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Idrissa S Chuma, Emmanuel K Batamuzi, D Anthony Collins, Robert D Fyumagwa, Luisa K Hallmaier-Wacker, Rudovick R Kazwala, Julius D Keyyu, Inyasi A Lejora, Iddi F Lipende, Simone Lüert, Filipa M D Paciência, Alexander Piel, Fiona A Stewart, Dietmar Zinner, Christian Roos, Sascha Knauf
We investigated Treponema pallidum infection in 8 nonhuman primate species (289 animals) in Tanzania during 2015-2017. We used a serologic treponemal test to detect antibodies against the bacterium. Infection was further confirmed from tissue samples of skin-ulcerated animals by 3 independent PCRs (polA, tp47, and TP_0619). Our findings indicate that T. pallidum infection is geographically widespread in Tanzania and occurs in several species (olive baboons, yellow baboons, vervet monkeys, and blue monkeys)...
June 2018: Emerging Infectious Diseases
Lucía Gallo Vaulet, Nicolás Morando, Ricardo Casco, Asunta Melgar, Silvia Nacher, Marcelo Rodríguez Fermepin, María A Pando
Even though syphilis can be easily diagnosed by simple and low-cost laboratory methods, it continues to be an important health problem. Rapid tests (RT) for the detection of treponemal antibodies can facilitate earlier diagnosis, access to treatment and linkage to care. The aim of this study was to analyse the usefulness of the incorporation of a RT in the detection of patients infected with T. pallidum in a sexually-transmitted disease (STD) clinic. Between March and December 2015, a syphilis RT was offered to patients who spontaneously attended the clinic...
May 15, 2018: Scientific Reports
Kun Gao, Xu Shen, Yong Lin, Xiao-Zhen Zhu, Li-Rong Lin, Man-Li Tong, Yao Xiao, Hui-Lin Zhang, Xian-Ming Liang, Jian-Jun Niu, Li-Li Liu, Tian-Ci Yang
The origin of nontreponemal antibodies during syphilis infection is hotly debated. Here, we analysed the immune response in rabbits immunized with various antigens. Inactivated treponemes elicited the production of low-titre nontreponemal antibodies in some rabbits. Cardiolipin combined with bovine serum albumin also induced anti-cardiolipin antibody production. These findings indicate that T. pallidum contained a cardiolipin antigen with weak immunogenicity. However, active T.pallidum induced higher nontreponemal antibody production with strong immunogenicity at an earlier time point, and the antibody titre was consecutive, suggesting the high nontreponemal antibody titre resulted from the combined effects of both the T...
April 25, 2018: Journal of Infectious Diseases
Michael Marks, Tommy Esau, Rowena Asugeni, Relmah Harrington, Jason Diau, Hilary Toloka, James Asugeni, Eimhin Ansbro, Anthony W Solomon, David Maclaren, Michelle Redman-Maclaren, David C W Mabey
INTRODUCTION: The human treponematoses comprise venereal syphilis and the three non-venereal or endemic treponematoses yaws, bejel, and pinta. Serological assays remain the most common diagnostic method for all treponemal infections. Point-of-care tests (POCTs) for syphilis and yaws allow testing without further development of infrastructure in populations where routine laboratory facilities are not available. Alongside the test's performance characteristics assessed through diagnostic evaluation, it is important to consider broader issues when rolling out a POCT...
April 2018: PLoS Neglected Tropical Diseases
Maciej Pastuszczak, Agnieszka Kotnis-Gąska, Bernadetta Jakubowicz, Iwona Martyka, Monika Bociaga-Jasik, Anna Wojas-Pelc
Until now only non-treponemal tests (e.g. rapid plasma reagin [RPR]) have been used to monitor syphilis activity (e.g. distinguishing between treated, untreated and repeat disease) and efficacy of treatment. However, they usually require manual operation and are less specific than treponemal tests. The aim of the current study was to evaluate the use of the antitreponemal IgM testing in the diagnosis of early and repeat syphilis in HIV-infected and non-infected patients. One hundred and seventeen patients with early syphilis were included in this prospective study...
January 1, 2018: International Journal of STD & AIDS
Karen Kim Jo Yaphockun, Shannon Wai
BACKGROUND: Syphilis is a sexually transmitted infection that was nearly eradicated in 2001 but is now making a resurgence. It has a wide range of clinical manifestations depending on disease stage. Neurosyphilis is an infrequently seen infectious disease with central nervous system involvement that can occur in either early- or late-stage syphilis. The diagnosis of neurosyphilis is challenging, primarily because Treponema pallidum, the infecting organism, cannot be cultured in vitro...
March 27, 2018: Journal of Emergency Medicine
Claire C Bristow, Chelsea Shannon, Sasha Herbst de Cortina, Jeffrey D Klausner
We aimed to determine if rapid treponemal tests intended for whole blood specimens could be used to detect treponemal antibody in oral fluid. We found a high sensitivity of oral fluid rapid testing, which increased with increasing RPR titer, suggesting potential for the development of accurate rapid oral syphilis tests.
March 29, 2018: Sexually Transmitted Diseases
David Šmajs, Michal Strouhal, Sascha Knauf
Treponema pallidum is an uncultivable bacterium and the causative agent of syphilis (subsp. pallidum [TPA]), human yaws (subsp. pertenue [TPE]), and bejel (subsp. endemicum). Several species of nonhuman primates in Africa are infected by treponemes genetically undistinguishable from known human TPE strains. Besides Treponema pallidum, the equally uncultivable Treponema carateum causes pinta in humans. In lagomorphs, Treponema paraluisleporidarum ecovar Cuniculus and ecovar Lepus are the causative agents of rabbit and hare syphilis, respectively...
March 22, 2018: Infection, Genetics and Evolution
Abdul Aziz Abdulai, Patrick Agana-Nsiire, Frank Biney, Cynthia Kwakye-Maclean, Sardick Kyei-Faried, Kwame Amponsa-Achiano, Shirley Victoria Simpson, George Bonsu, Sally-Ann Ohene, William Kwabena Ampofo, Yaw Adu-Sarkodie, Kennedy Kwasi Addo, Kai-Hua Chi, Damien Danavall, Cheng Y Chen, Allan Pillay, Sergi Sanz, Ye Tun, Oriol Mitjà, Kingsley Bampoe Asiedu, Ronald C Ballard
INTRODUCTION: The WHO yaws eradication strategy consists of one round of total community treatment (TCT) of single-dose azithromycin with coverage of > 90%.The efficacy of the strategy to reduce the levels on infection has been demonstrated previously in isolated island communities in the Pacific region. We aimed to determine the efficacy of a single round of TCT with azithromycin to achieve a decrease in yaws prevalence in communities that are endemic for yaws and surrounded by other yaws-endemic areas...
March 2018: PLoS Neglected Tropical Diseases
James Matthias, Gayle Keller, Susan Cha, Craig Wilson, Thomas A Peterman
BACKGROUND: Before searching prior records, sexually transmitted disease (STD) programs use syphilis reactor grids to exclude some reactive non-treponemal test results (RNTs) based on patient age, sex, and test titer. We propose a new algorithm that starts with comparing RNTs to previous syphilis non-treponemal tests and current treponemal test results. METHODS: De-duplicated RNTs from Florida's surveillance system (2006-2015) were extracted and stratified on morbidity...
March 13, 2018: Sexually Transmitted Diseases
Ariel Schlaen, Mariana Ingolotti, Cristobal Couto, Mario Saravia
Purpose: To report the spectral domain optical coherence tomography (SD-OCT) features of a focal retinitis in an elderly male patient with bilateral syphilitic panuveitis. Observations: In the left eye (LE), spectral domain SD-OCT images during the active period revealed hyperreflectivity extending through the full thickness of the retina with no individualization of the layers, except for the retinal pigment epithelium. Once the lesion healed, SD-OCT imaging revealed an inner retinal atrophy and a mild disruption of the retinal pigment epithelium...
March 2018: American Journal of Ophthalmology Case Reports
Carmen Phang Romero Casas, Marrissa Martyn-St James, Jean Hamilton, Daniel S Marinho, Rodolfo Castro, Sue Harnan
OBJECTIVES: To undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women. METHODS: Five electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women...
February 21, 2018: BMJ Open
Michelle Shuel, Kristy Hayden, Kamran Kadkhoda, Raymond S W Tsang
BACKGROUND: The province of Manitoba, Canada, with a population of approximately 1.3 million, has been experiencing increased incidence of syphilis cases since 2015. In this study, we examined the detection of Treponema pallidum DNA in 354 clinical samples from 2012 to 2016, and determined molecular types and mutations conferring resistance to azithromycin in the polymerase chain reaction (PCR)-positive samples. METHODS: T. pallidum DNA detection was done by PCR amplification of tpp47, bmp, and polA genes...
April 2018: Sexually Transmitted Diseases
Michael Marks, Oriol Mitjà, Christian Bottomley, Cynthia Kwakye, Wendy Houinei, Mathias Bauri, Paul Adwere, Abdul A Abdulai, Fredrick Dua, Laud Boateng, James Wangi, Sally-Ann Ohene, Regina Wangnapi, Shirley V Simpson, Helen Miag, Kennedy K Addo, Laud A Basing, Damien Danavall, Kai H Chi, Allan Pillay, Ronald Ballard, Anthony W Solomon, Cheng Y Chen, Sibauk V Bieb, Yaw Adu-Sarkodie, David C W Mabey, Kingsley Asiedu
BACKGROUND: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. We aimed to determine the efficacy of 20 mg/kg of azithromycin compared with 30 mg/kg azithromycin for the treatment of active and latent yaws. METHODS: We did a non-inferiority, open-label, randomised controlled trial in children aged 6-15 years who were recruited from schools in Ghana and schools and the community in Papua New Guinea...
April 2018: Lancet Global Health
A A Noda, L Grillová, R Lienhard, O Blanco, I Rodríguez, D Šmajs
OBJECTIVES: Bejel, caused by Treponema pallidum subsp. endemicum (TEN), was until now considered as a non-venereal disease endemic in areas with hot and dry climates. This study has identified TEN in clinical samples from Cuban patients previously diagnosed with syphilis. METHODS: We performed sequencing-based molecular typing on 92 samples from Cuban individuals diagnosed with syphilis. Moreover, to differentiate T. pallidum subspecies, multi-locus sequence analysis (MLSA) was designed and was applied to suspicious samples...
February 16, 2018: Clinical Microbiology and Infection
Olivia C Smibert, Adam W J Jenney, Denis W Spelman
Given the long term sequelae of untreated neurosyphilis and insensitive tests to detect treponemes in the cerebrospinal fluid, questions regarding the utility of a lumbar puncture and cerebrospinal fluid analysis either to confirm or exclude neurosyphilis are raised.
February 2018: Internal Medicine Journal
Sarah Heston, Sandra Arnold
Syphilis, caused by Treponema pallidum, is transmitted both sexually and transplacentally. Untreated syphilis is a progressive disease that may result in death or disability in children and adults. Syphilis diagnosis requires 2-stage serologic testing for nontreponemal and treponemal antibodies. Congenital syphilis diagnosis requires careful review of maternal testing and treatment, comparison of maternal and neonatal nontreponemal antibody titers, and clinical evaluation of the neonate. In this review, we present the current epidemiology of syphilis, and the clinical manifestations, diagnosis, and management of syphilis as they relate to pediatric practice, specifically, congenital syphilis and acquired syphilis in adolescents and pregnant women...
March 2018: Infectious Disease Clinics of North America
Ana Iglesias-Plaza, Maribel Iglesias-Sancho, Mónica Quintana-Codina, Javier García-Miguel, Montse Salleras-Redonnet
Inhibitors of tumor necrosis factor-alpha (anti-TNF-alpha) are widely used in different medical specialties. The main adverse effect of these agents is the increased risk of infection. We report the case of a 30-year-old man with ankylosing spondylitis who had begun receiving golimumab two weeks earlier. He presented with a 10-day history of salmon-colored lesions on trunk, palms and soles. The clinical suspicion was secondary syphilis. Treponemal and nontreponemal tests confirmed the diagnosis of syphilis...
February 3, 2018: Reumatología Clinica
Zhong-Shuai Wang, Xiao-Ke Liu, Jun Li
Background: Some syphilitic patients remain in a serologically positive state after the recommended therapy. Although we often retreat patients in clinical practice, the optimal treatment protocol remains uncertain due to the paucity of data regarding serological response to retreatment and long-term outcomes. Methods: We examined rapid plasma reagin serological test results of 70 serofast early syphilis cases who were retreated with 2.4 million units of benzathine penicillin weekly for 3 weeks...
January 31, 2018: Journal of Antimicrobial Chemotherapy
L X Dou, Q Wang, X Y Wang, Y P Qiao, M Su, X Jin, A L Wang
Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management' and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester...
January 6, 2018: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
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