The latter can be further subdivided into chorio-amnionitis (14), preterm labour (PTL) with chorio-amnionitis and intact membranes (3) and treponemal infection (1).
The primary cause of death in 18 of our cases was attributed to treponemal infection.
Now, immunological tests on bones from a Pleistoceneepoch bear prove that treponemal infections in the New World date back at least 11,000 years.
Although the new finding does not resolve the debate about the origin of treponemal infections, the immunological technique will help scientists trace the history of these and other infections.
Other treponemal infections
such as yaws cannot be differentiated serologically from syphilis, and a diagnosis of yaws is based on clinicoepidemiologic features (8); however, yaws is not endemic to Kumasi, and because this child had no clinical evidence of yaws, this disease is unlikely to be the cause of the seroconversion.
As has been demonstrated previously in southern Africa, the utility of both treponemal and non-treponemal serological tests for the diagnosis of primary syphilis is questionable, (16) since many patients with primary syphilis are seronegative (especially by the RPR test), while others with ulcerations caused by other organisms are seropositive (especially by the FTA-ABS test) as a result of previously treated treponemal infections