Download Syphilis In Ghana

SYPHILIS IN GHANA
HANNAH AGYEMANG
SENNYE MPHO MAPHAKELA
Defination and Cause
 Defination
Syphilis is a chronic systemic disease which can be
acquired or congenital.
 Cause
It is caused by the spirochaet bacteria called
Treponema Pallidum
Etiology
Often associated with poverty, prostitution, drug
addicts, promiscuity and this is usually referred to as
genital syphilis.
It can also be passed from mother to child. This is
called congenital syphilis.
Pathogenesis
This highly infectious disease is usually transmitted
from one person to another through sexual contact of
all kinds.
It can also be transmitted (but less often) by
any physical contact and blood transfusion.
In order for the bacteria to enter the host, there has to
be a lesion in the skin or mucosa.

Its incubation period is 3 weeks but it can also go up to
several months.
When the bacteria enters the host, it goes mainly
through 4 stages:
 Primary Stage
 Secondary Stage
 Latent Stage
 Tertiary Stage
Primary Stage
 It begins 3 weeks after exposure and lasts for 2-3 weeks
 At the site of the infection, there is a formation of the chancre (painless ulceration).
 Patients are sometimes unaware because the lesion is located in areas that are not easy
to see e.g cervix, urethra e.t.c
 There is also some discharge from the lesion that is highly infectious (because it
contains bacteria).
 After this, the bacteria enters the blood stream and the lymphatics, spreading it to the
whole body.
Secondary Stage
 Skin rash over the whole body except in the face. These are
contagious.
 There is also loss of hair, fever, malasie (tiredness), joint pain,
mild fever and sore throat.
 This symptoms go away after a few weeks
Latent Stage
 There are no symptoms
 It can lasts for 2-4 years so the patient is no longer
infectious except for congenital syphilis, that is, when it is
transmitted from mother to child during pregnancy which
can lead to deformation, mental retardation and even death
of the child.
Tertiary Stage
 Most dangerous stage.
 Only half of the untreated cases develop to tertiary stage but most of
them just end in latent or before.
 Symptoms are mostly in skin and bone.
 In the cardiovascular system, it can lead to weakening of aortic wall,
in the CNS, there can be loss of motor function and in the brain it
can lead to paresis, blindness, seizures e.t.c
 It can also destroy organs
Diagnosis & Treatment
 Diagnosis
Microscopy- Dark field microscopy
Serum test- detect antibodies
 Treatment
Antibiotics (penicillin) for two weeks
Prevention
 Abstain or be monogamous
 Patients with infectious syphilis should abstain until
they finish their treatment and have been tested
negative but if there should be some sexual activity,
latex condom must be used and it should cover the
lesion or the cancre.
 Avoid recreational drugs e.g alcohol and drugs which
can cloud your judgement and lead to unsafe sexual
practice
 Screening of pregnant women

In Ghana..
 Syphilis is responsible for an estimated 360,000 foetal and
perinatal deaths worldwide. A further 270,000 babies suffer
serious permanent defects because of congenital syphilis.
 In Ghana, the National HIV/STI Sentinel Surveillance has
reported a dramatic increase in mean syphilis seroprevalence
from 0.4% in 2003 to 6.5% in 2008, with site prevalence
ranging from 0% to 30.5% across 40 clinics involving 18,366
antenatal attenders.
 This large increase in maternal syphilis prevalence is worrying
and may be due to an unfolding epidemic of venereal syphilis
or the resurgence of yaws (endemic syphilis) in parts of Ghana
or could have been artificially caused by a recent change in the
surveillance testing algorithms.

 Syphilis screening coverage of pregnant women is still
very low in antenatal clinics across Ghana. A study of 210
health facilities in the Ashanti Region found that only
3.3% offered routine prenatal syphilis screening.
 Reasons for poor implementation may include lack of
awareness of the policy among service providers, lack of
training and late booking of visits to antenatal clinics.
 Education and training, continuity of screening test kit
supplies, drugs, supervision and quality control are
essential for a successful and sustainable maternal
syphilis screening programme.
Sources
 Clinical medicine (Kumar and Clark)
 Microbiology: An Introduction (Tortora, Funke,
Case)
 http://www.dfid.gov.uk/R4D/PDF/Outputs/Repro
HealthHIV_RPC/srhhiv-researchbriefing3syphilisscreeningghana.pdf