Resurfacing the Threat of Asymptomatic Syphilis: A Retrospective Analysis of Clinico-epidemiological Trends of Syphilis at a Tertiary Care Centre in Eastern Uttar Pradesh.

BACKGROUND

Syphilis is a bacterial infection caused by Treponema pallidum . In recent years, there has been a rising trend of syphilis noted worldwide, including in India. The aim of this study was to analyze the changing epidemiological patterns, demographic attributes, high-risk behavior, clinical presentations, and stages of syphilis among patients attending the sexually transmitted infections (STI) clinic at a tertiary healthcare facility in eastern Uttar Pradesh over the last 7 years.

PATIENTS AND

METHODS

We conducted a retrospective study spanning 7 years (2017-2023) at a tertiary care center. Demographics and clinical data of all confirmed cases were recorded and analyzed.

RESULTS

Over 7 years, 8,325 patients who attended the STI clinic were included in this study. Among STI clinic attendees, 2.78% tested positive for syphilis, confirmed by either a positive venereal disease research laboratory (VDRL) test along with a positive Treponema pallidum hemagglutination assay (TPHA) test or by TPHA positivity alone, with males representing the majority at 87%. The mean age of patients was 34.80 ± 8.01 years, with most patients falling into the 25-34 years age group. The prevalence of syphilis among STI clinic attendees showed a rising trend from 1.55% in 2017 to 4.05% in 2023, which was statistically significant. High-risk behaviors such as multiple sexual partners (62%) and contact with commercial sex workers (35%) were frequently reported. In our study, 73% of patients were diagnosed in the late latent stage of syphilis, whereas 13% were in the secondary stage, 9% in the early latent phase, and 5% in the primary stage. Additionally, concurrent STIs were observed in 24% of syphilis-positive patients, with genital warts being the most common.

LIMITATIONS: The retrospective nature of the study, and this being a single-center study, are the major limitations of this study.

CONCLUSION

This study shows that syphilis is becoming more common. Risky behaviors, such as engaging in sex with multiple partners or with sex workers, were identified as major contributing factors. There is a need for enhanced educational campaigns on safe sex practices.