LETTER TO EDITOR
|Year : 2008 | Volume
| Issue : 1 | Page : 46-47
Syphilis is predominantly an urban problem in Vellore district of Tamilnadu
N Balaji, Kavitha Balaji, L Karthikeyan, N Rekha
Sri Narayani Hospital and Research Center, Sripuram, Thirumalaikodi, Vellore - 632 055, Tamilnadu, India
Director and Chief Laboratory Services, Sri Narayani Hospital and Research Center, Sripuram, Thirumalaikodi, Vellore - 632 055, Tamilnadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Balaji N, Balaji K, Karthikeyan L, Rekha N. Syphilis is predominantly an urban problem in Vellore district of Tamilnadu. Indian J Sex Transm Dis 2008;29:46-7
|How to cite this URL:|
Balaji N, Balaji K, Karthikeyan L, Rekha N. Syphilis is predominantly an urban problem in Vellore district of Tamilnadu. Indian J Sex Transm Dis [serial online] 2008 [cited 2020 Jun 1];29:46-7. Available from: http://www.ijstd.org/text.asp?2008/29/1/46/42718
Syphilis is a sexually transmitted infection (STI) seen throughout India, the prevalence being especially high among those who practice unsafe sex and indulge in promiscuous sexual activity. Screening for syphilis infection is widely done in the country by using anticardiolipin antibody detection. This is the most widely used nontreponemal test. , The results of the screening test need to be confirmed by a specific treponemal test when there is any doubt about the diagnosis.  In India, the use of anticardiolipin antibodies for determining exposure to syphilis is part of routine antenatal care. The test is also used in screening individuals with high-risk behavior, whether or not there are clinical symptoms and signs of syphilis. We report our experience with the screening for syphilis over a 3-year period in the outpatient department of a 150-bed tertiary care center situated in Vellore district of Tamilnadu. The hospital extends services for a mixed rural and periurban /urban population.
Blood samples from 3840 individuals were collected over a 3-year period (2005-2007) for various investigations, including anticardiolipin antibodies screening. The investigations were carried out as part of routine antenatal and preoperative screening, as well as screening of those with suspected STI. Blood samples were taken after obtaining the verbal consent of the individual concerned. In all, 2304 persons from periurban/urban areas and 1536 individuals from rural communities were screened. The 3840 individuals included 2688 males and 1152 females. All sera samples were tested using the RPR test (Span Diagnostics, Surat, India) or Card test (Acon Biotech Co. Ltd, China) as per the manufacturer's instructions. No treponemal test was used for confirmation.
Of the 3840 individuals who were screened, 21 (0.55%) were found to be anticardiolipin antibody positive. Among the 1536 rural subjects tested, 3 (0.2%) were positive and there were 18 (0.78%) individuals who tested positive among the 2304 periurban/urban subjects. This difference was statistically significant ( P <0.015). Nine (0.33%) of the 2688 males and 12 (1.04%) of the 1152 females were positive. This difference was also statistically significant ( P <0.006).
Syphilis continues to be an important sexually transmitted infection in the community. In a study from Tamil Nadu that was based on data from three districts: Dindigul, Ramnad, and Tanjore, serodiagnosis of syphilis was established in 2.7% (50/1873) using the RPR test.  In our study, we have not used the treponemal test for confirmation of the diagnosis and so there are likely to be some false positive results; moreover, the use of only one test may give a lower sensitivity. 
In India, there is a paucity of information on the prevalence of syphilis in urban vs rural communities. Our data shows the significantly higher prevalence in the periurban/urban population compared to the rural population. The data also reveals that infection is significantly higher in females compared to males. (The number of males screened was more than double that of females.) These findings suggest that there is greater high-risk behavior among the urban population and that sexually active females are at greater risk of contracting the infection. The findings also emphasize the importance of syphilis screening in antenatal care and that appropriate treatment of infected mothers must be provided to prevent congenital syphilis
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