Syphilis Markers Research Articles

Uncommon Neurosyphilis: Subacute Meningomyelitis with Distinctive “Candle Guttering Appearance”

AbstractIn this article, we presented an exceedingly rare clinical case of neurosyphilis, radiological revealed a distinctive “candle guttering appearance.” Posttreatment for syphilis, both clinical symptoms and radiological markers showed complete resolution.

Social and individual vulnerability factors associated with syphilis among populations living on islands in the Brazilian Amazon.

The repercussions of the syphilis epidemic differ according to populations. Identifying and acknowledging the differences and specificities of populations is fundamental in the design and implementation of policies aimed at assisting the groups most vulnerable to syphilis. To estimate the prevalence of antibodies against Treponema pallidum and associated vulnerability factors among riverside populations of a capital city in the Brazilian Amazon. Cross-sectional study was conducted among residents of the periurban islands in Belém, northern Brazil, from August 2020 to January 2021. The inclusion criterion was being a resident of the riverside communities of the Combú Environmental Protection Area, aged 18years or over. The participants responded to questionnaire and were tested for syphilis using rapid test. Data were analyzed using multiple logistic regression by Minitab version 20® software. Overall, a total of 325 riverine were included. Age varied from 18 to 91years (average 40years). Prevalence of markers for syphilis was 5.9% (95%CI: 3.3%-8.4%). The multiple regression showed that as age increases, the chances of having syphilis also increase (p = 0.001; aOR: 1.04) and riverside dwellers with more than one sexual partner in the last 6months had more than four chances of having syphilis compared to people who had only one sexual partner (p = 0.007; aOR: 4.20). Syphilis circulates among traditional populations in the Amazon and is associated with factors of social and individual vulnerability.

Seroprevalence of Transfusion-Transmissible Infections among Family Replacement Donors and Voluntary Non-Remunerated Blood Donors During the COVID-19 Pandemic in Sub Saharan Africa.

Introduction : According to WHO, regular, voluntary, unpaid blood donors are the safest group of donors, as they have the lowest prevalence of blood transmitted infections. However, family/replacement blood donors is widely used in sub Saharan Africa and this practice was exacerbated during the COVID 19 pandemic. This study aimed to compare the seroprevalence of infectious markers in family replacement blood donors and voluntary non-remunerated blood donors during the COVID 19 pandemic in a country of sub Saharan Africa. 
 Materials and Methods
 Blood donors received at the National Centre of Blood Transfusion (NBTC) of Dakar from August 1st to October 31th 2021, were included in this study. All donors completed a pre-donation questionnaire. Donors identity, epidemiological parameters, reasons for donation and laboratory results were collected in the Inlog® software of the NBTC. The serological tests for HBV, HIV and HCV were performed with chemiluminescence technology. The Rapid Plasma Reagent test was used to find out treponemal antibodies. The determination of ABO and Rh blood groups was performed using monoclonal antisera following classical hemagglutination test on a plate.
 Results
 A total of 5002 donors were collected during this COVID-19 pandemic period. Blood family/replacement donors represented 54.0% and new voluntary donors represented 52.6%. Comparison of HIV, HCV and syphilis markers seroprevalence showed no statistically significant difference between new voluntary donors and new family replacement donors (p>0.05). However, for HBV the seroprevalence was significantly higher in new family replacement donors (p=0,002).
 Conclusion 
 The proper supply of blood was impacted by the COVID-19 pandemic meanwhile replacement donations had contributed to limiting the damage observed with blood shortages. However, the significant differences noted on the seroprevalences of transfusion-transmissible infections between voluntary non-paid donors and family/replacement donors strengthens WHO recommendations for the selection of volunteer non-paid donors to lower transfusion-transmissible HBV in sub Saharan Africa.
 
 
 
 
 
 
 
 

Anti-Treponema pallidum IgA response as a potential diagnostic marker of syphilis

ObjectivesSerological tests for syphilis detect mainly total Ig, IgM or IgG antibodies. We aimed to evaluate the specific IgA response in syphilis patients according to disease stage. MethodsA serum IgA-enzyme immunoassay was developed using commercially available microplates coated with recombinant treponemal antigens and an anti-IgA-conjugate. To define a cut-off, we used 91 syphilis positive and 136 negative sera previously defined by the rapid plasma reagin and the Treponema pallidum particle agglutination results. Then we determined the intra- and inter-assay precisions, diagnostic sensitivity according to the clinical stage (in 66, 55 and 42 sera from primary, secondary and latent syphilis patients, respectively) and specificity (in 211 sera from people with conditions different to syphilis). IgA values were further measured in 71 sera from patients with previously treated syphilis. ResultsThe newly developed IgA-enzyme immunoassay showed a good discrimination between negative and positive samples with intra- and inter-assay variation coefficients <20%. The sensitivity was 80.3% (95% CI, 70.0–90.6), 100.0% (95% CI, 99.1–100.0) and 95.2% (95% CI, 87.6–100.0) in primary, secondary and latent syphilis, respectively, and the specificity was 98.1% (95% CI, 96.0–100.0). Further, IgA values were negative in 61.3% (38/62) of patients with previously treated syphilis. DiscussionOur findings suggest serum IgA as a sensitive and specific marker of syphilis and its detection could be used as a screening assay for active infection. Further evaluation is needed in prospective longitudinal field studies.

Identification of potential biomarkers for diagnosis of syphilis from the cerebrospinal fluid based on untargeted metabolomic analysis.

The infection rate of syphilis continues to rise globally, and the difficulty in diagnosis of neurosyphilis promptly needs to be resolved. More specific and sensitive diagnostic markers for latent syphilis and neurosyphilis should be found. Here the metabolic profiles of 88 cerebrospinal fluid samples from syphilis patients and controls were analyzed by LC/MS-based untargeted metabolomics. In total, 272 metabolites based on 3937 features obtained in ESI- mode and 252 metabolites based on 3799 features in ESI+ mode were identified. The experimental process was evaluated by principal component analysis, partial least squares discriminant analysis, and hierarchical cluster analysis. A clear separation between latent syphilis and neurosyphilis was found. Levels of lipid and linoleic acid metabolites, such as 9-oxo-octadecadienoic acid and 9,10,13-trihydroxyoctadecenoic acid, were increased in syphilis patients. In patients with neurosyphilis, significant changes in levels of 5-hydroxy-L-tryptophan (5-HTP) and acetyl-N-formyl-5-methoxykynurenamine (AFMK) in the tryptophan-kynurenine pathway were also detected. Only one metabolite, theophylline, differed significantly between symptomatic and asymptomatic neurosyphilis patients. Additionally, KEGG analysis revealed significant enrichment of tryptophan metabolism pathways, indicating a high correlation between tryptophan metabolism and syphilis symptoms. Levels of linoleic acid metabolites, 5-HTP, AFMK and theophylline were significantly altered in different patients. The role of these differential metabolites in the development of syphilis is worthy of further exploration. Our results may promote the development of biomarkers for diagnosis of latent syphilis from neurosyphilis, and for that of asymptomatic neurosyphilis from symptomatic neurosyphilis in the future.

Five-year experience in providing infectious safety of donor blood and its components gained by the blood center of the RT Federal medical-biological agency

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p &lt; 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p &lt; 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p &lt; 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p &lt; 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

Пятилетний опыт обеспечения инфекционной безопасности донорской крови и ее компонентов ФГБУЗ центра крови ФМБА России

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p &lt; 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p &lt; 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p &lt; 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p &lt; 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

A rare case of unilateral acute posterior multifocal placoid pigment epitheliopathy with features of Vogt-Koyanagi-Harada disease

The purpose of this study is to report a rare case of unilateral acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with features of Vogt-Koyanagi-Harada (VKH) disease. Both the diseases have their own unique presentations and can lead to vision loss in the affected eye. Overlapping features of both diseases in the same eye is rare. A 28-year-old healthy female presented with loss of vision in her right eye for 10 days duration. Visual acuity in the affected eye was 20/200, N36. Fundus examination revealed numerous creamy yellow lesions overlying the posterior pole with subretinal fluid. Further investigations including fundus fluorescein angiography and optical coherence tomography were suggestive of overlapping features of both APMPPE and VKH disease. Baseline laboratory investigations and markers for Sarcoidosis, Tuberculosis, and Syphilis were normal. The patient was treated with tapering doses of oral steroids. One month following initiation of treatment, the vision had improved to 20/20, N6 with complete resolution of subretinal fluid in the right eye. The overlapping clinical and imaging features suggest that both diseases may be a part of a common inflammatory process that secondarily damages the outer retinal structures.

Prevalence of infection markers and associated factors in donors of a peruvian blood bank

We aimed to determine the prevalence of infection markers in donors of a Peruvian blood bank and to assess whether donor sociodemographic variables are associated with the presence of these markers. An analytical cross-sectional study was carried out in 5942 donors of a blood bank, whose data was collected during 2018. Positivity to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and HTLV I-II was determined, in addition to syphilis and Chagas disease. The prevalence of HIV was 0.81%; for HBV it was 6.19%; for HCV, 0.12%; for HTLV I-II, 0.66%; for Chagas disease, 2.76% and for syphilis it was 1.73%. Several sociodemographic factors were associated with infection markers positivity. The predominant donation type was non-voluntary (96%) and 53% had history of previous donation. The prevalence of infection markers for HIV, HBV, Chagas disease and syphilis in blood donors was high compared to other countries in the region.

Evaluation of the nontreponemal IgM antibodies in syphilis serofast patients: A new serologic marker for active syphilis

BackgroundSerofast status is challenging to interpret in clinical work, and distinguishing active syphilis in serofast patients can provide a reference for clinical diagnosis and treatment. However, effective serologic markers for active syphilis are still lacking. ObjectivesWe aimed to explore the possibility of nontreponemal IgM antibodies in distinguishing active syphilis in serofast patients. MethodsA total of 1501 clinical serum samples were collected from 301 serofast patients, and nontreponemal IgM antibodies were detected by chemiluminescence immunoassay. ResultsThe results showed that a total of 29 samples (9.63%) of 301 serofast patients were positive for nontreponemal IgM antibodies, and our limited follow-up data showed that 66.67% (2/3) of the serofast patients progressed to neurosyphilis and cardiovascular syphilis. ConclusionThese findings demonstrate that most serofast patients with positive nontreponemal IgM antibodies have evidence of progressive syphilis, and nontreponemal IgM antibodies can be used as a new serologic marker for the activity of syphilis. Nontreponemal IgM antibodies may play a role in the management of serofast patients.

Evaluation of the Seroprevalence of Infectious Diseases in 2,445 in vitro Fertilization Cycles.

To evaluate the seroprevalence of positive markers for syphilis, human immunodeficiency virus (HIV) I and II, human T cell lymphotropic virus (HTLV) I and II, and hepatitis B and C among women undergoing in vitro fertilization (IVF). We conducted a retrospective analysis among patients who underwent IVF, between January 2013 and February 2016, and who had complete screening records. We analyzed 1,008 patients who underwent IVF, amounting to 2,445 cycles. Two patients (0.2%) tested positive for HIV I and II and none for HTLV I and II. Three patients (0.3%) had positive screening for syphilis, and two (0.2%) had positive hepatitis C antibody test (anti-HCV). A positive hepatitis B virus surface antigen (HbsAg) test was observed in 4 patients (0.4%), while 47 (4.7%) patients were positive for IgG antibody to hepatitis B core antigen (anti-HbC IgG), and only 1 (0.1%) was positive for IgM antibody to hepatitis B core antigen (anti-HbC IgM). The anti-HbS test was negative in 659 patients (65.3%). Only 34.7% of the patients had immunity against the Hepatitis B virus. Patients with an anti-HbS negative result were older than those with a hepatitis B test (anti-HbS) positive result (36.3 versus 34.9; p < 0.001). The present study showed lower infection rates than the Brazilian ones for the diseases studied in patients undergoing IVF. Only a few patients were immunized against hepatitis B.

Detection and analysis of blood donors seropositive for syphilis.

The increasing incidence of syphilis worldwide has called attention to the risk of transmission by transfusion. To determine the prevalence of active syphilis in blood donors and characterise the serological profile of syphilis-positive donors. Samples positive for Treponema pallidum using the chemiluminescent microparticle immunoassay (CMIA) during blood donor screening from 2017 to 2018 were tested by the Venereal Disease Research Laboratory (VDRL) non-treponemal test and for anti-T. pallidum IgM by ELISA (Immunoassay Enzyme test for detection of IgM antibodies). The INNO-LIA Syphilis test (Line Immuno Assay solid test for confirmation antibodies to Treponema pallidum) was performed as a confirmatory test on samples that were positive on ELISA-IgM but negative on VDRL. ELISA-IgM (+) samples were also tested for T. pallidum DNA in sera by real-time polymerase chain reaction (PCR). Of 248 542 samples screened, 1679 (0.67%) were positive for syphilis by CMIA. Further analysis was performed on 1144 (68.1%) of these samples. Of those tested, 16% were ELISA IgM(+)/VDRL(+), 16.5% were ELISA IgM(-)/VDRL(+), 4.1% were ELISA IgM(+)/VDRL(-), and 63.4% were ELISA IgM (-)/VDRL(-). The INNO-LIA Syphilis test results were 33 (3%) positive, 2 (0.2%) undetermined and 12 (1%) negative. Of the 230 EIA-IgM(+) samples (20.1%), 5 (2.2%) were PCR positive. The prevalence of active syphilis in 2017 and 2018 was 0.1% and 0.07%, respectively, and overall prevalence of serologic markers for syphilis was highest among male, unmarried, 25-34-year-olds with a high school education and who were first-time donors. There is a risk of transfusion-transmitted syphilis in blood banks that exclusively use the VDRL test for donor screening, as is currently the situation in some Brazilian blood centres, as well as in other blood centres around the world.

Blood donation by men who have sex with men: using evidence to change policy.

In 2011 in the United Kingdom (UK), excluding Northern Ireland, the deferral of men who have sex with men (MSM) changed from lifetime to 12months. We describe MSM who donated before and after this to inform further policy reviews. Characteristics and sexual behaviours of donors identifying as male from routine surveillance are described. Rates of infections are compared pre- and post-implementation of a 12-month deferral. Donors are compared with screen negative male donors responding to a large-scale survey during 2013/2014. Comparing the five years pre- and post-change, the rate of confirmed positives for markers of HBV, HCV, HIV and syphilis decreased by 6·9% from 14·1 to 13·1/100000 donations. The rate of recent infections was unchanged (1·72/100000). Of 22776 survey responses identifying as male, MSM disclosed sex between men over 12months ago giving 99·35% compliance among male donors. Two-thirds of the 72 non-compliant MSM reported one to two partners and one-third had no new partners within 12months. The most commonly reported reason for non-compliance from MSM both positive and negative for infection was 'not important to declare' (37·2% and 40·7%). Test seeking was rare (9·3% and 2·1%). Compliance with the 12-month MSM deferral policy was very high. The very low rates of infections post-change demonstrated the effectiveness of the policy. These data were an important part of the 2017 review of all sexual behaviour deferrals.

Syphilis Infection Markers Among HIV Positive Individuals In The Mexico City HIV/AIDS Program.

The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2,383 HIV-positive individuals. Socio-demographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. Prevalence of "active or resolved" and "probable active" infection markers were 44.2% and 28.8%, respectively. Predictive factors were: Clinic Specialized Condesa Iztapalapa (CECI), previous syphilis diagnosis, MSM, and receptive sex practices. The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.

Prospects for the Use of Donor Blood in a Cardiac Surgery Clinic

Investigation of problems of infection among patients with heart diseaseand blood donors, diagnosisand detection of serological markers of hepatitis B, C, syphilis, HIV infection and alternative development of free donation.&#x0D; The aim. To analyze the dynamics of serotypes of infections in patients and donors in recent years, and to determine the prospects of free donation in a cardiac surgery clinic.&#x0D; Materials and methods. The study was performed by means of detection of hepatitis B, hepatitis C, syphilis and HIV infection markers in 19,965 patients with heart diseases and 9,502 donors in 2017-2019, and included analysis of the development of voluntary blood donation in Ukraine.&#x0D; Results. In 2017-2019, a 4-fold increase in the total amount of donated blood was noted due to the development of Voluntary Blood Donation (VBD) program. In patients with heart diseases requiring surgical treatment, the average rate of infection in this period was 5.76%. Among blood donors in those years, there was a notable increase in serological markers of syphilis (5.3-fold) and HIV infection (2.3-fold). In the process of examination and procurement of donated blood, the lack of donor blood from relatives of patients is 27%, and the lack of blood from voluntary donors is 17%.&#x0D; Conclusion. Increase in the amount of donated blood thanks to the first-time donors in the VBD program requires careful laboratory monitoring to detect antibodies to the causative agents of syphilis, hepatitis B, C and HIV, as well as mandatory post-quarantine laboratory monitoring of donor plasma.

Infectious safety of donor blood

Infectious safety of donor blood

Problems of infectious safety of donor blood components

Problems of infectious safety of donor blood components

Seroprevalence of transfusion-transmissible infectious diseases at a hemotherapy service located in southwest Bahia, Brazil

IntroductionThe serological screening of blood donors has been instituted by the Brazilian Ministry of Health and is mandatory in the research on several diseases transmissible through blood transfusion. Blood banks need to establish a screening service capable of reducing associated transfusions risks. ObjectiveThe objective of this study was to establish the prevalence of transfusion-transmissible infection markers in donors at a hemotherapy service located in southwest Bahia, Brazil. MethodsA retrospective study was performed between 2010 and 2016. Variables, such as the characterization of donors who were suitable and unsuitable for donation (in clinical screening), stratification by gender and age group and unsuitable samples for reactive test results (in serological screening) by aspecific antibodies against hepatitis B virus (anti-HBc and HBsAg), hepatitis C virus (anti-HCV), human T-lymphotropic virus (anti-HTLV I/II), HIV virus (anti-HIV I/II), chagas disease, and syphilis markers, were evaluated. ResultsCollected data showed that 3.13% of the donors were considered unsuitable for serological screening and that the prevalence of reactive test results was higher in donors aged between 30 and 39 years and in males. The means of the serological markers was 1.09% for syphilis reagents, 0.63% for anti-HIV I/II, 0.51% for anti-HBc and anti-HCV, 0.15% for HBsAg, 0.14% for HTLV I/II and 0.10% for Chagas disease. ConclusionThese results reflect the importance of awareness campaigns on sexually transmitted diseases and transfusion safety measures taken by hemotherapy services.

Seroepidemiology of syphilis among men who have sex with men in Burkina Faso, West Africa.

Men who have sex with men (MSM) have a disproportionate risk of acquiring sexually transmitted infections (STIs), such as syphilis. However, prevalence and determinants of syphilis among this population are less known in West Africa. This study aims to estimate syphilis prevalence among MSM in Burkina Faso. We conducted a cross-sectional biological and behavior survey in the two main cities of Burkina Faso, Ouagadougou and Bobo-Dioulasso. MSM were recruited using Respondent Driven Sampling (RDS) methods. Data were collected from January to April 2013 in Ouagadougou and from May to August 2013 in Bobo-Dioulasso. Out of the 657 MSM screened for syphilis, 6.1% (40/657) tested positive for Treponema pallidum antibodies and 1.1% (7/657) for active syphilis. Population-weighted prevalence of active syphilis was 2.1% (95% CI, 01.1-04.4) in Ouagadougou and 0.0% in Bobo-Dioulasso. Serologic markers of syphilis (anti-Treponema antibodies) were found among 7.4% (95% CI 5.0-10.8) of MSM in Ouagadougou and 5.0% (95% CI 3.1-8.0) in Bobo-Dioulasso. No significant differences were found in syphilis serological markers prevalence by participants' sociodemographic and behavioral characteristics. The prevalence of syphilis among MSM is low and comparable to that of other individuals of reproductive age in Burkina Faso. This low prevalence is very encouraging and suggests implementation of effective public health intervention programs which direct resources and services toward MSM to prevent further spread of syphilis infection and to limit HIV transmission in this group.

Serological Markers for Syphilis Among Persons Presenting With Syndromes Associated With Sexually Transmitted Infections: Results From the Zimbabwe STI Etiology Study.

Syphilis prevalence in sub-Saharan Africa appears to be stable or declining but is still the highest globally. Ongoing sentinel surveillance in high-risk populations is necessary to inform management and detect changes in syphilis trends. We assessed serological syphilis markers among persons with sexually transmitted infections in Zimbabwe. We studied a predominantly urban, regionally diverse group of women and men presenting with genital ulcer disease (GUD), women with vaginal discharge and men with urethral discharge at clinics in Zimbabwe. Syphilis tests included rapid plasma reagin and the Treponema pallidum hemagglutination assay. Among 436 evaluable study participants, 36 (8.3%) tested positive for both rapid plasma reagin and Treponema pallidum hemagglutination assay: women with GUD: 19.2%, men with GUD: 12.6%, women with vaginal discharge: 5.7% and men with urethral discharge: 1.5% (P < 0.0001). Syphilis rates in Zimbabwe are high in sentinel populations, especially men and women with GUD.