ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Gomez GB , Kamb ML , Newman LM , Mark J , Broutet N , Hawkes SJ , 2013. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ 91: 217–226.
-
2.
Korenromp EL et al.2019. Global burden of maternal and congenital syphilis and associated adverse birth outcomes: estimates for 2016 and progress since 2012. PLoS One 14: e0211720.
-
3.
Joseph Davey DL , Shull HI , Billings JD , Wang D , Adachi K , Klausner JD , 2016. Prevalence of curable sexually transmitted infections in pregnant women in low- and middle-income countries from 2010 to 2015: a systematic review. Sex Transm Dis 43: 450–458.
-
4.
World Health Organization , 2017. WHO Guideline on Syphilis Screening and Treatment for Pregnant Women. Available at: https://www.who.int/reproductivehealth/publications/rtis/syphilis-ANC-screenandtreat-guidelines/en/. Accessed December 22, 2021.
-
5.
Phang Romero Casas C , Martyn-St James M , Hamilton J , Marinho DS , Castro R , Harnan S , 2018. Rapid diagnostic test for antenatal syphilis screening in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open 8: e018132.
-
6.
Storey A , Seghers F , Pyne-Mercier L , Peeling RW , Owiredu MN , Taylor MM , 2019. Syphilis diagnosis and treatment during antenatal care: the potential catalytic impact of the dual HIV and syphilis rapid diagnostic test. Lancet Glob Health 7: e1006–e1008.
-
7.
Young N et al.2018. Integrated point-of-care testing (POCT) of HIV, syphilis, malaria and anaemia in antenatal clinics in western Kenya: a longitudinal implementation study. PLoS One 13: e0198784.
-
8.
Rodriguez PJ et al.2021. Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study. Lancet Glob Health 9: e61–e71.
-
9.
Government of Kenya Ministry of Health , 2018. Kenya National Guidelines for Prevention, Management, and Control of Sexually Transmitted Infections.https://nak.or.ke/wp-content/uploads/2019/05/final-STI-guidelines-17th-October-2018.pdf. Accessed January 14, 2022.
-
10.
Tessema ZT , Tamirat KS , Teshale AB , Tesema GA , 2021. Prevalence of low birth weight and its associated factor at birth in sub-Saharan Africa: a generalized linear mixed model. PLoS One 16: e0248417.
-
11.
Qin J , Yang T , Xiao S , Tan H , Feng T , Fu H , 2014. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis. PLoS One 9: e102203.
-
12.
Watson-Jones D et al.2002. Syphilis in pregnancy in Tanzania: I. Impact of maternal syphilis on outcome of pregnancy. J Infect Dis 186: 940–947.
-
13.
Temmerman M et al.2000. Effect of a syphilis control programme on pregnancy outcome in Nairobi, Kenya. Sex Transm Infect 76: 117–121.
-
14.
Hira SK et al.1990. Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin Med 66: 159–164.
-
15.
McDermott J , Steketee R , Larsen S , Wirima J , 1993. Syphilis-associated perinatal and infant mortality in rural Malawi. Bull World Health Organ 71: 773–780.
-
16.
Hong FC et al.2017. Risk of congenital syphilis (CS) following treatment of maternal syphilis: results of a CS control program in China. Nephrol Dial Transplant 65: 588–594.
-
17.
Hawkes SJ , Gomez GB , Broutet N , 2013. Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One 8: e56713.
-
18.
Blencowe H et al.2019. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 7: e849–e860.
-
19.
Munkhuu B , Liabsuetrakul T , Chongsuvivatwong V , McNeil E , Janchiv R , 2009. One-stop service for antenatal syphilis screening and prevention of congenital syphilis in Ulaanbaatar, Mongolia: a cluster randomized trial. Sex Transm Dis 36: 714–720.
-
20.
Myer L , Wilkinson D , Lombard C , Zuma K , Rotchford K , Karim SS , 2003. Impact of on-site testing for maternal syphilis on treatment delays, treatment rates, and perinatal mortality in rural South Africa: a randomised controlled trial. Sex Transm Infect 79: 208–213.
-
21.
Brandenburger D , Ambrosino E , 2021. The impact of antenatal syphilis point of care testing on pregnancy outcomes: a systematic review. PLoS One 16: e0247649.
-
22.
Wicher V , Wicher K , 2001. Pathogenesis of maternal–fetal syphilis revisited. Nephrol Dial Transplant 33: 354–363.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 731 | 731 | 35 |
| Full Text Views | 109 | 109 | 23 |
| PDF Downloads | 143 | 143 | 32 |
Associations between Antenatal Syphilis Test Results and Adverse Pregnancy Outcomes in Western Kenya
ABSTRACT.
Maternal syphilis remains a major contributor to poor pregnancy outcomes. Syphilis point-of-care (POC) tests are now used for pregnancy screening; the effect of screening on outcomes is unclear. We enrolled women presenting to antenatal care (ANC) in a matched cohort study at a single site in Kenya tested by either a syphilis-only or an HIV/syphilis dual POC test. Syphilis POC-positive women (patients) were matched 1:2 with POC-negative women (control subjects) on gravidity, gestational age, and HIV status, and were monitored through delivery. Syphilis serum testing was performed every 8 weeks. Pregnancy outcomes were assessed up to 1 month after delivery and compared using prevalence ratios. A total of 151 women were enrolled (51 patients and 100 control subjects) at a mean of 22 weeks gestation; 24% were HIV positive and 40% were paucigravid. A positive Treponema pallidum hemagglutination test was more common among patients (64.7%) than control subjects (11.1%, P < 0.001). Only two women met the definition for incident syphilis. Pregnancy outcomes were available for 147 women. The prevalence of low birthweight (LBW) was greater among patients (15.2%) than control subjects (5.4%, P = 0.052). Of the 109 women with concordant syphilis POC and Treponema pallidum hemagglutination test results at ANC enrollment, LBW prevalence was significantly greater among test-positive (25%) than test-negative (4.9%) women (adjusted prevalence ratio, 5.84; 95% CI, 1.08–31.5). Despite treatment with penicillin, latent syphilis at ANC enrollment was associated with a more than 5-fold increased risk of LBW. Alternate implementation strategies for syphilis POC testing may be necessary to realize the potential of ANC syphilis screening to improve pregnancy outcomes.
Author Notes
Financial support: This work was funded by a Priority Partnership Location research pilot award from the Duke Global Health Institute to J. L. and S. M. T.
Authors’ addresses: Jeremiah Laktabai, Department of Family Medicine, Moi University School of Medicine, Eldoret, Kenya, and Academic Model Providing Access to Healthcare, Moi Teaching and Referral Hospital, Eldoret, Kenya, E-mail: drlaktabai@yahoo.com. Victoria L. Mobley, Division of Public Health, Department of Health and Human Services, Raleigh, NC, and Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, E-mail: victoria.mobley@dhhs.nc.gov. Wendy Prudhomme-O’Meara, Academic Model Providing Access to Healthcare, Moi Teaching and Referral Hospital, Eldoret, Kenya, Duke Global Health Institute, Duke University, Durham, NC, and Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, E-mail: wendy.omeara@duke.edu. Steve M. Taylor, Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, Duke Global Health Institute, Duke University, Durham, NC, and Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, E-mail: steve.taylor@duke.edu.