Serologic tests for treponematoses in the United Arab Emirates

Background and Objective. Venereal syphilis is uncommon in the United Arab Emirates (UAE) and other Gulf states in the Middle East. Although nonvenereal syphilis (bejel) has been reported to be endemic in some of these countries, the extent of treponematoses in the UAE is unknown. The objectives were therefore, to investigate those who attended the outpatient clinic of a hospital in the UAE and to establish the seroprevalence of treponematoses and related clinical conditions. Methods. One thousand and eighty-four patients were serologically screened with a Rapid Plasma Reagin (RPR) and Treponema pallidum hemagglutination (TPHA) tests. The charts of seropositive and seronegative patients, matched for age and sex, were reviewed and compared for clinical problems. Results. A total of 47 people tested had antitreponema antibodies. The positivity rates varied considerably and rose with age from 0.36% for persons < 16 years to 8.3% for those > 50 years. Among the seropositive group, there were no obvious clinical signs of bejel on presentation, but osteoarthritis was significantly more common than in the seronegative group. Conclusions. In the UAE, although venereal syphilis is uncommon, there is a high seropositivity rate in the > 50-year age range possibly due to old or attenuated bejel.