SYPHILIS: EMERGING TRANSFUSION TRANSMISSIBLE INFECTION IN PAKISTAN

Abstract

Blood screening procedures in inadequate areas have increased the recognition of syphilis as Treponema pallidum causes this sexually transmitted infection that spreads through blood transfusions (TTI).  This research evaluates blood bank testing protocols and examines both population-wide statistics and infectious causes of syphilis transmission to measure how widespread the disease is among Pakistani blood donors. In the period from January to December 2024 a total of ten blood banks throughout both urban and rural areas of Pakistan conducted a cross-sectional survey.  A total of 2,500 volunteer blood donors age 18 through 60 underwent diagnostic testing with TPHA together with RPR for syphilis analysis.  Results showed that syphilis infected 1.2% (30 out of 2,500 blood donors) where men and donors aged from 25 to 34 years were more likely to have the disease (80% and 60% respectively).  The rate of blood donors diagnosed with syphilis showed no meaningful variation between hospitals in urban areas (1.0%) and hospitals in rural areas (1.3%) based on statistical analysis with p=0.53.  Regular RPR screening alone performed by blood banks detected 1.0% of cases but screening with the combination of RPR and TPHA identified 5.0% of instances.  The diagnostic tests demonstrated RPR testing results in 90% sensitivity alongside 95% specificity and FTA-ABS testing showed 95% sensitivity together with 98% specificity. The blood screening system in Pakistan displays significant failures in rural areas because these locations maintain outdated equipment and lack proper resources to detect cases.  The authors recommend a double diagnostic approach by combining TPHA with RPR tests nationwide to strengthen syphilis detection during transfusions in low-resource settings.  Public health campaigns must prioritize two essential objectives of improving blood donor awareness about TTIs in addition to enforcing adherence to WHO blood safety standards.  The prevention of transfusion-transmitted syphilis throughout Pakistan depends on better blood testing procedures as well as strengthened medical care infrastructure.