STI- Untreated syphilis could lead to blindness, mental illness

Nov 02, 2009

IT was a scourge of the 1890s, a disease that ravaged the body and the brain, driving some to madness or death.

THE state of Sexually Transmitted Infections (STIs) in Uganda is still worrying. The New Vision will, until World AIDS Day (December 1), publish articles on STIs, where to access free treatment and how to avoid the deadly diseases.

By Frederick Womakuyu
IT was a scourge of the 1890s, a disease that ravaged the body and the brain, driving some to madness or death.

It was the reason Mulago Hospital was started — to treat sexually transmitted infections (STIs), says Joseph Senzoga, the coordinator Disease Surveillance Response Unit Kampala district.

But syphilis still affects many people in Uganda. Dr Senzoga says a 2008 Kampala City health report indicates that there is almost an equal number of syphilis cases in children below four years and those above five years, including adults.

He says out of 14,240 children below the age of four, screened for the infection, 5,200 had syphilis. He adds that out of 19,825 children above five years (including adults) screened for syphilis, 6,215 had the disease.

Dr. Senzoga says 75% of the victims were females but explains that this could be because women turned up for screening in bigger numbers than males.
“The women are also unable to negotiate safe sex with their male partners who have multiple partners,” he notes.

Dr. Stephen Mugamba, an epidemiologist at Mulago Hospital, says syphilis is highly contagious and can be hard to detect, but is curable with antibiotics. If untreated in pregnant women, he says, it can cause still birth, birth defects and infant death.

Mugamba explains that the rising cases signify an increase in unsafe sex.
Dr. Senzoga warns that there could be an increase in HIV/AIDS due to the high syphilis cases.

“People who have syphilis are more likely to contract HIV/AIDS than others because of the open sores the disease causes.”

There are about 130,000 new cases of HIV infection in Uganda annually.
He adds that many people who may be having syphilis do not go for screening because of the stigma associated with the disease while others are not aware that the sores are a sign of infection.

Mode of transmission
Dr. Frank Kaharuza, the president of the Association of Obstetrics and Gynaecology of Uganda, says the infection spreads from the initial ulcer of an infected person to the skin or mucous membranes of the genital area, the mouth or the anus of a sexual partner.

It can also pass through broken skin on other parts of the body.
“A pregnant woman can pass syphilis to her unborn child. As a result, the child may be born with serious mental and physical problems.”

Symptoms
Dr. Kaharuza says the disease has three stages — primary, secondary and tertiary.

Primary syphilis
Dr. Kaharuza says the first sign is often a small, firm and round lesion at the point of the body where the disease was contracted. The lesion is painless and will heal without treatment, so many people are not aware they are infected.

Secondary syphilis
According to online sources, this stage is often marked by a skin rash that is characterised by brown sores. Rash appears anywhere from three to six weeks after the ulcer appears.

The rash heals within several weeks, leading to mild fever, fatigue, headache, sore throat, as well as patchy hair loss and swollen lymph glands throughout the body. The signs may come and go within one to two years.

Dr. Kaharuza says untreated syphilis may lapse into a latent stage during which the disease is no longer contagious and no symptoms are present.

“However, many people develop the complications of tertiary syphilis in which the bacteria damages the heart, eyes, brain, nervous system, bones and joints.” This stage can last decades.

Tertiary syphilis
About 30 years after initial infection, it can result in mental illness, depression, blindness, other neurological problems, heart disease, and ultimately death.

Prevention and treatment Using a condom reduces the chances of becoming infected, but it is not entirely effective.

“A condom may not cover all the sores or rashes in the affected areas. Direct skin contact may result in transmission,” says Dr. Senzoga.

He advises people to go for frequent medical check-ups and avoid multiple sexual partners.

Treatment of syphilis
Do not self medicate. Consult the doctor if you have the above symptoms.

For information on where to go for testing and treatment, please click here

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