The epidemiology of syphilis in pregnancy

Lumbiganon, Pagakrong; Piaggio, Gilda; Villar, J; Pinol, A.; Bakketeig, Leiv S.; Bergsjø, Per; Al-Mazrou, Yagob Y.; Ba’aqeel, Hassan S.; Belizán, José M.; Farnot, Ubaldo; Carroli, Guillermo; Berendes, Heinz W.

doi:10.1258/09564620260079653

Cited by 57 publications

(45 citation statements)

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“…Though treatment of gestational syphilis significantly decreases the risk of adverse pregnancy outcomes, women with syphilis during pregnancy are 2.5 times more likely to have adverse outcomes than women who were not infected at any time during pregnancy, even after treatment (26). A prospective cohort or case-control study controlling for variables such as HIV status and overall health might help to delineate this relationship more clearly.…”

Section: Table 1 Centers For Disease Control and Prevention Case Defmentioning

confidence: 99%

Maternal and congenital syphilis in rural Haiti

Lomotey¹,

Lewis²,

Gebrian³

et al. 2009

Rev Panam Salud Publica

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Objectives. A study was conducted to assess the prevalence of maternal syphilis and esti- ABSTRACTSyphilis continues to be a widespread global health problem, affecting 12 million people each year and resulting in significant morbidity and mortality (1). SubSaharan Africa has the highest prevalence of gestational syphilis, with up to 17% of pregnant women testing positive for syphilis at antenatal clinics (2). Several Latin American and Caribbean countries, including Haiti, also have very high reported rates of the disease (3, 4). Congenital syphilis rates closely parallel rates of primary and secondary syphilis in women of child-bearing age (5).Syphilis in pregnancy is a major risk for the mother and the fetus, frequently causing miscarriage, stillbirth, and neonatal death (6). Adverse pregnancy outcomes are known to occur in up to 80% of women with active syphilis during gestation (7). Congenital syphilis, particularly if untreated, usually causes deleterious consequences to the child-including deafness, blindness, and mental retardation. Given that 50% of infants with congenital syphilis are asymptomatic at birth (8), many such children born to women with unrecognized gestational syphilis could remain untreated. Early prenatal screening for syphilis, and proper treatment of women during pregnancy, is therefore the most costeffective approach to avoid prenatal complications and the high morbidity

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Section: Table 1 Centers For Disease Control and Prevention Case Defmentioning

confidence: 99%

Maternal and congenital syphilis in rural Haiti

Lomotey¹,

Lewis²,

Gebrian³

et al. 2009

Rev Panam Salud Publica

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“…7,8 Syphilis control is facilitated by the availability of inexpensive and sensitive diagnostic tests and effective and affordable treatment. 7,[9][10][11][12] Antenatal screening and treatment for the disease is highly cost-effective as a means to reduce fetal and infant morbidity and mortality, 13 and furthermore, such measures could contribute to reduced HIV transmission. 8,14 Every year, about 1.6 million pregnant women with syphilis remain undiagnosed in sub-Saharan Africa, including more than one million attending antenatal care.…”

Section: Introductionmentioning

confidence: 99%

Syphilis screening in Mozambique

Montoya

Lukehart

Brentlinger

et al. 2006

Bull World Health Organ

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Objective Programmes to control syphilis in developing countries are hampered by a lack of laboratory services, delayed diagnosis, and doubts about current screening methods. We aimed to compare the diagnostic accuracy of an immunochromatographic strip (ICS) test and the rapid plasma reagin (RPR) test with the combined gold standard (RPR, Treponema pallidum haemagglutination assay and direct immunofluorescence stain done at a reference laboratory) for the detection of syphilis in pregnancy. Methods We included test results from 4789 women attending their first antenatal visit at one of six health facilities in Sofala Province, central Mozambique. We compared diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of ICS and RPR done at the health facilities and ICS performed at the reference laboratory. We also made subgroup comparisons by human immunodeficiency virus (HIV) and malaria status. Findings For active syphilis, the sensitivity of the ICS was 95.3% at the reference laboratory, and 84.1% at the health facility. The sensitivity of the RPR at the health facility was 70.7%. Specificity and positive and negative predictive values showed a similar pattern. The ICS outperformed RPR in all comparisons (P<0.001). Conclusion The diagnostic accuracy of the ICS compared favourably with that of the gold standard. The use of the ICS in Mozambique and similar settings may improve the diagnosis of syphilis in health facilities, both with and without laboratories.Keywords Syphilis serodiagnosis; Prenatal diagnosis; Mozambique (source: MeSH, NLM). Mots clés Séro-diagnostic syphilis; Diagnostic prénatal; Mozambique (source: MeSH, INSERM). Palabras clave Serodiagnóstico de la sífilis; Diagnóstico prenatal; Mozambique (fuente: DeCS, BIREME). Voir page 103 le résumé en français. En la página 103 figura un resumen en español.

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“…5,9 It is estimated that 40% of pregnancies in women with non-treated primary or secondary syphilis evolve into fetal loss or neonatal death. 4 In recent years, an increase in syphilis prevalence in developing and industrialized countries has been seen, especially primary and secondary syphilis in childbearing women, with a consequent increase in the rate of neonatal syphilis. 2,16 RESUMO OBJETIVO: Estimar a prevalência de oportunidade perdida de prevenção a sífi lis e HIV entre gestantes que tiveram acesso ao pré-natal e fatores associados a não-testagem para esses agravos.…”

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Missed opportunities for congenital syphilis and HIV perinatal transmission prevention

Rodrigues

Guimarães

César³

2008

Rev. Saúde Pública

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Missed opportunities for congenital syphilis and HIV perinatal transmission preventionOportunidades perdidas na prevenção da sífi lis congênita e da transmissão vertical do HIV ABSTRACT OBJECTIVE: To estimate the prevalence of missed opportunities for congenital syphilis and HIV prevention in pregnant women who had access to prenatal care and to assess factors associated to non-testing of these infections. METHODS:Cross-sectional study comprising a randomly selected sample of 2,145 puerperal women who were admitted in maternity hospitals for delivery or curettage and had attended at least one prenatal care visit, in Brazil between 1999 and 2000. No syphilis and/or anti-HIV testing during pregnancy was a marker for missed prevention opportunity. Women who were not tested for either or both were compared to those who had at least one syphilis and one anti-HIV testing performed during pregnancy (reference category). The prevalence of missed prevention opportunity was estimated for each category with 95% confi dence intervals. Factors independently associated with missed prevention opportunity were assessed through multinomial logistic regression. RESULTS:The prevalence of missed prevention opportunity for syphilis or anti-HIV was 41.2% and 56.0%, respectively. The multivariate analysis showed that race/skin color (non-white), schooling (<8 years), marital status (single), income (<3 monthly minimum wages), having sex during pregnancy, history of syphilis prior to the current pregnancy, number of prenatal care visits (<6), and last prenatal visit before the third trimester of gestation were associated with an increased risk of missed prevention opportunity. A negative association with missed prevention opportunity was found between marital status (single), prenatal care site (hospital) and fi rst prenatal visit in the third trimester of gestation. CONCLUSIONS:High rates of non-tested women indicate failures in preventive and control actions for HIV infection and congenital syphilis. Pregnant women have been discontinuing prenatal care at an early stage and are failing to undergo prenatal screening for HIV and syphilis.

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The epidemiology of syphilis in pregnancy

Cited by 57 publications

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Maternal and congenital syphilis in rural Haiti

Maternal and congenital syphilis in rural Haiti

Syphilis screening in Mozambique

Missed opportunities for congenital syphilis and HIV perinatal transmission prevention

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