The child with syphilis. Credit: Monica Chaudhary
A 13-year-old boy reported to a Delhi hospital's ENT ward complaining of a hole in his mouth's hard palate which had been slowly enlarging. He was having difficulty in eating and nasal speech. The mother had a history of treatment for a genital lesion two years before the birth of the boy. The patient himself, however, had no history of any trauma, sexual assault, child abuse or drug abuse.
It is estimated that in women with syphilis of a few years duration, about half of the pregnancies are affected. One half of the affected pregnancies end in stillbirth and the other die around childbirth or due to serious post-birth infection (congenital syphilis).
"Congenital syphilis represents a significant financial and emotional burden in developing countries. Even one case of congenital syphilis is a sentinel public health event, since timely diagnosis and treatment of syphilis infected pregnant woman prevents transmission almost entirely," says lead researcher Monica Chaudhary of New Delhi's Maulana Azad Medical College.
Although the rate of congenital syphilis is declining in developed countries, a significant increase has been seen in underdeveloped countries in spite of the widespread use of penicillin since early 1950s.
The procedure to prevent congenital syphilis through antenatal screening and treatment is well established. But implementation of effective programmes has proved very difficult, especially in poor countries. "India's Prevention of Mother to Child Transmission Programme to arrest HIV transmission has been scaled up in antenatal clinics. This is an opportunity to promote early attendance and routine testing for syphilis and HIV," Chaudhary emphasises.
