Treatment for syphilis in antenatal care: compliance with the three dose standard treatment regimen

Abstract

Background: In South Africa, three doses of benzathine penicillin 2.4 MU at weekly intervals are recommended for treating syphilis in pregnancy. Limited information is available on compliance with the recommended regimen, in terms of time to starting treatment, number of doses, and timing of treatment. Methods: The study was conducted to establish the degree of compliance with treatment for syphilis. Timing of treatment and the titres of the rapid plasma reagin (RPR) positive women were recorded. A retrospective record review was conducted of 18 128 antenatal records. These were records of women attending antenatal care clinics in a tertiary hospital catchment area in KwaZulu Natal between February 2001 and January 2002. Results: Treatment patterns showed that 15.9% received no treatment, 13.2% one dose, 5.8% received two doses, and 64.8% received three doses. In total, 188 women (1.03%) were found to be RPR positive. Of these 36% were found to be high titre positives (titre >1:8). Conclusion: Completed treatment was significantly associated with age of gestation at first visit (p = 0.029), with women attending later in pregnancy less likely to receive all three doses of treatment.

Syphilis among pregnant women in Juba, Souther Sudan

“…These differences could be due to the better health system in Khartoum as opposed to that in Juba which is yet to be established to support maternal and child health. The prevalence results from this current study are different from those found by other workers who found very low rates ranging from a low of 0% in Kabul, Afghanistan (11), 0.9% in a suburban community in Northern Sudan (12) and 1.03% in South Africa (13). Other low prevalence of 4.0% in pregnant women has been found in Entebbe, Uganda (14).…”

Divergent spatial patterns in the prevalence of the human immunodeficiency virus (HIV) and syphilis in South African pregnant women

“…The high prevalence rates of syphilis among the more rural north-western women compared to their urban counterparts in the north-eastern part might be attributable to low education levels, limited access to health care and high levels of poverty (Yahya-Malima et al, 2008). As a result, the rural areas might lag behind urban areas in terms of treatment adherence as many rural, pregnant women attend late for antenatal care (Mullick et al, 2005).…”

Impact of Implementing Antenatal Syphilis Point-of-Care Testing on Maternal Mortality in KwaZulu-Natal, South Africa: An Interrupted Time Series Analysis

“…Syphilis point-of-care (POC) testing is provided as part of the routine antenatal services in South Africa. This was implemented to help improve healthcare access and neonatal health outcomes [7][8][9][10][11]. The introduction of syphilis POC testing has been shown to be effective in strengthening health systems by improving access to quality-assured prenatal screening and saving new-born lives in resource-limited settings [12,13].…”

“…Syphilis infection has been associated with HIV through facilitating HIV transmission and the combination of syphilis, particularly during pregnancy [9,15]. Early detection of Treponema pallidum and prompt penicillin treatment for pregnant women who test positive have been shown to be effective in reducing adverse pregnancy outcomes [16][17][18].…”