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| Year : 1998 | Volume
: 16
| Issue : 4 | Page : 158-161 |
Congenital syphilis in Delhi : An analysis of data and use of an inexpensive method for detection of IgM antibody to treponema pallidum
N Berry, P Bhalla, MD Mathur
Department of Microbiology, Maulana Azad Medical College, New Delhi 110 002
Correspondence Address:
N Berry
Department of Microbiology, Maulana Azad Medical College, New Delhi 110 002
 Source of Support: None, Conflict of Interest: None  | Check |
ABSTRACT: A rise in the number of congenital syphilis cases has been observed due to an increase in adult syphilis and the adoption of a broader case definition for congenital syphilis. In India, most laboratories rely on the results of Venereal Disease Research Laboratory (VDRL) test alone for the diagnosis of congenital syphilis since tests for IgM antibodies to Treponema pallidum are not available. We retrospectively analysed laboratory data for samples tested from children with clinical suspicion of congenital syphilis in six years with regard to their year wise distribution, age and sex profile, titers in VDRI positive cases and correlation of titres in infant - mother pairs. For the second part of the study, eight VDRL positive sera and two CSF samples from cases with clinical suspicion of congenital syphilis were subjected to VDRL and TPHA before and after treatment with 2-Mercaptoethanol (2-ME), in attempt to distinguish IgG and IgM class of antibodies. Forty eight (12 percent) of the 400 sera and 3(33 percent) of nine CSF samples from suspected congenital syphilis were VDRL positive. An increase in the number of cases over six years was observed. Of the 22 infant-mother pairs tested by the VDRL, 50 percent infants had greater than fourfold titre as compared to the mother. In the 8 sera and 2 CSF samples tested by VDRL and TPHA before and after treatment with 2-ME, the results of the two tests showed 87.5 percent concordance for detection of IgM antibody to T. pallidum. The modification used in this preliminary study was found useful in the distinguishing IgM class to antibodies from IgG and thus , would obviate the need for follow up serology to detect active infection can also be used for diagnosing neurosyphilis in infants with congenital disease.
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