Syphilis Almost Eliminated Everywhere Except In Africa

Syphilis – the once dangerous sexually transmitted disease (STD) has been efficiently treated, and the risk of its complications reduced with the discovery of penicillin. Although easily being transmitted through having unprotected oral, vaginal, or anal sexual intercourse, the symptoms of the syphilis infection have been efficiently treated within a matter of weeks with the use of penicillin antibiotics. 

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And although the rates of the syphilis infection are still dangerously high, affecting around 9.5% per 100,000 population in the United States back in 2017, there is a clear decline in the case numbers as compared before and after the discovery of penicillin. But there seems to be an exception to this rule. We keep seeing an extremely high increase in new syphilis cases in Africa, although there is an evident decrease everywhere else around the world.

A persistent increase in new syphilis cases in Africa

It was Dr. Chris Richard Kenyon, a scientist working at the Institute of Tropical Medicine in Antwerp, Belgium, who together with his team, researched the reasons behind the continuous increase of new syphilis infections in Africa, trying to shed a little light on the topic. These researchers published a study back in May 2016, which explored the details about continuous syphilis spread in Africa over the years.

What the study revealed was a noticeable increase in new syphilis cases, bigger as compared to the increase reported in the rest of the world. While most of the other countries over the world experienced an evident decline in the syphilis cases since the discovery of penicillin, the rates continued to be still high regarding Sub-Saharan Africa, with a focus on pregnant women.

With the one exception in the Solomon Islands and Papua New Guinea, where the rates of syphilis infection within pregnant women is estimated to be around 5%, the rest of the African countries seem to face rather high rates, with up to 10% of the pregnant women struggling with known syphilis infection. And to think about all of those people who are living and transmitting the infection without being aware of its existence. This only makes transmission a lot easier for more people to be affected by it.

Looking over data of pregnant women who have been tested since 1918, Dr. Kenyon discovered that although in most countries, the rates of pregnant women being affected by syphilis have efficiently declined. This, of course, is due to the responsible testing that has been introduced in most countries as a way to prevent the infection from transmitting to the baby in the womb and cause dangerous and potentially life-threatening complications.

High syphilis rates among pregnant women in Africa

However, the data also showed that the prevalence of syphilis among pregnant women continued at rates of about 6% in Africa, even 50 years after penicillin has first been introduced. Nowadays, we are still facing dangerously high syphilis rates among pregnant women in Africa. It has been estimated that the rates are around 2.7%, affecting roughly 1 million pregnancies annually. 

The study also looked over the time period between 1990 and 1999, which is when the highest rate of HIV/AIDS cases has been measured, resulting in an AIDS epidemic around the world. In 2008, however, the rates of syphilis significantly dropped. This was thanks to the new and improved systematic approach in managing the common STDs. 

But this was still not the case in Africa. Although the AIDS epidemic helped reduce the syphilis cases and although there had been a high rate of AIDS cases in Africa as well, there was no trace of the similar effect that this AIDS epidemic had left everywhere else around the world. The team of researchers noted that the African population still struggled with the high syphilis rates measured among pregnant women from the 1990s to 2008.

And as we mentioned earlier, that increase in syphilis rates continues to follow the African population until this day. Just to think about how many young lives are lost because of the horrible complications that this infection is causing. 

There have been a few different opinions as to what is the reason behind the continuous increase in syphilis cases, especially within pregnant women. While the protocol requires pregnant women to be tested for both HIV and syphilis and given proper therapy if an infection has been discovered, research shows that is not the case in Africa.

In Africa, roughly 4% of pregnant women have not been properly tested for syphilis nor for HIV. This can explain why this country continues to face an increase in HIV and syphilis cases. There is also the problem of sexual health being considered to be a tabu in countries like Africa. People seem to feel ashamed or afraid of talking about their sexual health and the ways that they can prevent these common sexually transmitted diseases (STDs), even with their doctors. And if we have learned anything over the years is that keeping quiet about any symptoms and fears that we might face cannot be the solution to our problems.

Sexual Education Might Be The Solution

The need to educate the African population about the many dangers that the common sexually transmitted diseases are hiding is higher than ever. Only with a good education on the topic of sexual health, it will be possible for these high rates to start declining at once. But that is not all. The usual strategy that is used around pregnant women needs to change as well. Proper testing needs to be introduced as a part of the scheduled visits at the doctor’s office, similar to how the sexual health of all pregnant women around the world is being handled. And if a positive case of any STD, including syphilis, has been diagnosed, it is of vital importance that proper treatment has been used.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973824/

https://www.cdc.gov/std/stats17/syphilis.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864207/

https://www.hindawi.com/journals/bmri/2019/4562385/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584768/

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