Point-of-Care Tests to Strengthen Health Systems and Save Newborn Lives: The Case of Syphilis

Abstract

Rosanna Peeling and colleagues describe their experience of introducing point-of-care testing to screen for syphilis in pregnant women living in low- and middle-income countries.

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

“…Screening of pregnant women for syphilis is national policy in most countries; yet, in 2001, it was estimated that less than 40% of pregnant women were screened for syphilis in Sub-Saharan Africa [22]. Since that time, point-of-care tests for syphilis, which can be performed anywhere and provide a result in 15 minutes, have been developed [6]. Moreover, considerable resources have been made available for the PMTCT of HIV in many African countries.…”

“…Despite syphilis screening of pregnant women being a recommended policy in many low-resource countries [6], in reality, infants of HIV-infected mothers who receive antiretroviral therapy prophylaxis and successfully complete steps along the PMTCT cascade may still die from congenital syphilis due to lack of maternal syphilis services [6]. A 2013 global analysis of antenatal surveillance data estimated that, in Africa, annually, more than 535 000 women with active syphilis become pregnant [7].…”

“…The integration of PMTCT of HIV services with maternal syphilis screening services is cost-efficient, saving providers' and clients' time [14]. Thus, the integration of services has the potential to increase uptake of each individual intervention and to lead to improved maternal and reproductive health [6,11].…”

Using electronic readers to monitor progress toward elimination of mother‐to‐child transmission of HIV and syphilis: An opinion piece

“…This has reduced neonatal mortality and adverse outcomes of pregnancy [4]. However, when testing using RDTs is highly decentralized or data quality is difficult to verify, data gathering for the monitoring and evaluation of country progress toward EMTCT of HIV and syphilis can present challenges.…”

Syphilis testing in antenatal care: Policies and practices among laboratories in the Americas

“…Despite this, preventable congenital syphilis infections continue to occur because pregnant women-especially those who are poor or living in rural settings-are often not screened according to national guidelines [6][7][8]. The most commonly used serologic screening tests for syphilis require specialized reagents and equipment and trained technicians-a laboratory capacity typically unavailable outside larger hospital or reference laboratories in most low-and middle-income countries [9]. However, globally, many pregnant women receive ANC at lower-level facilities without such laboratory capacity [6][7][8].…”