NTA Level 4 • Semester 1 • PST04102

Identification of Patients with Syphilis

Disease Control and Prevention • Source Session/Topic 31

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Session 31: Identification of Patients with Syphilis

Total Session Time: 120 minutes + 2 hours Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• Describe Causes of Syphilis

• Describe Mode of Transmission of Syphilis

• Describe Major Signs and Symptoms of Syphilis

• Explain Treatment of Syphilis

• Explain Prevention and Control of Syphilis

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

SESSION CONTENTS

STEP1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Causes of Syphilis (5minutes)

• Syphilis: A chronic multi-systemic disease caused by the bacteria

spirochetal bacterium Treponema pallidum.

STEP 3: Mode of Transmission of Syphilis (15 minutes)

|Activity: Buzzing (10 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What is the mode of transmission of Syphilis? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• The spirochaete Treponema pallidum enters the body through mucous

membranes and skin.

• The route of transmission of syphilis is almost always through sexual

contact, although there are other routes such as:

o Congenital Syphilis via transmission from mother to child in utero.

o Transfusion of unscreened blood.

o A patient with secondary syphilis who has mucosal or cutaneous lesion

may transmit the disease through physical contact.

o Unusual but possible transmission is accidental contact with infective

tissue.

STEP 4: Signs and Symptoms of Syphilis (40 minutes)

|Activity: Group discussion (20 minutes) |

| |

|DIVIDE students into small manageable groups |

| |

|ASK students to discuss on the following question |

| |

|What are the signs and symptoms of Syphilis? |

| |

|ALLOW students to discuss for 10 minutes |

| |

|ALLOW few groups to present and the rest to add points not mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

There are 3 main stages of the disease namely:

• Primary Syphilis

• Secondary Syphilis

• Tertiary Syphilis

Note: Different manifestations occur depending on the stage of the disease;

as outlined below:

Primary Syphilis

• Primary syphilis is typically acquired via direct sexual contact with the

infectious lesions of a person with syphilis.

• Approximately 10-90 days after the initial exposure (average 21 days), a

skin lesion

appears at the point of contact, which is usually the genitalia, but can

be anywhere on the body

o This lesion, called a chancre which is a firm, painless skin

ulceration localized at the point of initial exposure to the

spirochete, often on the penis, vagina, rectum or elsewhere like lips,

tongue, breast etc.

• The lesion may persist for 4 to 6 weeks and usually heals spontaneously.

• Local lymph node swelling can occur.

[pic]

Secondary Syphilis

• Secondary syphilis occurs approximately 1–6 months (commonly 6 to 8

weeks) after the primary infection.

• There are many different manifestations of secondary disease.

• A patient with syphilis is most contagious when he or she has secondary

syphilis.

• There may be a symmetrical reddish pink non-itchy rash on the trunk and

extremities.

• This is accompanied with mild constitutional systems, often described as

flu-like.

• These rashes tend to be symmetrical can involve the palms of the hands

and the soles of the feet.

• In moist areas of the body such as anus, vulva, perineum, mouth, and

axilla the rash becomes flat, broad, whitish lesions known as condylomata

lata.

• All of these lesions are infectious and harbor active treponema

organisms.

Tertiary Syphilis

• Tertiary syphilis usually occurs 1–10 years after the initial infection,

though in some

• Cases it can take up to 50 years.

• This stage is characterized by the formation of gummas which are soft,

tumor-like lesions of inflammation known as granulomas.

• They may appear almost anywhere in the body including the skeleton and

brain.

• The more severe manifestations include neurosyphilis and cardiovascular

syphilis

• The incubation period of syphilis varies from 10 days to 10 weeks with

average of 3 weeks.

STEP 5: Treatment of Syphilis (10 minutes)

• The drug of choice is intramuscular Benzathine benzylpenicillin

• Doxycycline

• Erythromycin

STEP 6: Prevention and Control of Syphilis (30 minutes)

|Activity: Group discussion (15 minutes) |

| |

|DIVIDE students into small manageable groups |

| |

|ASK students to discuss on the following question |

| |

|What are the prevention and control measures of Syphilis? |

| |

|ALLOW students to discuss for 10 minutes |

| |

|ALLOW few groups to present and the rest to add points not mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• Abstinence

o Encourage delaying sexual activity for young people

• Sexual and reproductive health education to young people in and out of

school

• Faithfulness (have one faithful uninfected partner)

• Using condoms correctly and consistently

o myths and misconceptions about condoms

• Screening and effective treatment of asymptomatic cases

• Effective treatment of STIs/RTIs

• Voluntary counseling and testing (VCT)

• Screening of blood for transfusion

• All pregnant women should be screened for syphilis routinely to prevent

congenital syphilis

STEP 7: Key Points (5minutes)

• Syphilis is sexually transmitted diseases cause by Treponema pallidum

• Syphilis is a disease characterized by a primary lesion, a later

secondary eruption and

tertiary manifestation.

• Syphilis can also be transmitted from mother to the newborn leading to

congenital

Syphilis.

• Syphilis can be prevented by proper and consistent condom use.

STEP 8: Evaluation (5minutes)

• What causes Syphilis?

• What is the mode of transmission of Syphilis?

• What are the signs and symptoms of Syphilis?

• What is the treatment of Syphilis?

• What are preventive and control measure of Syphilis?

STEP 9: Assignment (5 minutes)

|Activity: Take Home Assignment (5 minutes) |

| |

|DIVIDE students in groups or individuals |

| |

|ASK the students to work on the following Assignment |

|Prepare a presentation to be delivered to the class indicating |

|prevention and control methods of Syphilis. |

| |

|ALLOCATE time for students to do the assignments and submit |

| |

|REFER students to recommended reference |

References

Cook, G, & Zumla, A. (2003). Manson’s Tropical Diseases. (21st ed.).

London: Saunders Ltd.

Denyer, S. P. Hodges, N. A., & Gorman, S. P (2011) Ed. Hugo & Russell’s

Pharmaceutical Microbiology (8th ed). Oxford: Willey-Blackwell publishing

Eshuis, J, & Manschot, P. (1992). Communicable diseases, (1st ed).

Nairobi: AMREF

GoT (2004): National Infection Prevention and Control (IPC) Guidelines for

Healthcare Workers. Dar es Salaam: MOHSW

GoT (2007) National Guidelines for Management of Sexually Transmitted and

Reproductive Tract Infections (1sted). Dar es Salaam: MOHSW

GoT (2013) Standard Treatment Guidelines & National Essential Medicines

List (4thed). Dar es Salaam: MOHSW

Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable

Diseases. (4thed.). Nairobi: AMREF.

Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in

Sub-Saharan Africa, Nairobi: AMREF

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