Elimination of mother-to-child transmission of HIV and Syphilis (EMTCT): Process, progress, and program integration

Taylor, Melanie; Newman, Lori M.; Ishikawa, Naoko; Laverty, Maura; Hayashi, Chika; Ghidinelli, Massimo; Pendse, Razia; Khotenashvili, Lali; Essajee, Shaffiq

doi:10.1371/journal.pmed.1002329

Cited by 78 publications

(76 citation statements)

References 9 publications

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“…Dual HIV and syphilis RDT testing in countries was prioritized by the WHO for the elimination of mother-to-child transmission (MTCT) of HIV and syphilis by 2020 32,33 , but a recent review showed that while Prevention of Mother to Child Transmission (PMTCT) programmes for HIV have resulted in a dramatic decrease in the number of HIV-positive infants in sub-Saharan Africa, the rate of syphilis screening of pregnant women in the same countries has remained at unacceptably low levels of approximately 30% (ref. 34 ).…”

Section: Malariamentioning

confidence: 99%

REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes

et al. 2018

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Section: Malariamentioning

confidence: 99%

REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes

et al. 2018

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“…By 2012, these efforts had contributed to a reduction in global adverse pregnancy outcomes due to MTCT of syphilis to 350,000, including 210,000 perinatal deaths, and decreased the rates of maternal and congenital syphilis decreased by 38% and 39%, respectively 23,24 . In 2015, Cuba became the first country to be validated for having achieved elimination of MTCT of HIV and syphilis 54 . Subsequently, Thailand, Belarus and four United Kingdom Overseas Territories (Bermuda, the Cayman Islands, Montserrat and Antigua) was validated for elimination of MTCT of HIV and syphilis, Moldova was validated for elimination of MTCT of syphilis, and Armenia was validated for elimination of MTCT of HIV.…”

Section: Epidemiologymentioning

confidence: 99%

Syphilis

Peeling

Mabey

Kamb

et al. 2017

Nat Rev Dis Primers

492

387

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Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochetes and often imitate those of other diseases. The spirochete has a long latent period during which patients have no signs or symptoms, but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement is needed to ensure that syphilis is given high priority on the global health agenda. More investment in research is needed on the interaction between HIV and syphilis in MSM, as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.

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“…Congenital syphilis is a consequence of untreated syphilis in the mother. More than half of congenital syphilis cases resulted in premature labor, miscarriage, stillbirth, low birth weight, and even death of the neonates . The condition is preventable when all pregnant women are screened and treated appropriately .…”

mentioning

confidence: 99%

“…More than half of congenital syphilis cases resulted in premature labor, miscarriage, stillbirth, low birth weight, and even death of the neonates. 1 The condition is preventable when all pregnant women are screened and treated appropriately. 2 This has led the World Health Organization (WHO) to set a goal for the elimination of mother-tochild transmission of syphilis to 50 cases per 100 000 live births by 2030.…”

mentioning

confidence: 99%

Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

Anugulruengkitt

Yodkitudomying²,

Sirisabya

et al. 2020

Pediatrics International

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Background The World Health Organization has set a goal to eliminate mother‐to‐child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention. Methods A retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria. Results From 2013 to 2017, 69 syphilis‐infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78–164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18–32) years and 12 (17%) women had human immunodeficiency virus co‐infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non‐reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non‐reactive rapid plasma reagin at the age of 7 months. Conclusions Congenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.

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Elimination of mother-to-child transmission of HIV and Syphilis (EMTCT): Process, progress, and program integration

Abstract: Melanie Taylor and colleagues discuss progress towards eliminating vertical transmission of HIV and syphilis.

Cited by 78 publications

References 9 publications

REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes

REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes

Syphilis

Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

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