Abstract
Background: In South Africa, three doses of benzathine penicillin 2.4 MU at weekly intervals are recommended for treating syphilis in pregnancy. Limited information is available on compliance with the recommended regimen, in terms of time to starting treatment, number of doses, and timing of treatment.
Methods: The study was conducted to establish the degree of compliance with treatment for syphilis. Timing of treatment and the titres of the rapid plasma reagin (RPR) positive women were recorded. A retrospective record review was conducted of 18 128 antenatal records. These were records of women attending antenatal care clinics in a tertiary hospital catchment area in KwaZulu Natal between February 2001 and January 2002.
Results: Treatment patterns showed that 15.9% received no treatment, 13.2% one dose, 5.8% received two doses, and 64.8% received three doses. In total, 188 women (1.03%) were found to be RPR positive. Of these 36% were found to be high titre positives (titre ⩾1:8).
Conclusion: Completed treatment was significantly associated with age of gestation at first visit (p = 0.029), with women attending later in pregnancy less likely to receive all three doses of treatment.
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Selected References
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- Azeze B., Fantahun M., Kidan K. G., Haile T. Seroprevalence of syphilis amongst pregnant women attending antenatal clinics in a rural hospital in north west Ethiopia. Genitourin Med. 1995 Dec;71(6):347–350. doi: 10.1136/sti.71.6.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bam R. H., Cronjé H. S., Muir A., Griessel D. J., Hoek B. B. Syphilis in pregnant patients and their offspring. Int J Gynaecol Obstet. 1994 Feb;44(2):113–118. doi: 10.1016/0020-7292(94)90063-9. [DOI] [PubMed] [Google Scholar]
- Beksinska Mags E., Mullick Saiqa, Kunene Busisiwe, Rees Helen, Deperthes Bidia. A case study of antenatal syphilis screening in South Africa: successes and challenges. Sex Transm Dis. 2002 Jan;29(1):32–37. doi: 10.1097/00007435-200201000-00006. [DOI] [PubMed] [Google Scholar]
- Delport S. D., Rothberg A. D. Congenital syphilis--now a notifiable disease. S Afr Med J. 1992 Mar 21;81(6):288–289. [PubMed] [Google Scholar]
- Fleming D. T., Wasserheit J. N. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999 Feb;75(1):3–17. doi: 10.1136/sti.75.1.3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hira S. K., Bhat G. J., Chikamata D. M., Nkowane B., Tembo G., Perine P. L., Meheus A. Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin Med. 1990 Jun;66(3):159–164. doi: 10.1136/sti.66.3.159. [DOI] [PMC free article] [PubMed] [Google Scholar]
- INGRAHAM N. R., Jr The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta Derm Venereol Suppl (Stockh) 1950 Sep 4;31(Suppl 24):60–87. [PubMed] [Google Scholar]
- McDermott J., Steketee R., Larsen S., Wirima J. Syphilis-associated perinatal and infant mortality in rural Malawi. Bull World Health Organ. 1993;71(6):773–780. [PMC free article] [PubMed] [Google Scholar]
- Mullick Saiqa, Broutet Nathalie, Htun Ye, Temmerman Marleen, Ndowa Francis. Controlling congenital syphilis in the era of HIV/AIDS. Bull World Health Organ. 2004 Jun;82(6):431–432. [PMC free article] [PubMed] [Google Scholar]
- Rotchford K., Lombard C., Zuma K., Wilkinson D. Impact on perinatal mortality of missed opportunities to treat maternal syphilis in rural South Africa: baseline results from a clinic randomized controlled trial. Trop Med Int Health. 2000 Nov;5(11):800–804. doi: 10.1046/j.1365-3156.2000.00636.x. [DOI] [PubMed] [Google Scholar]
- Stray-Pedersen B. Economic evaluation of maternal screening to prevent congenital syphilis. Sex Transm Dis. 1983 Oct-Dec;10(4):167–172. doi: 10.1097/00007435-198311000-00001. [DOI] [PubMed] [Google Scholar]
- Temmerman M., Gichangi P., Fonck K., Apers L., Claeys P., Van Renterghem L., Kiragu D., Karanja G., Ndinya-Achola J., Bwayo J. Effect of a syphilis control programme on pregnancy outcome in Nairobi, Kenya. Sex Transm Infect. 2000 Apr;76(2):117–121. doi: 10.1136/sti.76.2.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watson-Jones Deborah, Gumodoka Balthazar, Weiss Helen, Changalucha John, Todd James, Mugeye Kokungoza, Buvé Anne, Kanga Zephrine, Ndeki Leonard, Rusizoka Mary. 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. J Infect Dis. 2002 Sep 3;186(7):948–957. doi: 10.1086/342951. [DOI] [PubMed] [Google Scholar]
- Wilkinson D., Sach M., Connolly C. Epidemiology of syphilis in pregnancy in rural South Africa: opportunities for control. Trop Med Int Health. 1997 Jan;2(1):57–62. doi: 10.1046/j.1365-3156.1997.d01-127.x. [DOI] [PubMed] [Google Scholar]
