Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study

BMC Infectious Diseases

Research Article

Nadine Pakker¹  Gertrude Namale²  Elizabeth Nalintya²  Joseph Sempa²  Rosalind Parkes Ratanshi²  Elly Katabira³  Yukari C Manabe⁴ 

[1] Amsterdam Institute for Global Health and Development, Amsterdam Medical Center, Amsterdam, Netherlands;Infectious Diseases Institute, Makerere College of Health Sciences, PO Box 22418, Mulago Hospital Complex, Kampala, Uganda;Infectious Diseases Institute, Makerere College of Health Sciences, PO Box 22418, Mulago Hospital Complex, Kampala, Uganda;Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda;Infectious Diseases Institute, Makerere College of Health Sciences, PO Box 22418, Mulago Hospital Complex, Kampala, Uganda;Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA;

关键词: Antenatal;    Syphilis;    Integration;    HIV;    Partner testing;   

DOI  :  10.1186/s12879-014-0739-1

 received in 2014-07-31, accepted in 2014-12-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSyphilis infection during pregnancy leads to avoidable morbidity and mortality and remains a significant problem in sub-Saharan Africa. Despite global initiatives to increase the proportion of pregnant women screened, implementation has been slow. We sought to investigate the feasibility of adding syphilis screening within an integrated antenatal HIV clinic.MethodsPregnant women attending the HIV antenatal clinic were sequentially enrolled and consenting participants answered a questionnaire on sexual behavior and previous pregnancies, provided sociodemographic data, and were tested using rapid plasmin reagin (RPR). If positive, participants were treated with benzathine penicillin. All were given a partner notification slip and were followed up after delivery to determine birth outcomes.Results584 of 606 (95.7%) women approached and consented to test for syphilis. 570 women were enrolled (median age 29 (IQR 25–32) with a median (IQR) CD4 of 372 (257–569) cells/μL). Of the 5.1% (29/570) with a positive RPR, all were asymptomatic, were successfully contacted, and treated with benzathine penicillin without adverse reactions. Overall, 61 (12.1%) of the participants had an adverse birth outcome. In the bivariate analysis, only age was significantly different between those with and without a positive RPR (RR = 1.15, 95% CI 1.065-1.248; p < 0.001). Partners of only 10 (34.5%) participants returned for treatment.ConclusionsStructural interventions such as opt-out testing for syphilis within integrated HIV-antenatal care clinics are feasible and capitalize on the excellent care programs that have already been established for HIV care. Novel approaches are required for partner notification.

【 授权许可】

CC BY   
© Manabe et al.; licensee BioMed Central. 2015