Infectious Disease- Syphilis
Activity Learning Outcomes
Through this assessment, the student will meet the following Course Outcomes.
Identify appropriate outcome measures and study designs applicable to epidemiological sub-fields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics. (CO3)
Identify important sources of epidemiological data. (CO6)
Syphilis is among the world’s highly contagious communicable diseases. The disease is caused by the bacterium Treponema pallidum (Satyaputra et al., 2021). Syphilis is majorly transmitted through sexual contact through the vagina, the anus, or through the mouth (World Health Organization, 2023). Besides transmission through sexual contact, it can also be transmitted from mother to child during pregnancy and the time of delivery.
Syphilis develops from primary syphilis, secondary syphilis, and latent syphilis to tertiary syphilis (Satyaputra et al., 2021). Symptoms vary with the stage of progression. Primary syphilis is majorly manifested by painless canker sores or ulcers. The ulcer mainly develops at the site of infection, such as on the shaft of the penis, inside the vagina, or the rectum. The symptoms may be hard to notice and disappear. However, the infection remains active and progresses to secondary syphilis. The main symptoms of secondary syphilis include the appearance of a rash on any part of the body, such as around the vagina, anus, penis, hands or legs, a sore throat, painful swollen lymph nodes, and a persistent fever. Untreated syphilis then progresses to the latent stage. The latent stage of syphilis progression occurs over two years of untreated syphilis, and all of the previously manifested symptoms may disappear for years (Satyaputra et al., 2021). Syphilis then progresses to the tertiary stage, which is characterized by various multisystem complications that impact the patient’s daily living.
Untreated syphilis risks serious complications, including risks of heart and brain damage (World Health Organization, 2023). As a multisystem infection, syphilis affects other body organs, such as damage to the eyes, bones, liver, and critical organs, making it a life-threatening disease. Additionally, untreated maternal syphilis is linked to adverse birth outcomes (ABOs), including estimated stillbirths, preterm deliveries, low neonatal weight and deaths, and infected newborns (World Health Organization, 2023).
Syphilis, as a bacteria-caused STI, is treatable using antibiotics. The major treatment option is the use of Benzathine penicillin. However, the dosage varies based on the stage in the progression of syphilis (Satyaputra et al., 2021).
In the United States, syphilis incidence rates, prevalence, morbidity, and mortality vary across demographics. Prevalence is high among young adults between 20 to 29 years. Over six million cases of syphilis are reported annually across the population aged between 15 and 49 years (Satyaputra et al., 2021). Reported cases rose from 101,590 in 2017 to 171,074 in 2022 (Centers for Disease Control and Prevention (CDC), 2022). Data on syphilis incidences and prevalence from 2017 to 2021 showed that men were more affected by syphilis as compared to women (Centers for Disease Control and Prevention (CDC), 2022). Notably, 2019 data also shows that people of African American descent were at a higher risk of having syphilis than Whites. Although syphilis increases the risk of comorbid infections and complications, it is treatable and thus has a low mortality rate. Only 22 deaths were reported in the U.S. in 2019 (Centers for Disease Control and Prevention (CDC), 2022).
The HP2020 identifies various determinants of health for STIs. Syphilis is among the areas of focus in the prevention of STIs. The social determinants of health-related to syphilis, as per the HP2020, include the socioeconomic status of an individual, behavioral factors, lifestyle factors, the individual’s environment, and biology.
Having a lower socioeconomic status, such as a low level of education and living in poverty, increases the risk of developing syphilis as it determines access to care and a living environment. Engaging in risky behaviours and lifestyles, such as the use of drugs and unprotected sex with multiple sex partners, increases the risk of syphilis (Tapp & Hudson, 2020).
Social determinants related to the environment focus on the individual’s living environment. This is from the housing factors to the region of residence. Living in regions with high prevalence rates for syphilis increases the risk of contracting the STI, as observed in the current global trends (Ghanem et al., 2020).
An individual’s biological factors, such as genetics and immunity, can increase their risk of getting infected with STIs such as syphilis. Additionally, the accessibility and quality of available care is also a major determinant of health concerning syphilis. Improved acces