Dr. Aishat Bello-Taslim, a registrar in the Department of Family Medicine at the Federal Medical Centre in Ebute Metta, Lagos, discusses syphilis, including its transmission, symptoms, and treatment in an interview with Alexander Okere. Syphilis is a bacterial infection primarily spread through sexual contact, caused by the bacterium Treponema pallidum. The infection can be transmitted through direct contact with syphilitic sores, which may appear on the penis, vagina, anus, rectum, and even the lips or mouth. Additionally, pregnant women with syphilis can pass the infection to their unborn children, a condition known as congenital syphilis.
The prevalence of syphilis in Nigeria remains unclear due to a lack of reliable statistics, but it is recognized as one of the most common sexually transmitted infections in the country. A pregnant mother can transmit the infection to her child through the placenta or during delivery if the baby comes into contact with a syphilitic sore. Syphilis can significantly impact pregnancy, leading to complications such as miscarriage, premature birth, low birth weight, and stillbirth. Babies born with congenital syphilis may initially show no symptoms but can develop serious health issues as they grow, including low blood levels, bone damage, enlarged liver and spleen, jaundice, skin rashes, and nerve problems that may cause blindness or deafness.
There is a strong connection between untreated syphilis and infertility in both men and women. In men, the infection can damage the epididymis and urethra, leading to infertility. In women, untreated syphilis can cause inflammation and scarring in the fallopian tubes and other reproductive organs, making it difficult for sperm to reach an egg. Syphilis is more common in men, particularly among those engaging in risky sexual behaviors, such as gay and bisexual men. These behaviors can lead to small injuries on the penis, increasing the risk of contracting the disease from asymptomatic infected individuals.
Syphilis occurs in four stages, each with distinct signs and symptoms. The primary stage is characterized by a round, firm, and painless sore, known as a chancre, which typically lasts three to six weeks. The secondary stage presents with a rash that does not itch, often found on the palms of the hands or the soles of the feet, along with symptoms like fatigue, muscle aches, fever, headache, weight loss, and swollen lymph nodes. The latent stage, or hidden stage, shows no visible symptoms and can last from one year to as long as 20 years. The tertiary stage is the most severe, potentially affecting various organs and systems, leading to serious complications such as cardiovascular syphilis and neurosyphilis.
The secondary stage of syphilis can often be mistaken for other skin conditions, such as psoriasis, due to its rash. The tertiary stage is life-threatening because it can cause significant damage to internal organs, leading to complications like hearing loss, memory loss, and severe neurological issues. Ocular syphilis can occur at this stage, potentially causing blindness when the bacteria affect the nerves supplying the eye.
Individuals who suspect they may have syphilis should seek medical attention for testing and treatment. Testing can involve screening for antibodies linked to syphilis infection or diagnostic blood tests to identify the bacteria. Treatment for all stages of syphilis typically involves intravenous antibiotics, specifically penicillin. Alternative antibiotics may be prescribed for those allergic to penicillin, but treatment cannot reverse damage caused by untreated syphilis.
Patients receiving treatment should avoid sexual contact for at least ten days after treatment and until all sores have healed, as condoms do not provide complete protection against syphilis. While some individuals may turn to herbal remedies for treatment, it is crucial to understand that syphilis is a bacterial infection that requires antibiotics. Misuse of herbal treatments can lead to further health complications.
There are many myths surrounding syphilis, including misconceptions about its causes and treatment. Some individuals may mistakenly believe that their symptoms are due to spiritual attacks or other non-medical issues, leading them to seek inappropriate treatments. It is essential for those suspecting syphilis to avoid purchasing antibiotics over the counter, as proper medical supervision is necessary to monitor for adverse effects and prevent antibiotic resistance.
Preventing syphilis involves understanding that having the infection once does not provide immunity against future infections. There are currently no vaccines available for syphilis, so prevention strategies include practicing abstinence, maintaining monogamous relationships, using condoms correctly, and getting tested regularly for sexually transmitted infections, especially for those at higher risk, such as pregnant women and individuals with multiple sexual partners.
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