SEROLOGICAL MARKERS FOR TREPONEMAL INFECTION IN CHILDREN IN RURAL KILIMANJARO, TANZANIA - EVIDENCE OF SYPHILIS OR NONVENEREAL TREPONEMATOSES

Objective: To determine the seroprevalence of treponemal infection and possible risk factors among children aged 0-14 in the general populat ion of a rural Tanzanian village. Methods: The survey was conducted as a part of a cross sectional study of a total village population on HI V and sexually transmitted diseases. Among 1708 registered children ag ed 0-14, the 553 first attending were tested for treponemal infection with both rapid plasma reagin test (RPR and Treponema pallidum haemagg lutination test (TPHA). These children belonged to a household cohort- also including their parents, siblings, and other household members-wi th 1339 members; 1224 (91.4% participated in the survey and 82.1% of t hese were tasted for treponemal infection. Results: The overall preval ence for the TPHA test was 6.4% among girls and 1.1% among boys (odds ratio, OR = 6.5; 95% confidence interval, CI: 1.9-22.3). The sex diffe rence was most pronounced in the age group 10-14; 11.1% among girls ve rsus 1.0% among boys (OR = 12.8; CI: 1.6-101.9). hmong the 20 children who were TPHA positive, we found two cases of active, congenital syph ilis. There was a lack of association between positive serology in chi ldren and positive serology in their parents. Conclusion: The highly s ignificant predominance of girls testing positive for TPHA, and the co ncomitant lack of association between parents' and children's serostat us might point to sexual transmission as being the most common route o f transmission of treponemal infection in girls during childhood in th is village. The sources of infection for the seropositive girls are po ssibly found outside the family.