Syphilis in Pregnancy in Tanzania. II. The Effectiveness of Antenatal Syphilis Screening and Single‐Dose Benzathine Penicillin Treatment for the Prevention of Adverse Pregnancy Outcomes

Deborah Watson‐Jones, Balthazar Gumodoka, Helen Weiss, John Changalucha, James Todd, Kokungoza Mugeye, Anne Buvé, Zephrine Kanga, Leonard Ndeki, Mary Rusizoka, David Ross, Janeth Marealle (+3 others)
2002 Journal of Infectious Diseases  
Treatment for maternal syphilis with single-dose benzathine penicillin (2.4 million units intramuscularly) is being implemented in many parts of sub-Saharan Africa. To examine the effectiveness of this regimen, a prospective cohort of 1688 pregnant women was recruited in Tanzania. Birth outcomes were compared among women treated for high-titer ( ; rapid n p 133 plasma reagin [RPR] titer у1:8 and Treponema pallidum hemagglutination assay [TPHA]/ fluorescent treponemal antibody [FTA] positive)
more » ... low-titer ( ; RPR titer !1:8 and n p 249 TPHA/FTA positive) active syphilis and 950 uninfected women. Stillbirth or low-birth-weight live births were observed in 2.3% and 6.3%, respectively, of women treated for high-titer active syphilis and in 2.5% and 9.2%, respectively, of seronegative women. There was no increased risk for adverse pregnancy outcome for women treated for high-titer active syphilis (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.4-1.4) or low-titer active syphilis (OR, 0.95; 95% CI, 0.6-1.5), compared with seronegative women. Single-dose treatment is effective in preventing adverse pregnancy outcomes attributable to maternal syphilis. Maternal syphilis remains an important cause of adverse pregnancy outcome in sub-Saharan Africa [1] [2] [3] [4] [5] . A recent study in the Mwanza region of Tanzania, discussed in a companion paper [6] , has shown that 49% of women who had high-titer active syphilis (defined as a rapid plasma reagin [RPR] titer у1:8 and a positive Treponema pallidum hemagglutination assay [TPHA] or fluorescent treponemal antibody [FTA] test result), experienced an adverse pregnancy outcome, compared with 11% of seronegative women. Antenatal screening and treatment of syphilis in pregnant women is a priority in regions with high syphilis seroprevalence and has been recommended as a potentially feasible and cost-effective intervention [7-10].
doi:10.1086/342951 pmid:12232835 fatcat:hda64bivtfdffiyklinro27xgu