Syphilis on rise among young people

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In Mongolia, an average of 16,000 people get infected with sexually transmitted diseases each year. Syphilis alone accounts for 40 percent of these incidences. The prevalence of syphilis was stable until 2016 but steadily increased until 2021, reaching a relatively high level compared to other Asian countries. Therefore, doctors are stressing the need to prevent syphilis and provide young people with better sexual health education and information services.

Doctor of the National Center for Communicable Diseases S.Otgonsukh said, “Syphilis is a sexually transmitted bacterial disease, but it is curable. In recent years, there has been an increase in the number of asymptomatic and latent syphilis cases among people of reproductive age. About 45 percent are aged 20 to 29. People aged 30 to 34 make up 15 to 18 percent. Unfortunately, up to 50 percent of those registered with syphilis are married or have sex on a regular basis.”

“Among the newly screened pregnant women, 99.1 percent were tested for syphilis and 1.7 percent were tested positive. In particular, 2.3 percent of those tested in Arkhangai Province were infected with syphilis, 1.8 percent in Dundgovi, 2.1 percent in Orkhon, 2.2 percent in Uvs, and 2.6 percent in Khuvsgul, which is 0.1 to 0.9 percent higher than the national average,” he noted

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Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore – typically on the genitals, rectum, or mouth. Syphilis spreads from person to person via skin or mucous membrane contact with these sores. After the initial infection, the syphilis bacteria can remain inactive in the body for decades before becoming active again.

Without treatment, syphilis can severely damage the heart, brain, or other organs, and can be life-threatening, according to doctors. Syphilis can also be passed from mothers to unborn children. The risk of infection of the fetus with syphilis includes fetal miscarriage in early pregnancy low birth weight, growth retardation in the mother, premature birth, birth defect and stillbirth.

As of 2021, 27 cases of congenital syphilis per 100,000 live births were reported in Mongolia, according to the National Statistics Office. Last year, 12,465 cases of sexually transmitted diseases were reported nationwide. Of these registered cases, 3,617 or 29 percent were syphilis. Sexually transmitted infections include syphilis, gonorrhea, and sexually transmitted diseases.

Congenital syphilis, which is transmitted from mother to fetus is also prevalent. More than 70,000 women give birth nationwide every year. In 2019, 66 cases of syphilis were transmitted from mother to fetus, before it decreased to 37 cases in 2020 and 19 in 2021.

Out of 66 cases of congenital syphilis detected in 2019, 12 led to deaths and 30 to stillbirths. This means that there are many cases of infant mortality due to congenital syphilis.

According to the 2020 survey, Khuvsgul, Dornod, Khovd and Uvs provinces were had the highest number of syphilis cases. However, the number of infections was relatively low in Arkhangai, Bayan-Ulgii and Govisumber provinces in the reporting period.

Doctor of the National Center for Communicable Diseases Ch.Urtnasan said, “People with syphilis do not seek treatment or remain unaware about their infection for a long time. In other words, during sexual intercourse, the bacterium usually enters the body through the genital mucosa and appears on the men’s penis. Women, on the other hand, are more likely to be unaware that they are infected because bacteria are more likely to stay inside the vagina. If the person is infected, a painless, bright red ulcer or hard scar may form at the site of infection after three to four weeks. After a while, the hard sores disappear. However, this does not mean that the disease has disappeared. During this time, the disease spreads throughout the body using blood vessels. From this point on, the patient may experience symptoms such as malaise, headache, and fever. If an infected person doesn’t act, the disease can last for about two years. There are cases when patients feel no pain. The longer the disease progresses, the more organs can get damaged, especially the nervous system and liver. If the patient is not treated at all, gradual damage to the internal organs, bones, and nervous system can cause the heart and blood vessels to suffer the most. Treatment at this stage of the disease can stop the pathological process, but it is not possible to fully restore the function of the injured organ. Therefore, doctors and specialists warn that if you have casual sex, it is important to get tested and detect syphilis early.”

“The main cause of syphilis is promiscuous sex. Having extramarital affairs and casual sex without condoms can cause sexually transmitted diseases. Syphilis is increasing every year due to the lack of condom use, self-protection, and faithfulness. Secondly, stress has the greatest impact. Young people seem to have a weak ability to cope with life’s challenges. When they are a little upset or angry, they tend to drink. In other words, they are choosing the wrong way to deal with stress. However, there is a downside to drinking, which can lead people to have casual sex as they don’t have much self-control or restraint,” the doctor added.

In addition, parents do not talk to their children about sex or sexually transmitted diseases. Children tend to face difficulties bringing up the topic first. Instead, they talk about it with their close friends and peers and get false or inaccurate information. For example, there is a misconception that a pregnant woman can give birth to a child with syphilis even if she is treated for syphilis. Pregnant women who receive such information may make the wrong choices, such as not going to a health facility or choosing abortion. Therefore, parents, teachers and educators should systematically inform and talk to children and adolescents about love, fidelity, sexuality, sexual intercourse and etc. If a pregnant mother is diagnosed with syphilis in the first three months of pregnancy and treated promptly, the baby will not be infected and be born healthy. From the fourth month, infection in the mother’s bloodstream can directly infect the baby. Therefore, doctors said that it is important to understand that early antenatal care has a huge impact on maternal and child health. Newborns are also tested for infection after birth and treated if necessary.

In recent years, sexually transmitted diseases have become the predominant infectious disease registered with the National Center for Communicable Diseases of Mongolia. In particular, the most common sexually transmitted diseases are syphilis, gonorrhea and trichomoniasis. Between 2001 and 2015, syphilis was most prevalent, according to the center. Considering this, a wide range of measures need to be taken. For example, during the social era, Mongolia had a population of about 500,000 and one in two people had syphilis. At that time, syphilis was common due to the small population. Back then, Russian and Mongolian doctors launched a “cultural campaign” and forcibly treated all of the infected, completely eradicating syphilis nationwide.  

As the disease has been on the rise with the population growth, the country needs to take action. Even if we can’t take such drastic measures as we did several decades ago, similar results can be achieved through a government policy tailored to today’s society and situation. During socialism, to treat syphilis, sick people were forced to stay in the soum center for at least 21 days while receiving two injections in the morning and in the evening. But now medicine and technology have all developed. It’s possible to treat syphilis in the early stage with a single injection, according to doctors. If it has progressed, the injection is given three times a week. In addition, the diagnosis of syphilis has become much faster and more detailed.        

The number of people suffering from this disease is not decreasing but increasing day by day. According to the National Center for Communicable Diseases, 5,000 new cases of syphilis are treated each year, but even more are diagnosed the following year. What’s more, syphilis mostly occurs in people aged 15 to 49 who should have the knowledge and skills to protect themselves from the disease. A very small percentage of mothers with syphilis give birth to children with congenital syphilis, the National Center for Communicable Diseases reported. Therefore, there is a good chance of suppressing the silent plague known as syphilis by launching a new health campaign suitable for today’s society. However, the absence of such initiation has led to almost no progress in this matter.

People with syphilis are treated free of charge so people should get preventive checkups at least once a year. It is also recommended that you seek medical attention immediately if you’re experiencing any symptoms. The government launched the nationwide medical examination for all Mongolians on May 1. Through this, citizens can undergo free testing for syphilis and other sexually transmitted infections.

Enkhnaranjav Tumurbaatar

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