An Epidemiologic study of syphilis prevalence in serum and cerebrospinal fluid in institutionalized subjects

Kweon, Hyuk Jin; Kim, Sang Won; Kim, Dong Seok

Abstract

BACKGROUND: Institutionalized subjects were assumedly suggested to be a high-risk for the infectious source of syphilis.
OBJECTIVE
Our purpose was to study the syphilis prevalence institutionalized subjects who were admitted in Taegu Hope Village for the poor or crippled and to evaluate the presence of neurosyphilis among them. MEHTODS: We conducted the serologic tests for syphilis with the qalitative and quantative VDRL and TPHA tests in 1558 subjects(M:936, F:622). The trend of the rcactive rate was compared with those of the two studies dong, in the same institute in 1983-1985 and 1988. The cerebrospinal fluid (CSF) examination was perfarmed among the reactive subjects.
RESULTS
There were 97(6.2%) reactive subjects. There were 80(82.5%) reactive subjects with titers of 1:4 or below and 17(17.5%) with titers of 1:8 or over The biologic false positive rate of VDRL test was 12.6%, showing 92.3% with the titer below 1:4. The reatest number of the subjects were in their 40s and 50s in both sexes. The rate in subjects in their 40s or over was 3 times higher than in the younger groups. The CSF examination showed 5(5.2%) with significant neurosyphili;ic findings. There were 1 male and 4 females, with an avechge age of 47.8 years. Four had asymplomatic and 1 meningovascular forms. The CSF findings revealed an increased number of white cells in 4 and an increased total protein level in 3. The CSF-VE)RL titers were trended lower than seum titers. From the comparison of the results since 1983, i.e., 11,6% in 1983-1985, 7.5% in 1988 and 6.2 % in 1992, the reactive rate of syphilis was gradually decreasing, but still remained high.
CONCLUSION
The drastic control in the sociomedical aspect is needed n institutionalized subjects who are at high-risk for syphilis was well as the CSF examination for the presence of neurosyphilis among the reactive subjects.