Newborn Syphilis Death Cases Preventable; Africa Most Stricken

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Academic Journal
Main Category: Sexual Health / STDs
Also Included In: Pregnancy / Obstetrics
Article Date: 16 Jun 2011 - 9:00 PDT


Low cost interventions to increase the coverage of screening and treatment of syphilis during pregnancy could prevent more than half of newborn deaths and stillbirths related to the disease, which is responsible for nearly 500,000 perinatal deaths every year in sub-Saharan Africa alone.

More than 2 million pregnant women are infected with syphilis every year. Screening of pregnant women for syphilis is recommended in nearly all countries but is not widely implemented, and less than one in eight pregnant women is screened.

Without screening and treatment, up to 69% of women will experience an adverse pregnancy outcome such as stillbirth, low birth weight, or disability of an infant. Yet adverse outcomes caused by syphilis are entirely preventable

The authors of a new study that states syphilis in particular is still a newborn death epidemic say:

"This review adds to the observational evidence of the benefits of single interventions such as penicillin for the treatment of diagnosed syphilis in pregnancy and of the diagnostic efficacy of rapid point-of-care tests. We showed the levels of benefit that could be achieved at a population level, when single interventions are combined and delivered as a comprehensive program. This study also suggests that the resources needed to roll out programs for antenatal screening will be a worthwhile investment for reduction of adverse pregnancy outcomes and improvement of neonatal and child survival."

Sarah Hawkes from University College London, London, UK and colleagues reviewed the evidence for the effectiveness of interventions to increase syphilis testing and treatment rates, and improve pregnancy outcomes. The meta-analysis included ten studies and over 41,000 women and showed that interventions that include offering decentralized, same-day testing and treatment could reduce perinatal deaths by 54%, stillbirths by 58%, as well as reducing congenital syphilis (an infected live-born infant).

Studies of pregnant women infected with syphilis in Africa have revealed rates of 17.4% in Cameroon, 8.4% in South Africa, 6.7% in Central African Republic and 2.5% in Burkina Faso. In the Western Pacific, relatively high rates of 8% in the South Pacific, 4% in Cambodia and 3.5% in Papua New Guinea have been reported. In 1997, studies amongst pregnant women in the Eastern Mediterranean Region showed syphilis infection rates of 3.1% in Djibouti, 3.0% in Morocco and 2.4% in Sudan.

David Mabey and Rosanna W Peeling from London School of Hygiene and Tropical Medicine, London, UK comment:

"The perception among many public health experts, program managers, and policy makers that syphilis has disappeared has probably been the greatest barrier to preventing syphilis deaths in babies. If you don't test for it you don't find it, which reinforces the impression that it is no longer an issue. If all pregnant women were screened, and those who tested positive were treated with one dose of benzathine penicillin before 28 weeks' gestation, no stillbirths or neonatal deaths would be due to syphilis."

No single organization regularly collates STD statistics worldwide, and different countries have different types and levels of reporting systems. It is thought that many reports substantially underestimate the number of new STD cases because social stigma and other factors prevent people seeking health care.

Sources: The Lancet Infectious Diseases Journal and Avert Statistics

Written by Sy Kraft
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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