KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

Prevalence of Syphilis andCo-infection with HIV and Syphilis13.1 KEY FINDINGS• The prevalence of syphilis seropositivity in Kenya was 1.8%.• Prevalence was similar between women (1.7%) and men (1.9%), except amongadults aged 50-64 years, among whom the higher prevalence for men comparedto women was marginally significant (4.4% vs. 2.5%).• Syphilis seropositivity significantly increased with numbers of lifetime sexualpartners and was significantly higher in uncircumcised than circumcised men.• Among participants who were seropositive for syphilis, 16.9% also had HIV,71.5% had HSV-2 and 15.9% had both HIV and HSV-2.• Syphilis seropositivity was signifincantly higher among HIV-infected than HIVuninfectedadults.13.2 INTRODUCTIONThe 2007 KAIS is the first national seroprevalence survey of syphilis in Kenya. Syphilis is asexually transmitted infection (STI) caused by the bacterium Treponema pallidum and is a commoncause of genital ulcer disease in many countries. Syphilis causes three stages of symptomaticdisease: primary syphilis, characterised by an ulcer at the site of infection; secondary syphilis,characterised by a generalised rash and fever; and tertiary syphilis characterised by neurological,cardiovascular and other potentially life‐threatening and severely disabling systemic signs andsymptoms, including joint degeneration. Time between secondary syphilis and the appearance oftertiary syphilis can be two or more decades, and is referred to as latent syphilis. Syphilis is mosttransmissible in the primary and secondary stages, but pregnant women can transmit theinfection to the fetus at any point, causing congenital syphilis. Syphilis is easily curable withpenicillin, although not all damage is reversible, especially in congenital and tertiary syphilis.Like HSV‐2, syphilis has been associated with an increased risk of acquiring and transmittingHIV, most likely through genital ulcers. HIV‐infected individuals co‐infected with syphilis areKAIS 2007 228