Tamil Nadu Sees Alarming Rise in Congenital Syphilis Cases: NACO Report

In 2023-24, Tamil Nadu saw a significant spike in congenital syphilis diagnoses, with the number of affected babies increasing from just five in the previous year to 600, as reported by the National AIDS Control Organisation (NACO). However, officials from the Tamil Nadu State AIDS Control Society have clarified that this rise was due to a "data error."

Syphilis, a prevalent sexually transmitted infection, can be passed from an infected pregnant woman to her baby if proper treatment is not administered. According to the World Health Organization (WHO), early and effective treatment during pregnancy can prevent this transmission.

NACO’s 2024 report, Sankalak: Status of National AIDS and STD Response, indicated that 3,579 cases of congenital syphilis were reported in India in 2023-24, based on data from the Health Management Information System. Among the states, Karnataka had the highest number with 933 cases, followed by Maharashtra at 836, and Tamil Nadu at 600. This marks a drastic increase from Tamil Nadu's 14 cases in 2020-21 and 20 cases in 2021-22. Notably, only 111 of the 600 affected infants in Tamil Nadu received treatment.

Referring to the NACO report's figures, a representative from the Tamil Nadu State AIDS Control Society insisted that the actual number of congenital syphilis cases was far lower, with only eight confirmed cases in 2023-24, according to their records. Despite the report being published on World AIDS Day, December 1, 2024, the officials have yet to notify NACO about the discrepancy.

The NACO report emphasized that infants exposed to syphilis require ongoing monitoring, including clinical assessments and serological tests, to detect potential complications. Infants diagnosed with congenital syphilis should begin treatment immediately, with benzathine penicillin G being the recommended first-line medication. ^[1]

The Elimination of Vertical Transmission of HIV and Syphilis (EVTHS) Guidelines 2024 recommend that syphilis-exposed infants be placed in specialized neonatal intensive care units at birth and receive continued pediatric care. The guidelines also call for full cooperation between State AIDS Control Societies and the State National Health Mission to ensure universal HIV and syphilis testing among pregnant women, connect infected women to appropriate interventions, and provide care for exposed infants. ^[2]

However, sources within the Health Department have raised concerns about shortages in both benzathine penicillin and testing kits. Additionally, ineffective counseling on high-risk behavior remains a barrier to reducing the spread of syphilis.

A health official speculated that the higher number of cases could be attributed to improved detection methods. “Early diagnosis in pregnant women is essential to prevent mother-to-child transmission. All antenatal women are tested for both HIV and syphilis at primary care facilities,” the official explained.

Diagnosis typically involves X-rays, serological tests, and cerebrospinal fluid analysis. If left untreated, the infection can progress to neurosyphilis, leading to seizures. However, with prompt treatment, the risk of severe complications can be significantly reduced.

References:

1. National AIDS Control Organization (NACO). SANKALAK - Status of National AIDS & STD Response 2024. 6th ed. New Delhi: NACO, 2024. Accessed January 28, 2025. https://naco.gov.in/sites/default/files/SANKALAK_6th%20_Edition_0_0.pdf.

2. National AIDS Control Organization (NACO). National Guidelines for Elimination of Vertical Transmission of HIV and Syphilis. New Delhi: NACO, 2024. Accessed January 28, 2025. https://www.naco.gov.in/sites/default/files/EVTHS%20Guidelines%202024_High%20Res%20shared%20with%20SACS%20dated%203rd%20Dec%202024%20by%20NC.pdf.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)