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Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis

BACKGROUND: Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country. AIM AND OBJECTIVES: To analyze the changing trends in cli...

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Autores principales: Kaur, Ravneet, Gupta, Sharang, Sarangal, Rishu, Chopra, Dimple, Singh, Harmeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343136/
https://www.ncbi.nlm.nih.gov/pubmed/37457540
http://dx.doi.org/10.4103/ijstd.ijstd_109_22
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author Kaur, Ravneet
Gupta, Sharang
Sarangal, Rishu
Chopra, Dimple
Singh, Harmeet
author_facet Kaur, Ravneet
Gupta, Sharang
Sarangal, Rishu
Chopra, Dimple
Singh, Harmeet
author_sort Kaur, Ravneet
collection PubMed
description BACKGROUND: Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country. AIM AND OBJECTIVES: To analyze the changing trends in clinical presentation of syphilis and the current status of HIV/AIDS-syphilis co-infection in our area. MATERIALS AND METHODS: This is a hospital-based retrospective analysis of records of sexually transmitted disease (STD) patients enrolled in “Suraksha clinic” in the department of Skin and VD at a Tertiary Care Hospital in North India. Patient records were analyzed from January 2018 to December 2021. The demographic, clinical, and serological profiles of patients were assessed to study the percentage of syphilis patients attending the STD clinic and their clinical presentations. RESULTS: A total of 7153 patients were enrolled in the”Suraksha clinic” from January 2018 to December 2021, these included the venereal disease patients (3137) and nonvenereal disease patients (4016) who were registered for HIV and venereal disease research laboratory (VDRL) screening from the dermatology outpatient department. Out of 3137 sexually transmitted infection (STI) patients, 139 patients tested positive for VDRL. Treponema pallidum hemagglutination was found positive in 137 patients and negative in two patients. Hence, 137 patients were confirmed syphilis cases, constituting 4.36% of total STD cases in our STI clinic in 4 years. Out of 137 patients, 2 (1.45%) presented with primary chancre, 6 (4.37%) with lesions of secondary syphilis and 129 (94.16%) were found serologically reactive without any symptoms or clinical signs, i.e., in latent syphilis. Our records also showed 14 (10.21%) cases of HIV and syphilis co-infection. CONCLUSION: In our study, a remarkable rise in the number of patients in the latent syphilis stage is observed over primary and secondary syphilis stage. This signifies the persistence of syphilis in subclinical phase in the community and unfortunately, it goes unnoticed. These could be “warning signs” for changing disease pattern of syphilis in India and points toward hidden resurgence of syphilis as being reported in various parts of the world. To actively look for these “hidden cases,” there is a need to strengthen “Suraksha clinics.” VDRL testing should be mandatory along with routine testing in all patients visiting the hospital irrespective of their disease. We also propose for the central registration of syphilis patients on lines of HIV-infected patients' registry.
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spelling pubmed-103431362023-07-14 Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis Kaur, Ravneet Gupta, Sharang Sarangal, Rishu Chopra, Dimple Singh, Harmeet Indian J Sex Transm Dis AIDS Original Article BACKGROUND: Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country. AIM AND OBJECTIVES: To analyze the changing trends in clinical presentation of syphilis and the current status of HIV/AIDS-syphilis co-infection in our area. MATERIALS AND METHODS: This is a hospital-based retrospective analysis of records of sexually transmitted disease (STD) patients enrolled in “Suraksha clinic” in the department of Skin and VD at a Tertiary Care Hospital in North India. Patient records were analyzed from January 2018 to December 2021. The demographic, clinical, and serological profiles of patients were assessed to study the percentage of syphilis patients attending the STD clinic and their clinical presentations. RESULTS: A total of 7153 patients were enrolled in the”Suraksha clinic” from January 2018 to December 2021, these included the venereal disease patients (3137) and nonvenereal disease patients (4016) who were registered for HIV and venereal disease research laboratory (VDRL) screening from the dermatology outpatient department. Out of 3137 sexually transmitted infection (STI) patients, 139 patients tested positive for VDRL. Treponema pallidum hemagglutination was found positive in 137 patients and negative in two patients. Hence, 137 patients were confirmed syphilis cases, constituting 4.36% of total STD cases in our STI clinic in 4 years. Out of 137 patients, 2 (1.45%) presented with primary chancre, 6 (4.37%) with lesions of secondary syphilis and 129 (94.16%) were found serologically reactive without any symptoms or clinical signs, i.e., in latent syphilis. Our records also showed 14 (10.21%) cases of HIV and syphilis co-infection. CONCLUSION: In our study, a remarkable rise in the number of patients in the latent syphilis stage is observed over primary and secondary syphilis stage. This signifies the persistence of syphilis in subclinical phase in the community and unfortunately, it goes unnoticed. These could be “warning signs” for changing disease pattern of syphilis in India and points toward hidden resurgence of syphilis as being reported in various parts of the world. To actively look for these “hidden cases,” there is a need to strengthen “Suraksha clinics.” VDRL testing should be mandatory along with routine testing in all patients visiting the hospital irrespective of their disease. We also propose for the central registration of syphilis patients on lines of HIV-infected patients' registry. Wolters Kluwer - Medknow 2023 2023-06-06 /pmc/articles/PMC10343136/ /pubmed/37457540 http://dx.doi.org/10.4103/ijstd.ijstd_109_22 Text en Copyright: © 2023 Indian Journal of Sexually Transmitted Diseases and AIDS https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kaur, Ravneet
Gupta, Sharang
Sarangal, Rishu
Chopra, Dimple
Singh, Harmeet
Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title_full Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title_fullStr Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title_full_unstemmed Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title_short Are we moving from symptomatic to asymptomatic syphilis: A retrospective analysis
title_sort are we moving from symptomatic to asymptomatic syphilis: a retrospective analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343136/
https://www.ncbi.nlm.nih.gov/pubmed/37457540
http://dx.doi.org/10.4103/ijstd.ijstd_109_22
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