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ORIGINAL CONTRIBUTIONS
Year : 1990  |  Volume : 56  |  Issue : 1  |  Page : 25-26

The incidence of congenital syphilis and hepatitis-B virus surface antigen carrier state among deaf mute children




Correspondence Address:
Gururaj A Kumar


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Source of Support: None, Conflict of Interest: None


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  Abstract 

Three hundred deaf mute children of both the sexes, aged between 5-16 years were examined for the presence of syphilitic stigmata. All these children were having bilateral total sensory-neural deafness. None showed Hutchinson's triad. VDRL and micro TPHA tests for syphilis and RPHA test for HbsAg tested Blood samples. VDRL test was positive in 15 (5%) TPHA test in 34 (1133%) cases and HBsAg in 36 (12%) cases. VDRL and TPHA tests were both Positive in 15 (5%) cases, but VDRL negativity was observed in 19,(6.3%) TPHA positive cases, while VDRL, TPHA and HBsAg were positive in6 (2%) cases.


Keywords: Deaf-mutes, VDRL, TPHA test, HBV infection, Association


How to cite this article:
Kumar GA, Lakshmi N, Babu SV. The incidence of congenital syphilis and hepatitis-B virus surface antigen carrier state among deaf mute children. Indian J Dermatol Venereol Leprol 1990;56:25-6

How to cite this URL:
Kumar GA, Lakshmi N, Babu SV. The incidence of congenital syphilis and hepatitis-B virus surface antigen carrier state among deaf mute children. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2019 Oct 19];56:25-6. Available from: http://www.ijdvl.com/text.asp?1990/56/1/25/3473


Congenital syphilis may cause sensori-neural hearing loss as a late manifestation and adequate hearing is a pre-requisite for the normal develop­ment of communication skills in children, and the most common cause of delayed speech is hearing loss[1]. Sensori-neural deafness caused by congenital syphilis is potentially treatable if diagnosed early.[2] It is therefore useful to carry out serological tests for syphilis in such cases.

Sexual promiscuity carries the risk of infection with hepatitis B virus (HBV) also. The present study was therefore undertaken to know the incidence of clinical stigmata and positive serological evidence for syphilis and HBsAg carrier state in a group of deaf mute children with bilateral total sensori-neural hearing loss of obscure origin.


  Materials arrd Methods Top


Three hundred children of both the sexes aged between 5 and 16 years, residing at a local deaf and dumb school and earlier diagnosed to be having bilateral total sensori-neural deafness were studied. Their detailed past and family histories were obtained and a thorough clinical examination was done for the classical stigmata of congenital syphilis. Children found to be suffering from defective vision were examined under slit lamp for the presence of iridocyclitis. Blood samples were tested for the VDRL test, micro TPHA test using Syfhatect brand kit of Wellcome Laboratories, UK, and reverse passive haemagglutination q,RPI-A) test using Cellognost brand kit of Hoechst India. The VDRL positive sera were further tested quantitatively and a titre of 1 : 8 and above was taken as significant. Sera positive for HBsAg were subjected to the liver function tests, namely serum bilirubin estimation, Van den Bergh's reaction, thymol turbidity test and SGPT.


  Results Top


Out of 300 children, 186 were males and 114 females. The clinical stigmata of congenital syphilis seen in these children are shown in [Table - 1]. Bilateral total sensori-neural deafness was seen in all, but none had the complete Hutchinson's triad. Other clinical stigmata were found either alone or in combinations, Results of the serological tests are shown in [Table - 2]. In 2 males and 3 females the VDRL test was positive in 1 : 16 dilution, while in the remaining 8 males and 2 females the VDRL test was positive in 1 : 8 dilution. The liver function tests were normal in all the sera tested.


  Comments Top


This study shows that congenital syphilis still occurs and affects the labyrinth. It can affect the ear at almost any age involving both the ears in a progressive manner.[3],[4],[5],[6],[7]

People with sensori-neural deafness are often referred to, or approach specialists in the field, working in major hospitals, where facilities for micro TPHA test are likely to be available. This test is most popular, simple, specific, rapid, economic, reproducible and is available in kit form in India. Several studies[8],[9],[10] have shown that this test and FTA-ABS test are comparable in all categories of syphilis except the primary stage. The reagin tests usually revert to negative after antibiotic therapy, whereas tre­ponemal tests remain positive. VDRL test is useful in cases of sensori-neural deafness, for judging the activity of the disease. It will be of further help to do a micro TPHA test also when Facilities are available especially in VDRL negative cases.

HBV infection especially in the children infected perinatally or early in life may persist resulting in a carrier state and may progress to chronic liver disease.[11] In our study, 36 (12%) cases showed the presence of HBsAg but none of them suffered from jaundice or showed deranged liver function tests.

 
  References Top

1.Eviata L : Evaluation of hearing in the high risk infants, Otolaryngol Clinics N Amer, 1985; 18 169-186.  Back to cited text no. 1    
2.Hendershot EL : Luetic deafness, Laryngoscope, 1973; 78 : 865-870.  Back to cited text no. 2    
3.Kerr AG, Smyth GDL and Cinnamond MJ Congenital syphilitic deafness, J Laryngol Otol, 1973; 87 : 1-12.  Back to cited text no. 3    
4.Tamari MJ and Itkyn P : Penicillin and syphilis of the ear, Eye Ear Nose Throat Man, 1951; 30 252-261, 301-309.  Back to cited text no. 4    
5.Karmodi CS and Schuknecht HE : Deafness in congenital syphilis, Arch Otolaryngol, 1966; 83 18-27.  Back to cited text no. 5    
6.Zoller M, Wilson WR, Nadol Jr BJ et al : Detec­tion of syphilitic hearing loss, Arch Otolaryngol, 1978; 104 : 63-65.  Back to cited text no. 6    
7.Hughes KB and Murray DPJ : Congenital syphilis presenting as a case of deafness, J Laryngol Otol, 1981; 95 : 75-80.  Back to cited text no. 7    
8.Young H, Henrichsen C and Robertson HHD Treponema pallidum haemagglutination test as a screening procedure for the diagnosis of syphilis, Brit J Vener Dis, 1974; 50 : 341-346.  Back to cited text no. 8    
9.Lesinsky J, Krack J and Kadziewiez E : Specificity, sensitivity and diagnostic value of the TPHA test, Brit J Vener Dis, 1974; 50 : 334-340.  Back to cited text no. 9    
10.Luger A, Schmidt B, Spendling Wimmer I et al Recent observations on the serology of syphilis, Brit J Vener Dis, 1980; 56 : 12-16.  Back to cited text no. 10    
11.World Health Organisation, Advances in viral hepatitis. Report of the WHO Expert Committee on viral hepatitis, Technical Report Series, No 602. Geneva, 1977.  Back to cited text no. 11    


    Tables

[Table - 1], [Table - 2]



 

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