Table 2. Syphilis screening, treatment and management recommendations in pregnant women (n = 62 guidelines).

Recommendation	n (%)	Consistent with WHO recommendations
Screening   Universal  First screening early in pregnancy  Repeat screening during 3rd trimester and/or at delivery	57/62(92) 46/57(81) 21/46* (46)	Yes Yes Yes
Laboratory diagnosis  Algorithm recommended (at least one)  Traditional algorithm†  Reverse algorithm‡	47/62 (76) 38/47§ (81) 31/47§ (66)	Yes Yes Yes
Treatment recommendations  Recommended injectable penicillin as first-line therapy  Recommended BPG 2.4 MU IM for early syphilis and 7.2 MU for late syphilis  Recommended BPG 7.2 MU IM in 3 weekly doses, regardless of stage  Recommended.BPG 2.4 MU IM as a single doses regardless of stage  Allowed non-penicillin regimens to be included as alternative treatment	59/62 (95) 45/59 (76) 8/59¶ (14) 6/59¶ (10) 42 (68)	Yes Yes No No Yes
Desensitisation recommended for penicillin-allergic women	31 (50%)	Yes

*Of the guidance documents recommending repeat screening during pregnancy.

^†Non-treponemal test done first and confirmed with a treponemal test.

^‡Treponemal test done first and confirmed with one or more non-treponemal tests.

^§Documents described at least one diagnostic algorithm for syphilis screening.

^¶Among guidelines recommended treatment with injectable penicillin.