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LETTER TO THE EDITOR
Year : 2013  |  Volume : 57  |  Issue : 2  |  Page : 117-118  

Trend of syphilis in a tertiary care hospital, New Delhi: 2001-2009


1 Assistant Professor, Department of Microbiology, G B Pant Hospital, Maulana Azad Medical College, New Delhi, India
2 Assistant Professor, Department of Microbiology, Maulana Azad Medical College, New Delhi, India
3 Director Professor, Department of Microbiology, Maulana Azad Medical College, New Delhi, India

Date of Web Publication15-Jul-2013

Correspondence Address:
Abha Sharma
Assistant Professor, Department of Microbiology, G B Pant Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.114979

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How to cite this article:
Sharma A, Rawat D, Bhalla P. Trend of syphilis in a tertiary care hospital, New Delhi: 2001-2009. Indian J Public Health 2013;57:117-8

How to cite this URL:
Sharma A, Rawat D, Bhalla P. Trend of syphilis in a tertiary care hospital, New Delhi: 2001-2009. Indian J Public Health [serial online] 2013 [cited 2019 Nov 17];57:117-8. Available from: http://www.ijph.in/text.asp?2013/57/2/117/114979

Sir,

World Health Organization estimates approximately 340 million new cases of sexually transmitted infections (STI) occur every year,75-85% of them in the developing countries.[1] Syphilis has for long been one of the major STI in the world. Since year 2000 the incidence has been rising, with increasing reports of syphilis from United States, Europe and India. [2],[3] Syphilis infection has a great impact on the Indian population and therefore a better understanding of the trends in the prevalence of syphilis could help in the improvement of public health STI prevention efforts in the country and their integration with human immunodeficiency virus (HIV) prevention.

In developing countries like India screening for syphilis is carried out by Venereal Disease Research Laboratory (VDRL) test. We conducted a retrospective analysis of laboratory data (2001-2009) to analyze trends in Syphilis at our Tertiary Care Hospital in New Delhi. Out of the total 80,695 cases screened for syphilis using VDRL, 1,580(1.95%) were VDRL reactive. [Figure 1] shows the year wise distribution of total cases and it has been observed that there has not been a significant change in the trend of VDRL reactive cases over the past 9 years. Despite the awareness campaigns about HIV and fear of contracting Sexually Transmitted Diseases, plus emphasis on syndromic approach to the management of STDs, the burden of syphilis still remains the same in the community. An increasing trend in the VDRL positivity among men was noted while it was decreasing among women. However, the sero prevalence of syphilis was found to be slightly higher among women when observed each year. VDRL positivity was seen highest in the age group of 21-30 years each year. However, an increasing trend in sero positivity was noted in the age group of 31-40, 41-50 and >50 years while a decreasing trend was seen in the age group of 10-20 years. In the era of internet, probably the newer generation is more aware and has gained better sex education and is knowledgeable. Also, a gradual decline in the VDRL positivity was seen among the antenatal women [Table 1]. A decline in the sero reactivity for syphilis among Ante Natal Cases has been reported in another study from India.[4] It is assumed that doctors and the nursing staff educated the women in antenatal clinics about symptoms and risk factors of syphilis. Furthermore, regular monitoring of STIs by the medical staff hasled to this downward trend. However among the STD clinic attendees, there has not been much change in the VDRL positive cases over the past 9 years. This implies that syphilis still remains a major problem in India, probably the most common STD as reported by other studies in India [5],[6] and indicating that the health-care facilities have to gear up their efforts in control and management of STDs like syphilis. Since 2005 onwards, VDRL screening for patients from Anti Retroviral Therapy clinic commenced in our laboratory and it was noted that the sero positivity has increased from 7.4% in 2005 to 6% in 2009 among patients on ART. This may be because the patients are referred for syphilis screening usually the day ART is initiated in them and studies8 have shown that syphilis is independently associated with HIV and increases transmission of HIV-1. Whether the effect of ART will decrease the incidence of VDRL reactivity or not, to document this further studies are required.
Figure 1: Year wise distribution of clinical samples tested for syphilis by Venereal Disease Research Laboratory

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Table 1: Prevalence of VDRL positive cases among different groups

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To conclude, population based data on rates of syphilis infection are very few. Further similar studies are required from all over India to understand the current status of syphilis infection in the Indian population and thus assessing the impact of STI and HIV prevention programs in our country.

 
   References Top

1.Global prevalence and incidence of selected curable sexually transmitted infections: Overview and estimates. WHO/HIV-AIDS/2001-02.Geneva: World Health Organization; 2001.  Back to cited text no. 1
    
2.Velicko I, Arneborn M, Blaxhult A. Syphilis epidemiology in Sweden: Re-emergence since 2000 primarily due to spread among men who have sex with men. Euro Surveill 2008;13:19603.  Back to cited text no. 2
    
3.Ray K, Bala M, Gupta SM, Khunger N, Puri P, Muralidhar S, et al. Changing trends in sexually transmitted infections at a Regional STD Centre in north India. Indian J Med Res 2006;124:559-68.  Back to cited text no. 3
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4.Sethi S, Sharma K, Dhaliwal LK, Banga SS, Sharma M. Declining trends in syphilis prevalence among antenatal women in northern India: A 10-year analysis from a tertiary healthcare centre. Sex Transm Infect 2007;83:592.  Back to cited text no. 4
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5.Thappa DM, Kaimal S. Sexually Transmitted Infection in India: current status (except HIV/AIDS). Indian J Dermatol 2007;52:78-82.  Back to cited text no. 5
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6.Reynolds SJ, Risbud AR, Shepherd ME, Rompalo AM, Ghate MV, Godbole SV, et al. High rates of syphilis among STI patients are contributing to the spread of HIV-1 in India. Sex Transm Infect 2006;82:121-6.  Back to cited text no. 6
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