Syphilis among blood donors ‘on the rise’ in Sindh

Experts urge stronger screening, public awareness, and policy action

By Mukhtar Alam

KARACHI: A report by the Sindh Blood Transfusion Authority (SBTA) has raised alarm over significant prevalence of syphilis among blood donors across the province as the 2024 data shows 1.16% of the total 10,851 screened donors tested positive for the sexually transmitted infection.

The highest infection rate was recorded at the Regional Blood Centre (RBC) in Sukkur (2.7%), followed by Shaheed Benazirabad (2.5%), and Jamshoro and Karachi (1.6% each).

Overall, the SBTA recorded 13,800 transfusion-transmitted infections (TTIs) among voluntary and replacement donors in 2024 — a drop from 18,414 cases in 2023. Despite the decline, syphilis cases increased proportionally -- 25.48% of all TTIs, up from 24.39% the previous year. Other TTI rates included hepatitis C (1.9%), hepatitis B (1.5%), HIV (0.1%), and malaria (0.1%).

Keen observers are worried that the data highlights potential gaps in screening and prevention efforts, as well as differences in healthcare infrastructure, screening practices, or population characteristics across regions.

Dr Abdul Ghafoor Shoro, Secretary General of the Pakistan Medical Association (PMA) said the infection remained a significant public health concern in Sindh as well, with studies indicating a notable prevalence among high-risk groups, including female sex workers and transgender individuals.

The lack of comprehensive data and inconsistent safe sex practices exacerbated the issue, the doctor said, adding: “In order to effectively control the spread of syphilis, we need targeted interventions, increased screening, and enhanced public awareness”.

Dr Abdul Ghafoor Shoro

Dr Shoro further shared that implementing universal syphilis screening in antenatal clinics and ensuring blood safety through donor screening are crucial steps. “It’s imperative that we take a proactive approach to address this growing concern and protect the health of our communities.”

A senior doctor at the Sindh Government Hospital, Liaquatabad, confirmed that eight syphilis cases had been identified over the past year. “We use to inform patients of their health status and refer them to tertiary care for treatment,” she added. However, a formal response from the Sindh Health Department regarding broader prevention and treatment strategies remains unavailable.

Prof Dr Farhat Jafri, Dean, Faculty of Community Medicine at the Karachi Metropolitan University, expressed concern over the silent spread of syphilis in Sindh, calling it an under-recognised yet growing public health threat. “Despite global progress in controlling sexually transmitted infections, Pakistan lags behind owing to limited surveillance and fragmented data. “The 2.5% prevalence among blood donors in Sindh, particularly among men aged 25–40, should be seen as a red flag — not only pointing to unsafe transfusion practices but also suggesting wider community transmission that often goes unnoticed,” he said.

Prof Jafri underscored that although mandatory screening policies exist, their inconsistent enforcement — especially in rural and under-resourced settings — compromise blood safety protocols. He also criticised the continued reliance on outdated RPR tests rather than adopting more accurate and sensitive CLIA-based methods, which could significantly improve early detection.

Prof Dr Farhat Jafri

According to him, the prevalence of syphilis in high-risk groups, combined with poor public awareness, stigma, and lack of access to preventive services, has allowed the infection to remain largely unchecked. “Without a coordinated, multi-sectoral response — including diagnostic upgrades, community education, outreach to vulnerable populations, and robust epidemiological surveillance — Sindh risks facing a preventable sexually transmitted infections crisis. Political commitment and focused policy action are essential for reversing this trend,” he concluded.

According to Dr Sohaima Manzoor, Assistant Professor at Sindh Infectious Diseases Hospital and Research Centre, DUHS, syphilis is a growing concern globally, with an estimated 7 million new cases occurring each year, as reported by the World Health Organisation.

Dr Manzoor explains that syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum, which can mimic other illnesses, earning it the nickname of “The Great Imitator”. Early symptoms include a painless ulcer or sore, known as a chancre, which may go unnoticed.

“If left untreated, syphilis can progress to secondary stages, presenting as rashes and flu-like symptoms, and can remain silent for years before leading to serious complications, including heart disease, neurological problems, or even death,” Dr Manzoor warned.

She emphasised the importance of testing and early diagnosis, particularly of pregnant women, as syphilis can lead to miscarriages, stillbirths, or fetal abnormalities. Dr Manzoor recommended regular testing for anyone who is sexually active, especially those with multiple partners.

“Syphilis can be effectively treated with penicillin in early stages, making early detection key to preventing transmission and complications,” she stressed.

To prevent syphilis, Dr Manzoor advocated for safe sex practices and regular testing. “Public awareness, health and sex education, and routine testing can greatly reduce the spread of syphilis,” she added.

“Pregnant women at risk should be screened to prevent congenital syphilis in newborns,” Dr Manzoor said, highlighting the importance of prenatal care in preventing the transmission of syphilis from mother to child.

Courtesy: Social Track, Karachi (May 30, 2025)