By Jaime Espina

For Marianas Variety

KOLONIA, Pohnpei (Oct. 14) - Pohnpei Director of Health Simao Nanpei is worried about the increasing incidence of syphilis in the state, saying that it was most likely "only the tip of the iceberg."

Statistics made available by Nanpei showed that, from 73 cases from January to September last year, the number of new cases confirmed over the same period this year had jumped to 101, an increase of around 38 percent.

"We are averaging about 10 cases (detected) a month," Nanpei said, but added, "we suspect there are many, many more cases" that go undetected and untreated, especially among the "high risk population" of sexually active youth and those who have multiple sex partners.

All the cases the health department has detected and treated, said Nanpei, involved pregnant mothers, people wanting to donate blood and those who seek treatment for other sexually transmitted diseases, for whom testing for diseases is mandatory.

"We really have no way of testing teenagers" unless such tests become mandatory, Nanpei said. However, he added, this was highly unlikely.

Another problem in detecting syphilis cases is "we often run out of reagents" used in testing for possible infection, Nanpei said. "And if we were to test everyone, the amount we would need would cost us an arm and a leg."

In the case of infected childbearing women, Nanpei said, "We have had cases of newborns being born with the disease. Some have died although others have pulled through."

The only ones who seek voluntary testing for syphilis, said Nanpei, "are the partners who have already tested positive" and who would be the ones most likely to have been the cause of infection.

However, Nanpei acknowledged that, in many cases, should a husband turn out positive and to have been the source of his wife’s infection, convincing him to volunteer information about his other sexual contacts is difficult.

In the case of married couples, he said, "We offer them counseling because we don’t want to break up their families."

Because the symptoms of syphilis often take years to appear, said Nanpei, people who may be infected "see no reason to come in for testing." Thus, he said, "You could continue to go around carrying the disease" and spreading it.

This, he said, was unfortunate since syphilis is easily treated or reversed even up to its second stage.

Nanpei acknowledged a lack of public awareness about syphilis and other sexually transmitted diseases and attributed this to what he described as a "taboo" against discussing sexuality, especially within the family. "We need to move away from that" tradition, he said.

But he said there have been efforts to seek alternative means to educate the high-risk population, citing a multi-purpose center opened in Kolonia four months ago where young people may gather to socialize and, at the same time, receive education on public health and safe sex.

October 14, 2003

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