Syphilis Infection in Asikuma Odoben Brakwa District, Ghana

Asikuma Odoben Brakwa District

By identifying the risk factors of the common STDs, we will be able to raise awareness for their existence and over time, work to eliminate them. With that, we can act to decline the STD rates on a global level, with a focus on where those rates are the highest. That is exactly what a group of researchers has done back in 2019, trying to identify the risk factors for existing syphilis infection among pregnant women.

What are the syphilis risk factors among pregnant women in Aiskuma Odoben Brakwa District in Ghana?

Syphilis is one of the common sexually transmitted infections (STIs). It is caused by a bacteria called Treponema pallidum. Like any other STD, syphilis as well is transmitted through unprotected sexual intercourse, including oral, vaginal, and anal sex.

The first and most characteristic symptoms of existing syphilis infection is a painless sore that can appear anywhere on the sexual organs, rectum, lips, or inside the mouth. People usually fail to notice this first symptom and continue to live with the existing infection, eventually helping it spread if they engage in unprotected sexual intercourse in the near future.

Although we have penicillin since the 1990s, there is a continuous spread of syphilis on an international level, with more than 10 million individuals being diagnosed with an existing syphilis infection each year. Of course, the prevalence of syphilis is higher in high burden countries and rural areas such as Africa, especially in the Aiskuma Odoben Brakwa district in Ghana, Africa.

The overall prevalence of syphilis in Aiskuma Odoben Brakwa district in Ghana has been estimated to be around 3.2% with a higher prevalence among women, about 5.7%, as compared to men, among which the prevalence is around 1.7%. The prevalence seems to be dangerously high among pregnant women with a prevalence of 1.6% in 2016, which poses its own threats knowing how syphilis can be easily transmitted to the baby in the womb during pregnancy.

But it is not only the congenital syphilis infection that we need to fear. Other complications such as stillbirth, low birth weight, spontaneous abortion, and neonatal death are possible as well. In fact, syphilis during pregnancy is considered to be the second leading cause of stillbirth on a global level.

Because of the high prevalence rates, researchers have conducted a study that was later published in 2019, with the hopes of identifying the exact risk factors for developing a syphilis infection during pregnancy among pregnant women in the Aiskuma Odoben Brakwa district in Ghana, Africa. Identification of the risk factors can help to later focus on their elimination and improvement so that the rates of syphilis can significantly decline.

One of the risk factors was found to be married since syphilis infection was more common among couples that have been married as compared to those individuals who have been single, although the difference was not significant. The prevalence of syphilis was high in those who have reported a history of coerced sexual intercourse and those who have engaged in unprotected sexual intercourse of any kind with multiple partners. Living in rural areas such as the Aiskuma Odoben Brakwa district in Ghana, Africa played one of the biggest roles as a significant risk factor.

Biggest risk factors

As it turns out, being in a marriage, living in a rural area, and having a history of coerced sexual intercourse play the role of the biggest risk factors for syphilis in the Aiskuma Odoben Brakwa district in Ghana, Africa where there has been a high syphilis prevalence, especially in women and in pregnant women.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973824/
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3967-6#ref-CR5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527824/
https://academic.oup.com/cid/article/35/Supplement_2/S200/316361
https://www.who.int/gho/sti/en/
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3967-6

Congenital Syphilis is On the Rise with Developing Countries at a Major Risk

Syphilis information

Congenital syphilis is the second cause of stillbirths around the world, malaria being the first. This infection is an incredibly common STIs that has resulted in more than 200,000 stillbirths across the globe. Plus, there are 6 million new reported cases of infected every single year.

In order to eliminate this infection on a global scale, the WHO has made it their mission to give access to adequate syphilis treatment and testing for any pregnant woman. The idea is to boost the overall health and improve the survival rate of children born in developing countries.

However, these countries, particularly in the sub-Saharan African region, have long been struggling to deal with the infection. It seems that they have yet to fulfill their goal of dealing with congenital syphilis.

Read more: Syphilis Symptoms

The Importance of Early Syphilis Diagnostics for Pregnant Women

With the current advances in science and technology, there are adequate medications that can help treat this infection. Plus, it is easily preventable, so people can take precautions to avoid this infection altogether.

For pregnant women, however, the timing has to be impeccable. These women need to seek syphilis screenings early in the pregnancy to receive benzathine penicillin G (BPG). The best time for this screening would be right before the second trimester.

Shortage of Benzathine Penicillin Puts a Strain on Syphilis Treatment

In many parts of the world, WHO has been successful in eliminating congenital syphilis in pregnant women. Twelve countries have managed to eliminate maternal syphilis completely. For developing countries, however, it’s a completely different story.

Read More: Syphilis Treatment

In these countries, there is one major issue, and that is the shortage of benzathine penicillin.

Based on an analysis carried out by multiple research programs for health, of the 95 countries evaluated, 49% had BPG shortages, while 59% stated they had adequate supplies for all their patients.

Due to BPG shortages, 10 of these countries stated relying on alternative and cheaper treatment.

They used ceftriaxone, erythromycin, and amoxicillin. The problem is that these treatments were not nearly as effective as BPG for maternal syphilis. In other words, women who received these treatments could still pass their infection onto the fetus.

The Need for Immediate Action Is Now

According to WHO, 95% of all pregnant women who get prenatal care should be screened for congenital syphilis. Testing for syphilis is of utmost importance for early and adequate syphilis treatment.

This should be the main concern for prenatal care for all countries. If a woman is diagnosed with this infection, she needs to get proper BPG treatment to make sure the infection is no longer in her system.

Product: Right Sign Syphilis Test

Product: One Step Syphilis Test

Monitoring Health Is the Key to Eliminating Congenital Syphilis

Once a woman has been treated for syphilis, especially when pregnant, her health must be monitored closely to make sure the infection doesn’t reappear or progress. This helps detect the infection early on and receive treatment to avoid any potential complications.

Congenital syphilis can be easily managed

Congenital syphilis can be easily managed and treated. But, without an on-time diagnosis, a pregnant woman can pass this infection onto her child and cause premature death, low infant weight, defects, and can cause deformities. As a result, syphilis screening and treatment should be a top priority for all developing countries.

References

https://www.who.int/reproductivehealth/congenital-syphilis-estimates/en/

https://www.who.int/reproductivehealth/shortages-benzathine-penicillin/en/ https://www.who.int/reproductivehealth/congenital-syphilis/WHO-validation-EMTCT/en/

Signs and Symptoms of Syphilis

Syphilis information

This is a sexually transmitted disease that affects the genital and spreads to other parts of the body organs. There are no apparent signs of this disease as it manifests in stages. Usually, one can have the bacteria for many months or even years before noticing anything. This aspect of discreetness is what makes syphilis spread widely. In essence, the clinical signs depend on which stage one is in the disease. Notably, there are four stages.

  • Primary stage
  • Secondary stage
  • Latent (hidden) stage
  • Tertiary (late) stage

Primary Stage

The symptoms of syphilis can incubate in your body for up to 3 months after exposure. In the initial stages, you can develop some discomfort in your lymph nodes. In most cases, the swelling of the lymph nodes does not last for long. Eventually, it disappears. Visibly, you will notice some painless sores on your skin or the entry spot of the bacteria. If the sore develops inside your genitals, you may never notice any anomalies. About half of the people under exposure to the bacteria develop the chancre or sore during this stage.

Secondary Stage

It may take weeks or months for the secondary signs to come out after the initial sores. It is not a must that you have the signs right away. Some start noticing the manifestations after years. Nevertheless, you will still infect others when you do practice safe sex. Some of the symptoms include

  • Reddish-brown sores after skin rashes
  • Ulcer sores in your mouth, genitals, and anus
  • Swelling of your lymph glands
  • Fever and headaches
  • Fatigue and muscle aches
  • Weight loss

These symptoms may disappear and come back later. But it is rare for people to proceed from this stage. Most signs trigger a visit to the doctor.

Latent Stage

This is the stage where the bacteria become passive in your body. You may never develop any signs for years, yet still harboring the disease. Similarly, you may continue transmitting the bacteria to unsuspecting partners.

Tertiary Stage

When the symptoms reappear at this stage, most of the body organs are suffering from the bacteria. This can be way after even a decade. Though there are several signs of this stage, the main categories are

  • Gummatous syphilis
  • Neuro syphilis
  • Cardiovascular syphilis

The combination of the three can manifest symptoms including

  • Brain damage
  • Stroke
  • Inflammation of the spinal nerves
  • Deafness
  • Dementia
  • Heart diseases
  • Damage of the blood vessels
  • Personality changes

Read More: Syphilis symptoms

Read More: Syphilis Overview

Signs in Children

Sometimes the mother may pass the bacteria to her infant during delivery. When that happens, the baby may develop these signs

  • Groin rashes
  • Bone disfiguring
  • Swelling of glands
  • Brain dysfunction
  • Painless sores on the feet and hands

In children, syphilis is fatal. Since their immunity is still developing, the bacteria thrive in the body, causing damage quickly. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809176/

http://www.health.gov.za/index.php/131-diseases/286-syphilis

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