Table 2. Summary of estimated outcomes with parameters from the base case scenario, single CS policy strategies, and combination strategies.
| Factor/Outcome | 2009 Base Case | Single CS Policy Strategies | Most Effective Combination CS Policy Strategies | ||||||||
| Increased Prenatal Screening Coverage | Earlier Prenatal Testing | Decreased Syphilis Incidence | Increased Treatment Completion | Improved Test Sensitivity and Specificity | Increased Test Seeking | Two-Pronged Screening Strategy | Three-Pronged Strategy 1 | Three-Pronged Strategy 2 | Four-Pronged Strategy | ||
| Base case | Refer to Table 1 | Total prenatal coverage: 57% | 1st trimester testing: 23%; 2nd trimester testing: 23%; 3rd trimester testing: 28% | Age-specific | Adult: 80%; pregnant women: 85% | Test sensitivity: 95%; test specificity: 98% | 40% | ||||
| Parameter change based on policy | — | Total prenatal coverage: 95% | 1st trimester testing: 30%; 2nd trimester testing: 30%; 3rd trimester testing: 10% | Uniform 50% decrease | Adult: 95%; pregnant women: 95% | Test sensitivity: 99%; test specificity: 99% | 80% | (1) Increased prenatal screening coverage; (2) earlier prenatal testing | (1) Increased prenatal screening coverage; (2) earlier prenatal testing; (3) decreased syphilis incidence | (1) Increased prenatal screening coverage; (2) earlier prenatal testing; (3) increased treatment completion | (1) Increased prenatal screening coverage; (2) earlier prenatal testing; (3) increased treatment completion; (4) improved test sensitivity and specificity |
| Feasibility | — | Demonstrated globally including China [4],[10],[22] | Demonstrated in low-income settings [36] | None | Demonstrated globally including China [4],[10],[22] | None | None | ||||
| CS model outcomes (cases per 100,000 live births) | Model outcome: 184; 95% CI: 172, 196; reported: 139 | 78; 95% CI: 73, 83 | 160; 95% CI: 149, 171 | 172; 95% CI: 160, 184 | 175; 95% CI: 163, 187 | 176; 95% CI: 164, 188 | 176; 95% CI: 165, 187 | 50; 95% CI: 46, 54 | 50; 95% CI: 46, 54 | 35; 95% CI: 32, 38 | 27; 95% CI: 24, 30 |
| Reduction a (from base case) | — | 58%; 95% CI: 55, 60 | 13%; 95% CI: 7, 19 | 7%; 95% CI: 0, 13 | 5%; 95% CI: −2, 11 | 4%; 95% CI: −2, 11 | 4%; 95% CI: −2, 11 | 73%; 95% CI: 71, 75 | 73%; 95% CI: 71, 75 | 81%; 95% CI: 79, 83 | 85%; 95% CI: 84, 87 |
a
These values were compared to the 2009 base case estimate.