Syphilis in pregnant women in Zambia

Because of the high incidence of congenital syphilis at the University Teaching Hospital, Lusaka, Zambia, the potential risks of congenital infection and fetal loss due to syphilis were assessed by screening 202 antenatal patients, 340 pregnant women admitted to the hospital whose pregnancies ended in either spontaneous abortion or stillbirth, and 469 consecutive babies delivered at the hospital. Primary serological screening was performed with the rapid plasma reagin test, and reactive sera were confirmed by the Treponema pallidum haemagglutination test. In all cases detailed histories were obtained and patients were examined for clinical signs of syphilis. The TPHA test result was reactive in 12.5% of antenatal patients and in 42% of women who aborted in the later half of pregnancy. Among 469 consecutive babies delivered at the hospital, 30 had reactive results to the TPHA test; of these two were stillborn and four had signs of congenital syphilis at birth. Thus, syphilis appears to affect adversely an appreciably high number of pregnant women in Zambia. For this reason a special campaign to screen adequately and treat pregnant women and neonates is needed.     

Syphilis in pregnant women in Mozambique.

To establish the prevalence of syphilis in pregnant women in Mozambique and evaluate present diagnostic methods, 1468 pregnant women in eight of the country's 10 provinces were examined using the Venereal Disease Research Laboratory (VDRL) test. Positive serum samples were also analysed using the Treponema pallidum haemagglutination (TPHA) assay and one group was also analysed using the fluorescent treponemal antibody absorbed (FTA-ABS) test. The prevalence of VDRL seroreactivity was found to be between 4.5% and 14.6%, whereas the prevalence of treponemal disease as verified by TPHA or FTA-ABS tests was between 1.6% and 9.8%. It is concluded that syphilis is relatively common among pregnant women in Mozambique. The predictive value of a positive VDRL test, when adequately performed, was     

Syphilis seroprevalence among pregnant women and its role as a risk factor for stillbirth in Maputo, Mozambique.

OBJECTIVE: To elucidate the role of current syphilis as a risk factor for foetal death. METHODS: Sera were obtained from 57 women with third trimester foetal death (cases) and 58 women with foetus alive (controls) matched for age and parity. All sera reactive in qualitative Rapid Plasma Reagin (RPR) analyses were tested with serial twofold dilutions to determine endpoint flocculation titres and tested with the micro-haemagglutination assay for Treponema pallidum (MHA-TP). Placental biopsies were sectioned and stained by haematoxylin-eosin and Warthin-Starry for light microscopy. SETTING: Central Hospital, in Maputo, Mozambique, from January 1990 to June 1991. RESULTS: The MHA-TP was reactive in 42% of cases and in 12% of controls (OR = 5.3; 95% CI: 1.9-15.4). The RPR card test was reactive at the dilution of 1.32 or greater in 28% of cases and in 7% of controls. All these results were confirmed by MHA-TP (OR = 5.3; 95% CI: 1.5-15.4). In 9/28 (32%) MHA-TP seroreactive women (7 cases and 2 controls) placental morphological changes indicated syphilitic infection. CONCLUSION: MHA-TP seroreactivity and high titre RPR were associated with stillbirth. Morphological changes presumptive of syphilis infection were found in 32% placentas histologically studied. Syphilis is a risk factor for foetal death in Maputo, Mozambique.     

广州市番禺区1074例孕妇梅毒感染情况及危险因素调查

目的:探讨广州市番禺区孕妇梅毒的高危因素,为进一步做好梅毒的预防和控制提供科学依据。方法:对广州市番禺区何贤纪念医院首次就诊的孕妇进行梅毒实验室检测和问卷调查。结果:共对1 074例孕妇进行梅毒血清检测和相关调查,梅毒阳性率为1.12%(12/1074)(95%CI为0.41%~1.62%)。Logistic回归分析结果显示,孕妇感染梅毒的危险因素为孕后性行为时未使用安全套[OR=0.075,95%CI:(0.024,0.237)]和性伴患有梅毒[OR=65.875,95%CI:(16.454,263.744)]。结论:广州市番禺区孕妇梅毒感染率较高,应及时对孕妇开展梅毒筛查,针对危险因素采取有效的干预措施。     

Syphilis screening and intervention in 500,000 pregnant women in Shenzhen, the People's Republic of China

OBJECTIVES: To understand the disease epidemiology of syphilis in pregnant women, and to evaluate the effectiveness of the screening and intervention programme, for the purpose of controlling mother-to-child syphilis transmission in Shenzhen, in the People's Republic of China (PRC). METHODS: At the Shenzhen Center for Disease Control and Prevention (SZCDC), we used the toluidine red unheated serum test (TRUST) for the primary screening of pregnant women, and confirmed positive results with the Treponema pallidum particle agglutination (TPPA) test. We informed and treated those with positive results. For the women who chose to proceed with the pregnancy, we clinically screened their babies for congenital syphilis using the 19S-IgM FTA-Abs test. RESULTS: Between 1 July 2002 and 31 December 2005, we screened 477,656 pregnant women for syphilis, of whom 2208 (0.5%) tested positive. From 2003 to 2005, we collected epidemiological and treatment data from 2019 positive syphilis cases. Of these, 1855 (91.9%) of the pregnant women received treatment. Among the 1020 infants born to these women, 92 (9.0%) were confirmed to have congenital syphilis. If we exclude the mothers who had syphilis positive babies without undergoing prenatal screening, the project's success rate for mother-to-child transmission intervention was 99.1%. CONCLUSIONS: After four years of implementation, we proved the programme to be successful in preventing mother-to-child syphilis transmission. Further work should be done to ensure the earlier screening and treatment of pregnant women.     

Correlates of syphilis seroreactivity among pregnant women: the HIVNET 024 Trial in Malawi, Tanzania, and Zambia

OBJECTIVES: The objectives of this cross-sectional study were to determine correlates of syphilis seroprevalence among HIV-infected and -uninfected antenatal attendees in an African multisite clinical trial, and to improve strategies for maternal syphilis prevention. RESULTS: A total of 2,270 (86%) women were HIV-infected and 366 (14%) were HIV-uninfected. One hundred seventy-five (6.6%) were syphilis-seropositive (7.3% among HIV-infected and 2.6% HIV-uninfected women). Statistically significant correlates included geographic site (odds ratio [OR] = 4.5, Blantyre; OR = 3.2, Lilongwe; OR = 9.0, Lusaka vs. Dar es Salaam referent); HIV infection (OR = 3.3); age 20 to 24 years (OR = 2.5); being divorced, widowed, or separated (OR = 2.9); genital ulcer treatment in the last year (OR = 2.9); history of stillbirth (OR = 2.8, one stillbirth; OR = 4.3, 2-5 stillbirths); and history of preterm delivery (OR = 2.7, one preterm delivery). CONCLUSION: Many women without identified risk factors were syphilis-seropositive. Younger HIV-infected women were at highest risk. Universal integrated antenatal HIV and syphilis screening and treatment is essential in sub-Saharan African settings.     

Herpes in pregnant women

The course of herpes in 3 pregnancies is described. Characteristic efflorescence emerged during pregnancy; clinical manifestations disappeared 1-2 weeks after the disease resolution. The time of efflorescence was different in each pregnancy. Diaminodiohenylsulfon therapy was fairly effective.     

Atopic dermatitis in pregnant women

Thirty-six patients with atopic dermatitis exacerbating during pregnancy are described. Case histories, the disease course, and the earlier therapy for this condition are analyzed, and the treatment administered to these patients with due consideration for the pregnancy dates is described. Recommendations on the follow-up of pregnant patients with atopic dermatitis are given.     

Syphilis in women of reproductive age in Mogadishu, Somalia: serological survey.

In Mogadishu, Somalia 223 women of childbearing age, including prostitutes, were tested for serum markers for syphilis by the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum haemagglutination assay (TPHA). Sera reactive in either of these tests were tested for IgM antibodies by solid phase haemadsorption assay (SPHA). Three per cent of sera from 67 pregnant women and none of those from 71 educated women gave positive results that were confirmed with the TPHA. In contrast, 58% of sera from 85 prostitutes were confirmed as being positive, 26% of which were SPHA positive, which indicated active syphilis. The proportion of TPHA positive sera increased with age among the prostitutes. As venereal syphilis is highly prevalent in prostitutes in Mogadishu, a strategy of intervention based on screening followed by treatment seems to be indispensable.     

妊娠妇女银屑病治疗的研究进展

妊娠妇女银屑病的治疗与普通人群银屑病的治疗不同,不仅要考虑治疗方法的有效性,还应尽量避免对孕妇及胎儿产生的不良影响。目前,关于妊娠妇女银屑病的治疗主要有局部疗法、光疗法和系统疗法,尚无统一规范。首选局部疗法,外用糖皮质激素类药物被认为是一线疗法;光疗法中最常用的是中波紫外线;系统用药如维A酸类药物、糖皮质激素、免疫抑制剂及生物制剂,但可能对妊娠妇女自身产生不良影响,也可能导致胎儿宫内发育迟缓、畸胎、低出生体重儿等不良反应,因此,妊娠妇女的银屑病应慎用系统疗法。     

Syphilis. Symptomatologie

Ohne Zusammenfassung     

Syphilis. Therapie

Ohne Zusammenfassung     

Syphilis. Symptomatologie

Ohne Zusammenfassung     

Syphilis. Symptomatologie

Ohne Zusammenfassung     

Syphilis. Therapie

Ohne Zusammenfassung