Syphilis threatens the inmates in Sana’a central prison [Archives:2008/1132/Health]

Amira Al-Sharif
[email protected]
Sana'a University's Faculty of Medicine and Health Sciences tested 200 random subjects from among more than 3,000 inmates living at the Central Prison in Sana'a. The study found that four of the inmates tested positive for the Treponema pallidum bacterium that causes syphilis.

Maha Rowhan Abdu Al-Maqtari, a researcher for the project, says that if the study found four cases of syphilis in only 200 people, this bodes poorly for the other 2,800 or so prisoners that haven't yet been tested for the disease.

“'If we do this test on 1,000, we might have more cases because these [200] are the only ones who agreed to be tested,” Al-Maqtari observed.

Syphilis is transmitted three main ways: through sexual contact, blood transfusions and in-utero transmission from mother to child.

Besides the prisoners, the Sana'a University study observed 102 recipients of blood transfusions and 98 pregnant women between August 2005 and August 2006; however, no cases of syphilis were found among these other two groups.

The transfusion recipients and pregnant women tested in the study were recruited from local hospitals and health centers.

Only antibodies, not personal histories, studied

Rather than relying on first-person accounts, Al-Maqtari collected blood samples from the test group of prisoners and then examined the blood to see if it contained any of the antibodies indicating syphilis.

“Most individuals refused to answer or misled us about the sexually transmitted symptoms,” Al-Maqtari noted, “being embarrassed to talk about the disease's symptoms, as well as living in an Islamic country where these subjects are barred.”

Al-Maqtari says that testing inmates will prevent them from spreading the disease, both while incarcerated and once they return to society.

“The obstacle I faced was that there was no information about sexually transmitted diseases in Arab countries, but especially in Yemen,” Al-Maqtari stated.

Symptoms and effects of syphilis

The Treponema pallidum bacteria first affects the genital area, then spreads through the blood to organs such as the liver and kidneys, and in the final stages, to the heart and brain, eventually causing death.

The first symptoms for syphilis sufferers are usually painless circular, purplish ulcers appearing on the genital area between two and 10 weeks after infection.

Stage two of the disease includes fever, headache and skin rashes or sores, while the third stage, or advanced syphilis, causes organ malfunction and insanity.

Congenital, untreated syphilis can affect pregnancy, leading to miscarriage, stillbirth or prenatal death.

Syphilis worldwide

First diagnosed in 1905, syphilis can cause death and remains a very real public health problem, with an estimated 12 million cases annually worldwide. More than 3,000 infants are born with congenital syphilis annually in the United States. Infection rates among pregnant women in the Islamic nations of Djibouti, Sudan, Iran, Qatar, Bahrain, Jordan, Iraq and Saudi Arabia average 0.85 percent.

Prevention and control

While the common antibiotic penicillin is the mainstay of treatment for all stages of syphilis, those patients who are allergic to penicillin can be treated with other anti-treponemal antibiotics. Continuous use of antibiotics can reduce the risk of transmission between sexual partners, pregnant women, blood donors and recipients.

Although several vaccines are under investigation in clinical trials, no effective vaccine currently is available.

Sexual abstinence is recommended for syphilis patients, as condoms don't always protect against the disease.

Routine screenings and awareness campaigns about the symptoms and dangers of syphilis are another way to reduce the number of cases in Yemen.
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