean age of the patients was 30.9 years, and most were between 21 and 30 years old.

Male patients were predominantly manual laborers or long-distance drivers, while nearly 90% of female patients were homemakers. Based on the modified Kuppuswamy socioeconomic scale, most belonged to the upper-lower class.

When it comes to marital status, 63% were married, including 53 females and 73 males; greater than 40% of females showed positive RPR serology and were antenatal. About 20% of male respondents reported being either bisexual or homosexual.

Half of the respondents reported a history of either premarital or extramarital contact, and 36% said that that they had engaged in sexual contact with paid sex employees. Nearly 30% were polygamous, and nearly 85% reported that that they had engaged in unprotected sexual intercourse.

Nearly 25% of patients had primary chancres, 44.5% had secondary syphilis, 30.5% had latent syphilis, and only 0.5% had congenital syphilis (a two-day-old girl with no clinical manifestation). Tertiary syphilis was not seen within the study. Chancres were found on the tongue and glans, while 43 patients had rashes in various parts of the body. Along with syphilis, 25 individuals also had herpes progenitalis, 7 had genital molluscum contagiosum, 10 had chancroid, and 6 had concurrent genital warts. Screening suggested that 5 females and 28 males were HIV-positive and positive RPR titers across all 200 patients.


Though effective treatments are widely available, syphilis continues to have a high prevalence rate and has seen a resurgence in cases in India and a number of other other countries. Comparisons with previous studies suggest an upward-rising trend in syphilis cases.

The predominantly male patient group may very well be resulting from their engaging in additional dangerous behaviors and since they usually tend to seek treatment early on. At the identical time, females are restricted by cultural and social stigma and usually tend to be asymptomatic. Earlier initiation of sexual intercourse, if it just isn’t accompanied by protected practices, may very well be a risk factor for STIs.

Though other studies have found strong associations between STIs and lower education, which limits self-care ability and understanding, the vast majority of patients on this study were literate.

Drivers and each day wage laborers who migrate to search out work look like a high-risk group because they spend prolonged periods away from their partners, resulting in dangerous sexual behaviors. The findings also indicate the necessity to goal industrial sex employees to advertise protected behaviors to cut back the rising burden of STIs.

Infection and re-infection rates may be high in men who’ve sex with men living with HIV – this group may be targeted with interventions to cut back stigma around their conditions, bring them closer to health services, and improve their quality of life.

There’s a pressing must limit the spread of STIs through rapid diagnostic kits, sex education, and protected sex education. High-risk groups may be targeted in an economical way. Most significantly, the stigma around STIs should be addressed to make sure prevention and effective treatment.

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