High treponemal seroprevalence among adult hospitalised patients in Tulear, Madagascar

The study aims to determine syphilis and Human Immunodeficiency Virus (HIV) seroprevalence rates among adult hospitalizeispatients in Tulear, Madagascar. In a cross-sectional study, sera from all adult inpatients at the Tulear hospital were screened using rapid plasma reagin; reactive sera were confirmed using Treponema pallidum hemagglutination. All sera were also tested for HIV antibodies by enzyme immunosorbent assay and reactive specimens were confirmed by Western blot. Age, sex, and clinical information were collected from patient charts. Overall, 36 (24.5%) of 147 hospitalised patients were found to be syphilis seroreactive, one patient (0.7%) had HIV antibodies. Syphilis was mentioned on the patient charts of only three (8.3%) of the 36 syphilis seroreactive individuals; they were all three diagnosed with neurosyphilis. Eleven (15.9%) of the 69 female hospitalized patieiss were syphilis seroreactive compared to 25 (32.0%) of 78 men (OR:0.4; p=0.03). The high treponemal seroprevalence found among hospitalizedspatients illustrates the mostly unrecognized disease burden in the Malagasy society. Effective syphilis control measures are urgently needed to decrease related morbidity and mortality and as a preventive HIV control strategy.