Recall of symptoms and treatment of syphilis and yaws by healthy blood donors screening positive for syphilis in Kumasi, Ghana

Objective: To describe the recalled medical history, clinical manifestations, and treatment of yaws and syphilis by syphilis seroreactive blood donors in Kumasi, Ghana. Methods: Of the blood donors at Komfo Anokye Teaching Hospital, Kumasi, Ghana tested with the syphilis rapid diagnostic test (RDT) and later by rapid plasma reagin (RPR) test, 526 were seroreactive. Four hundred and seventy-one (89.5%) of these subjects were confirmed with the Ortho-Vitros Syphilis TP test as the gold standard and were interviewed to determine past or present clinical manifestations of yaws and syphilis. Results: Of the 471 respondent donors, 28 (5.9%) gave a history of skin lesions and sores; four (14.3%) of these subjects, who were all male and RPR-positive, recalled a diagnosis of syphilis. All four reported having had skin lesions/bumps with slow-healing sores, but only one of them had had these symptoms before the age of 15 years. Conclusions: A small proportion of confirmed seroreactive donors in this sample had any recall of symptoms or treatment for yaws or syphilis. These data suggest that clinical questioning adds little further information to the current screening algorithm. The relative contribution of yaws and syphilis to frequent positive tests in endemic areas remains speculative

Syphilis screening practices in blood transfusion facilities in Ghana

Objectives The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis antibodies in blood donors in Ghana was also estimated. Methods Over an 11-month period, from February 2014 to January 2015, a semi-structured questionnaire was administered to 122 laboratory technical heads out of a total of 149 transfusion facilities in Ghana. The response rate was 81.9%. Results A total of 58 (48%) transfusion facilities tested donors for syphilis, with an estimated 3.7% seroprevalence (95% confidence interval 3.6–3.8%). A total of 62 782 out of 91 386 (68.7%) donations were tested with assays that are not recommended. The estimated syphilis seroprevalence in voluntary donations was 2.9%, compared to 4.0% in family donations (p = 0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs). Conclusions Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health