ABSTRACT
To determine the prevalence of cerebrospinal fluid abnormalities in Southeast Asian refugees with reactive serologic tests for syphilis, we evaluated 65 patients, 36 prospectively and 29 retrospectively, in a primary care clinic. Information was collected on history of treponemal infections, neurologic symptoms and signs, and total protein concentration, leukocyte count, and the VDRL test in the cerebrospinal fluid. Neurologic symptoms were reported by all patients for whom data were available. Abnormal neurologic signs were found or noted in medical records in 15 (42%) prospectively evaluated patients and 9 (64%) of 14 retrospectively evaluated patients for whom data were available. No patient had evidence of congenital or non-neurologic sequelae such as cutaneous or cardiovascular manifestations of syphilis. No patient had a positive cerebrospinal fluid VDRL test, 1 had more than 5 x 10(6) leukocytes per liter (5 leukocytes per mm3), and 6 (9%) had elevated total protein levels in the cerebrospinal fluid. Previous therapy for syphilis was not associated with lower serum VDRL reactions, neurologic symptoms and signs, or cerebrospinal fluid findings. In the absence of other indications, routine examination of the cerebrospinal fluid in seropositive Southeast Asian refugees who have nonspecific neurologic symptoms has a low yield, perhaps because of the high prevalence of yaws in this population, and may not be warranted.
Subject(s)
Syphilis Serodiagnosis , Syphilis/cerebrospinal fluid , Syphilis/ethnology , Adolescent , Adult , Aged , Aged, 80 and over , Asia, Southeastern/ethnology , Cerebrospinal Fluid/cytology , Cerebrospinal Fluid Proteins/analysis , Female , Humans , Leukocyte Count , Male , Middle Aged , Neurosyphilis/diagnosis , Neurosyphilis/ethnology , Prospective Studies , Retrospective Studies , Syphilis/diagnosis , Yaws/diagnosis , Yaws/ethnologyABSTRACT
A clinical and serological epidemiological study done on a yaws focus in the Santiago Basin area, province of Esmeraldas, showed a prevalence of 11.3% for active clinical lesions and a seropositivity of 94.9%. The Rio Santiago was hyperendemic for yaws (prevalence, 17.9%; seropositivity, 98.0%) while Rio Zapallito was found to be mesoendemic and the Rio Cayapas and Rio Onzoles hypoendemic. Active and latent evidence of yaws was found only in the black race. Children, ages 5-12 year, were found to have the highest incidence (55.8%) of clinical lesions, with the majority found on the legs (64.2%). Papilloma was the most prevalent lesion (55.4%). Mass treatment of the basin using benzathine penicillin G was done according to WHO recommendation.
