06 Mar Ending Congenital Syphilis
Recent publications AIGHD/AMC Department of Global Health by Gabriela Gomez on Ending Congenital Syphilis
Congenital syphilis, transmitted during pregnancy to babies, continues to be a significant public health burden. But it is inexpensive to detect and treat and would be relatively simple to eliminate.
AIGHD worked with other partners to build the World Health Organization’s investment case for eliminating mother-to-child transmission of syphilis [World Health Organization. 2012.
Link: Investment case for eliminating mother-to-child transmission of syphilis: promoting better maternal and child health and stronger health systems.
Gabriela Gomez of AIGHD helped to estimate the total burden of congenital syphilis and the impact of congenital syphilis on pregnancy outcomes. Three key peer-reviewed papers build the investment case:
– Newman L, Kamb M, Hawkes S, Gomez GB, Say L, Seuc A, Broutet N estimate that in 2008, 1.4 million pregnant women around the world were infected with syphilis, 80% of whom had attended antenatal care services. The researchers reached this figure by entering information on the numbers of syphilis infections in 97 countries and antenatal clinic attendance from 147 countries into a model. Following consultation with experts to develop a realistic scenario, the authors estimated that the percentage of pregnant women tested for syphilis and adequately treated ranged from 30% in Africa and the Mediterranean region to 70% in Europe. The model estimated that in 2008, syphilis infections in pregnant women caused 520,000 harmful outcomes, including 215,000 stillbirths, 90,000 neonatal (baby) deaths, 65,000 preterm or low birth-weight babies, and 150,000 babies with congenital infections. Link: Global Estimates of Syphilis in Pregnancy and Associated Adverse Outcomes: Analysis of Multinational Antenatal Surveillance Data; PLoS Medicine 2013
– Two systematic reviews and meta-analyses were used to estimate the number of adverse pregnancy outcomes that were included in the scenario analysis of the investment case.
• The impact of syphilis on adverse pregnancy outcomes: A systematic literature review and meta-analysis by Gomez GB, Kamb M L, Newman L M, Broutet N, Mark J, Hawkes S J) Link: Bulletin of WHO, March 2013.
• Does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis by Hawkes SJ, Gomez GB, Broutet N, link: PLoS One 2013.
Despite an increase in the proportion of women who access antenatal care, mother-to-child transmission of syphilis continues to cause preventable illness and deaths in newborns. Timely access to quality healthcare and strengthening of health systems would help ensure that maternal syphilis is detected early and treated before it causes damage in pregnancy.