1. Hannah Agyemang Sennye Mpho Maphakela
SYPHILIS IN GHANA
Hannah Agyemang
Sennye Mpho Maphakela

2. Defination and Cause Defination
Syphilis is a chronic systemic disease which can be acquired or congenital.
Cause
It is caused by the spirochaet bacteria called Treponema Pallidum

3. Etiology
Often associated with poverty, prostitution, drug addicts, promiscuity and this is usually referred to as genital syphilis. It can also be passed from mother to child. This is called congenital syphilis.

4. Pathogenesis
This highly infectious disease is usually transmitted from one person to another through sexual contact of all kinds. It can also be transmitted (but less often) by any physical contact and blood transfusion. In order for the bacteria to enter the host, there has to be a lesion in the skin or mucosa.

5. 
Its incubation period is 3 weeks but it can also go up to several months.
When the bacteria enters the host, it goes mainly through 4 stages:
Primary Stage
Secondary Stage
Latent Stage
Tertiary Stage

6. Primary Stage It begins 3 weeks after exposure and lasts for 2-3 weeks
At the site of the infection, there is a formation of the chancre (painless ulceration).
Patients are sometimes unaware because the lesion is located in areas that are not easy to see e.g cervix, urethra e.t.c
There is also some discharge from the lesion that is highly infectious (because it contains bacteria).
After this, the bacteria enters the blood stream and the lymphatics, spreading it to the whole body.

7. Secondary Stage
Skin rash over the whole body except in the face. These are contagious.
There is also loss of hair, fever, malasie (tiredness), joint pain, mild fever and sore throat.
This symptoms go away after a few weeks

8. Latent Stage There are no symptoms
It can lasts for 2-4 years so the patient is no longer infectious except for congenital syphilis, that is, when it is transmitted from mother to child during pregnancy which can lead to deformation, mental retardation and even death of the child.

9. Tertiary Stage Most dangerous stage.
Only half of the untreated cases develop to tertiary stage but most of them just end in latent or before.
Symptoms are mostly in skin and bone.
In the cardiovascular system, it can lead to weakening of aortic wall, in the CNS, there can be loss of motor function and in the brain it can lead to paresis, blindness, seizures e.t.c
It can also destroy organs

10. Diagnosis & Treatment Diagnosis Microscopy- Dark field microscopy
Serum test- detect antibodies
Treatment
Antibiotics (penicillin) for two weeks

11. Prevention Abstain or be monogamous
Patients with infectious syphilis should abstain until they finish their treatment and have been tested negative but if there should be some sexual activity, latex condom must be used and it should cover the lesion or the cancre.
Avoid recreational drugs e.g alcohol and drugs which can cloud your judgement and lead to unsafe sexual practice
Screening of pregnant women

12. 

13. In Ghana..
Syphilis is responsible for an estimated 360,000 foetal and perinatal deaths worldwide. A further 270,000 babies suffer serious permanent defects because of congenital syphilis.
In Ghana, the National HIV/STI Sentinel Surveillance has reported a dramatic increase in mean syphilis seroprevalence from 0.4% in 2003 to 6.5% in 2008, with site prevalence ranging from 0% to 30.5% across 40 clinics involving 18,366 antenatal attenders.
This large increase in maternal syphilis prevalence is worrying and may be due to an unfolding epidemic of venereal syphilis or the resurgence of yaws (endemic syphilis) in parts of Ghana or could have been artificially caused by a recent change in the surveillance testing algorithms.

14. 
Syphilis screening coverage of pregnant women is still very low in antenatal clinics across Ghana. A study of 210 health facilities in the Ashanti Region found that only 3.3% offered routine prenatal syphilis screening.
Reasons for poor implementation may include lack of awareness of the policy among service providers, lack of training and late booking of visits to antenatal clinics.
Education and training, continuity of screening test kit supplies, drugs, supervision and quality control are essential for a successful and sustainable maternal syphilis screening programme.

15. Sources Clinical medicine (Kumar and Clark)
Microbiology: An Introduction (Tortora, Funke, Case)