Context-Appropriate Interventions to Prevent Syphilis: A Narrative Review

Peterman, Thomas A.; Cha, Susan

doi:10.1097/olq.0000000000000804

Cited by 11 publications

(12 citation statements)

References 93 publications

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“…Publicity and education about the harms of undetected and untreated syphilis should be strengthened at women’s first ANC visit to increase their awareness of the risk of syphilis and their willingness to be tested and treated. Besides, one-stop services that include rapid syphilis testing and treatment at the first antenatal visit could contribute to a reduction in the number of CS cases 31. Meanwhile, the awareness of the importance of syphilis testing in pregnancy and counselling services in antenatal clinics should be further strengthened at all levels of healthcare 8…”

Section: Discussionmentioning

confidence: 99%

Development and validation of an individualised nomogram to predict mother-to-child transmission in pregnant women with syphilis in China: a retrospective cohort study

Feng,

Gao,

Wang

et al. 2024

BMJ Open

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ObjectivesThe elimination of mother-to-child transmission (MTCT) of syphilis has been set as a public health priority. However, an instrument to predict the MTCT of syphilis is not available. We aimed to develop and validate an intuitive nomogram to predict the individualised risk of MTCT in pregnant women with syphilis in China.DesignRetrospective cohort study.SettingData was acquired from the National Information System of Prevention of MTCT of Syphilis in Guangdong province between 2011 and 2020.ParticipantsA total of 13 860 pregnant women with syphilis and their infants were included and randomised 7:3 into the derivation cohort (n=9702) and validation cohort (n=4158).Primary outcome measuresCongenital syphilis.ResultsAmong 13 860 pregnant women with syphilis and their infants included, 1370 infants were diagnosed with congenital syphilis. Least absolute shrinkage and selection operator regression and multivariable logistic regression showed that age, ethnicity, registered residence, marital status, number of pregnancies, transmission route, the timing of syphilis diagnosis, stage of syphilis, time from first antenatal care to syphilis diagnosis and toluidine red unheated serum test titre were predictors of MTCT of syphilis. A nomogram was developed based on the predictors, which demonstrated good calibration and discrimination with an area under the curve of the receiver operating characteristic of 0.741 (95% CI: 0.728 to 0.755) and 0.731 (95% CI: 0.710 to 0.752) for the derivation and validation cohorts, respectively. The net benefit of the predictive models was positive, demonstrating a significant potential for clinical decision-making. We have also developed a web calculator based on this prediction model.ConclusionsOur nomogram exhibited good performance in predicting individualised risk for MTCT of syphilis, which may help guide early and personalised prevention for MTCT of syphilis.

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Section: Discussionmentioning

confidence: 99%

Development and validation of an individualised nomogram to predict mother-to-child transmission in pregnant women with syphilis in China: a retrospective cohort study

Feng,

Gao,

Wang

et al. 2024

BMJ Open

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“…Although substance use was frequently reported among mothers of infants with congenital syphilis, all but 1 of the cases with substance use reported using marijuana only and none reported IVDU, which has been more often associated with syphilis [ 20 , 21 , 23 ]. Recreational marijuana use was illegal during all years included in this study but became legal in Illinois in 2020.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Pregnant Women With Syphilis and Factors Associated With Congenital Syphilis at a Chicago Hospital

Thornton

Chaisson

Bleasdale

2022

Open Forum Infectious Diseases

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Background Congenital syphilis incidence has more than tripled in recent years, in parallel with the resurgence of syphilis among reproductive-aged women. An understanding of risk factors associated with maternal syphilis infection can guide prevention of congenital syphilis through prenatal diagnosis and treatment. We aimed to describe factors associated with maternal syphilis and congenital syphilis at a public medical center in Chicago, Illinois. Methods Maternal syphilis diagnoses were identified using a database for local health department reporting. Medical records were reviewed for infant congenital syphilis diagnoses, sociodemographic information, medical history, and other behavioral factors. Maternal characteristics associated with congenital syphilis were assessed using logistic regression. Results Of 106 maternal syphilis diagnoses between 2014-2018, 76 (72%) had a known pregnancy outcome; of these, 8 (11%) delivered an infant with congenital syphilis. Women with psychiatric illness and non-injection substance use each had over a five-fold increased odds of having an infant with congenital syphilis. Cases with congenital syphilis were more likely to have late or scant prenatal care and initiated treatment nearly three months later in pregnancy. None were HIV positive or reported incarceration, intravenous substance use, sex work, or having sex with MSM. Conclusion Maternal psychiatric illness and substance use may have complicated prenatal care and delayed syphilis treatment, describing a population in need of public health intervention. Women experiencing such barriers to care may benefit from closer follow-up after a prenatal syphilis diagnosis to prevent congenital transmission.

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“…Primary healthcare facilities serve as the initial point of contact for individuals seeking medical care, regardless of their socioeconomic status or healthcare needs. By incorporating syphilis services into these facilities, individuals are more likely to access testing and treatment services, especially in underserved and remote regions where specialized clinics may be limited [107,108] Moreover, integration enables a comprehensive approach to sexual health. Primary healthcare providers are well-positioned to address various health needs of their patients, including sexual health.…”

Section: Integration Of Syphilis Services Into Primary Healthcarementioning

confidence: 99%

Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions

Fajemiroye,

Moreira,

Ito

et al. 2023

Venereology

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In recent years, the global resurgence of syphilis has posed significant challenges to public health. This sexually transmitted infection, caused by the bacterium Treponema pallidum, can have severe consequences if left untreated, including neurological and cardiovascular complications. Diagnosing syphilis is complex due to its diverse clinical presentations, necessitating a multifaceted approach, including serological, molecular, and direct techniques such as dark-field microscopy. Penicillin remains the primary and effective treatment, but emerging macrolide-resistant strains have spurred investigations into alternative antibiotics. Syphilis vaccine development faces unique hurdles, yet promising strategies are under investigation. Targeted prevention strategies focus on high-risk populations such as men who have sex with men, pregnant women, and individuals with multiple sexual partners. The integration of syphilis services into primary healthcare enhances accessibility, early detection, and treatment. Innovative point-of-care diagnostics offer rapid, sensitive testing, while ongoing vaccine research holds the potential for long-term prevention. Addressing the global burden of syphilis requires a multifaceted approach, encompassing immunological advancements, innovative diagnostics, targeted prevention, and primary healthcare integration. Collaborative efforts between governments, healthcare systems, researchers, and communities are essential to effectively combat syphilis, striving toward a syphilis-free future that promotes better sexual health and overall well-being.

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Context-Appropriate Interventions to Prevent Syphilis: A Narrative Review

Cited by 11 publications

References 93 publications

Development and validation of an individualised nomogram to predict mother-to-child transmission in pregnant women with syphilis in China: a retrospective cohort study

Development and validation of an individualised nomogram to predict mother-to-child transmission in pregnant women with syphilis in China: a retrospective cohort study

Characteristics of Pregnant Women With Syphilis and Factors Associated With Congenital Syphilis at a Chicago Hospital

Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions

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