Skip to main content
PMC home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1997 Dec;73(6):522–527. doi: 10.1136/sti.73.6.522

Serological markers for treponemal infection in children in rural Kilimanjaro, Tanzania: evidence of syphilis or non-venereal treponematoses?

E Klouman 1, E J Masenga 1, N E Sam 1
PMCID: PMC1195938  PMID: 9582474

Abstract

OBJECTIVE: To determine the seroprevalence of treponemal infection and possible risk factors among children aged 0-14 in the general population of a rural Tanzanian village. METHODS: The survey was conducted as a part of a cross section study of a total village population on HIV and sexually transmitted disease. Among 1708 registered children aged 0-14, the 553 first attending were tested for treponemal infection with both rapid plasma reagin test (RPR) and Treponema pallidum Haemagglutination test (TPHA). These children belonged to a household cohort--also including their parents, siblings, and other household members--with 1339 members; 1224 (91.4% participated in the survey and 82.1% of these were tested for treponemal infection. RESULTS: The overall prevalence for the TPHA test was 6.4% among girls and 1.1% among boys (odds ratio, OR = 6.5; 95% confidence interval, CI: 1.9-22.3). The sex difference was most pronounced in the age group 10-14; 11.1% among girls versus 1.0% among boys (OR = 12.8; CI: 1.6-101.9). Among the 20 children who were TPHA positive, we found two cases of active, congenital syphilis. There was a lack of association between positive serology in children and positive serology in their parents. CONCLUSION: The highly significant predominance of girls testing positive for TPHA, and the concomitant lack of association between parents' and children's serostatus might point to sexual transmission as being the most common route of transmission of treponemal infection in girls during childhood in this village. The sources of infection for the seropositive girls are possibly found outside the family.

Full text

PDF
522

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baribwira C., Muteganya D., Ndihokubwayo J. B., Moreno J. L., Nduwimana M., Rufyikiri T. Un aspect des maladies sexuellement transmissibles chez le jeune enfant au Burundi: les gonococcies secondaires à des sévices sexuels. Med Trop (Mars) 1994;54(3):231–233. [PubMed] [Google Scholar]
  2. Bogaerts J., Lepage P., De Clercq A., Mukeshimana M., Serufilira S., Piot P., Verhaegen J. Shigella and gonococcal vulvovaginitis in prepubertal central African girls. Pediatr Infect Dis J. 1992 Oct;11(10):890–892. doi: 10.1097/00006454-199210000-00018. [DOI] [PubMed] [Google Scholar]
  3. Coovadia Y. M., Karim S. S. A community-based seroprevalence survey of syphilis in black children. Genitourin Med. 1990 Apr;66(2):124–124. doi: 10.1136/sti.66.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Drew R. S. Sexual abuse of children in rural Zimbabwe: a report from Elim Hospital. Trop Doct. 1994 Apr;24(2):81–81. doi: 10.1177/004947559402400214. [DOI] [PubMed] [Google Scholar]
  5. Duncan M. E., Tibaux G., Pelzer A., Mehari L., Peutherer J., Young H., Jamil Y., Darougar S., Piot P., Roggén E. Teenage obstetric and gynaecological problems in an African city. Cent Afr J Med. 1994 Sep;40(9):234–244. [PubMed] [Google Scholar]
  6. Duncan M. E., Tibaux G., Pelzer A., Reimann K., Peutherer J. F., Simmonds P., Young H., Jamil Y., Daroughar S. First coitus before menarche and risk of sexually transmitted disease. Lancet. 1990 Feb 10;335(8685):338–340. doi: 10.1016/0140-6736(90)90617-e. [DOI] [PubMed] [Google Scholar]
  7. Ekweozor C. C., Adeyemi-Doro F. A., Ashiru J. O., Osoba A. O. Anogenital warts in patients attending the sexually transmitted diseases clinic in Ibadan, Nigeria. Afr J Med Med Sci. 1994 Dec;23(4):311–314. [PubMed] [Google Scholar]
  8. Engelkens H. J., Judanarso J., Oranje A. P., Vuzevski V. D., Niemel P. L., van der Sluis J. J., Stolz E. Endemic treponematoses. Part I. Yaws. Int J Dermatol. 1991 Feb;30(2):77–83. doi: 10.1111/j.1365-4362.1991.tb04215.x. [DOI] [PubMed] [Google Scholar]
  9. Engelkens H. J., Niemel P. L., van der Sluis J. J., Meheus A., Stolz E. Endemic treponematoses. Part II. Pinta and endemic syphilis. Int J Dermatol. 1991 Apr;30(4):231–238. doi: 10.1111/j.1365-4362.1991.tb04626.x. [DOI] [PubMed] [Google Scholar]
  10. Greenwood A. M., D'Alessandro U., Sisay F., Greenwood B. M. Treponemal infection and the outcome of pregnancy in a rural area of The Gambia, west Africa. J Infect Dis. 1992 Oct;166(4):842–846. doi: 10.1093/infdis/166.4.842. [DOI] [PubMed] [Google Scholar]
  11. Haffejee I. E. Sexual abuse of Indian (Asian) children in South Africa: first report in a community undergoing cultural change. Child Abuse Negl. 1991;15(1-2):147–151. doi: 10.1016/0145-2134(91)90099-y. [DOI] [PubMed] [Google Scholar]
  12. Howard P. A., Marumo L. P., Coetzee D. J. Child abuse in Alexandra. A clinic-based study and a community programme. S Afr Med J. 1991 Oct 19;80(8):393–396. [PubMed] [Google Scholar]
  13. Ismail S. O., Ahmed H. J., Jama M. A., Omer K., Omer F. M., Brundin M., Olofsson M. B., Grillner L., Bygdeman S. Syphilis, gonorrhoea and genital chlamydial infection in a Somali village. Genitourin Med. 1990 Apr;66(2):70–75. doi: 10.1136/sti.66.2.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Jaffe A. M., Roux P. Sexual abuse of children--a hospital-based study. S Afr Med J. 1988 Jul 16;74(2):65–67. [PubMed] [Google Scholar]
  15. Klouman E., Masenga E. J., Klepp K. I., Sam N. E., Nkya W., Nkya C. HIV and reproductive tract infections in a total village population in rural Kilimanjaro, Tanzania: women at increased risk. J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Feb 1;14(2):163–168. doi: 10.1097/00042560-199702010-00010. [DOI] [PubMed] [Google Scholar]
  16. Meheus A., Antal G. M. The endemic treponematoses: not yet eradicated. World Health Stat Q. 1992;45(2-3):228–237. [PubMed] [Google Scholar]
  17. Nduati R. W., Muita J. W. Sexual abuse of children as seen at Kenyatta National Hospital. East Afr Med J. 1992 Jul;69(7):350–354. [PubMed] [Google Scholar]
  18. Noordhoek G. T., Cockayne A., Schouls L. M., Meloen R. H., Stolz E., van Embden J. D. A new attempt to distinguish serologically the subspecies of Treponema pallidum causing syphilis and yaws. J Clin Microbiol. 1990 Jul;28(7):1600–1607. doi: 10.1128/jcm.28.7.1600-1607.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Odugbemi T., Onile B. A. Pediatric gonorrhea: is it receiving adequate attention? Am J Reprod Immunol Microbiol. 1988 Sep;18(1):32–34. doi: 10.1111/j.1600-0897.1988.tb00230.x. [DOI] [PubMed] [Google Scholar]
  20. Richens J. Sexually transmitted diseases in children in developing countries. Genitourin Med. 1994 Aug;70(4):278–283. doi: 10.1136/sti.70.4.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Schrijvers D., Josse R., Trebucq A., Dupont A., Cheringou H., Larouzé B. Transmission of syphilis between sexual partners in Gabon. Genitourin Med. 1989 Apr;65(2):84–85. doi: 10.1136/sti.65.2.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Sehgal V. N., Jain S., Bhattacharya S. N., Thappa D. M. Yaws control/eradication. Int J Dermatol. 1994 Jan;33(1):16–20. doi: 10.1111/j.1365-4362.1994.tb01485.x. [DOI] [PubMed] [Google Scholar]
  23. Westcott D. L. Sexual abuse of children. A hospital-based study. S Afr Med J. 1984 Jun 2;65(22):895–897. [PubMed] [Google Scholar]
  24. van Niekerk C. H., van Niekerk L. C., van den Ende J. Positiewe serologiese toetse vir sifilis by swart laerskoolkinders van Bloemfontein. 'n Loodsstudie. S Afr Med J. 1985 Jan 19;67(3):90–91. [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES