Mali: Treating syphilis, a sexually transmitted infection

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This story was originally published in December 2022. 

It’s four in the afternoon in Médine, a city in Segou, Mali. A group of women and young girls have gathered to learn more about sexual and reproductive health. The session is led by an organization called Walé, a local non-profit devoted to raising awareness about sexually transmitted infections, supporting people living with HIV, and improving the sexual and reproductive health of people in the region. 

Aminata is a woman in her 20s from a nearby town, who is married with a young daughter. Several years ago, she was diagnosed with syphilis, and she is attending the event to share her experience with others. 

She says that, before she was married, she had an active sex life with several partners, and that neither she nor her partners wore condoms during sex.

She continues, “After a while, I noticed pimples on my genitalia. After a consultation with a gynaecologist, the doctor told me that I had syphilis.”

Syphilis is a sexually transmitted infection, or STI, that can be contracted during sexual intercourse, either oral, genital, or anal. Pregnant people with syphilis can also transmit the infection to their unborn child. The first signs of syphilis are firm, round, and painless sores on the penis, vagina, anus, rectum, lips, or mouth. These can last three to six weeks. 

The sores heal regardless of whether the person receives treatment. But, even after they disappear, treatment is required to prevent the infection from progressing. 

Without treatment, there will be more sores, as well as rough, reddish-brown rashes. Other symptoms include fever, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. Over time, the symptoms may recede, but the infection remains in the body until treated. 

Kadidia Sidibé Diarra is a midwife and health specialist with the Association de Soutien au Développement des Activités de Population. Mrs. Diarra says: “The duration and symptoms of the different stages of syphilis vary greatly from one individual to another. This makes the illness difficult to diagnose. If the person has no clinical signs [of syphilis], the diagnosis is based on questioning and an examination.”

Aminata says she did not pay attention to the pimples on her genitalia. She thought it was a skin allergy until she discovered a sore inside her vagina. As the infection progressed, she also developed a fever and headaches. 

So she decided to get tested for STIs at a health centre. The doctor asked about her sexual activities and took a blood sample. The test confirmed that Aminata had syphilis, an infection which, at the time, she had never heard of. 

According to Dr. Mamadou Coulibaly, a gynaecologist at the Centre de Santé de Reference, if syphilis is not treated properly and in time, it can cause complications during pregnancy, damage to internal organs, and even lead to death within 10 to 30 years of infection. Syphilis can also increase the risk of contracting HIV. 

Luckily, the test caught Animata’s infection early. Dr. Coulibaly prescribed a course of antibiotics, which is the typical treatment. Months later, Aminata took a follow-up blood test and her results were negative. The doctor advised Aminata to continue getting tested at least three times each year, and to use protection during sexual activities. 

Aminata got married to a man one year after completing her syphilis treatment. But in the months following her marriage, she had two miscarriages. Aminata and her husband went to a doctor to try to figure out the problem. The tests showed that both she and her husband had syphilis.

The couple each followed a course of antibiotics, which successfully treated their infections. A year later, Aminata was once again pregnant and, this time, gave birth to a healthy baby girl. 

Looking back on her history with syphilis, she says: “I now understand the importance of sexual and reproductive health in a woman’s life!”

According to Dr. Coulibaly and Ms. Diarra, regular screening for STIs enables people to care for their sexual and reproductive health. They urge everyone to visit health services for regular STI testing and to use protection during sexual activities.

Aminata echoes their messages. She encourages her community to protect themselves during sex and get tested regularly. 

She adds that education is key, and says, “Let’s go to our health services regularly to get accurate information on how STIs are transmitted.” 

Animata’s name was changed in this story to protect her privacy.

This resource was produced through the “HÉRÈ – Women’s Well-Being in Mali” initiative, which aims to improve the sexual and reproductive health well-being of women and girls and to strengthen the prevention of and response to gender-based violence in Sikasso, Ségou, Mopti, and the district of Bamako in Mali. The project is implemented by the HÉRÈ – MSI Mali Consortium, in partnership with Farm Radio International (FRI) and Women in Law and Development in Africa (WiLDAF) with funding from Global Affairs Canada.

Photo: A group of women meets at a health post to discuss issues of common concern. Credit: Nena Terrell, USAID Ethiopia.