Title: Epidemiology of syphilis in pregnancy in rural South Africa: opportunities for control.

POPLINE Document Number: 120546

Author(s):

Wilkinson D
Sach M
Connolly C

Source citation:

TROPICAL MEDICINE AND INTERNATIONAL HEALTH, 1997 Jan;2(1):57-62.

Abstract:

A case-control study involving 200 pregnant South African women indicates that maternal syphilis infection has a substantial impact on pregnancy outcome. The first 50 women diagnosed with syphilis at booking for antenatal care in Hlabisa Health District in KwaZulu/Natal served as cases; 3 women who tested negative for syphilis and who presented for antenatal care at the same time and to the same clinic as each case served as controls. The overall prevalence of syphilis in the 7723 women booked for antenatal care at district clinics in 1994 was 6.5%. Multiple logistic analysis identified 2 independent risk factors for maternal syphilis: gravidity 3-5 (odds ratio (OR) 2.3, 95% confidence interval (CI) 0.9-5.8 when compared to gravidity 2 or less and OR 3.2, 95% CI 1.0-10.3 when compared to gravidity 6 or more) and previous perinatal death (OR 3.1, 95% CI 1.0-8.8). 6 of the 8 perinatal deaths (4 early neonatal deaths and 4 stillbirths) in this study involved women with syphilis; all 4 of the stillbirths were to cases. The OR for an adverse pregnancy outcome in women with syphilis was 11.8 (95% CI 2.0-67.4). Only 22 women with syphilis received all 3 recommended doses of penicillin. Women who had 0-1 dose of penicillin had a greater risk of perinatal death than those who received 2-3 doses (OR 19.4, 95% CI 1.7-944.6). On-site screening for syphilis and immediate initiation of penicillin treatment could have a substantial impact on pregnancy outcomes in this district.

Keywords:

South Africa
Case Control Studies
Rural Population
Pregnant Women
Syphilis
Screening
Prevalence
Pregnancy Outcomes
Fetal Death
Neonatal Mortality
Risk Factors
Treatment
Women
Prevention and Control
Africa, Southern
Africa, Sub Saharan
Africa
Developing Countries
Studies
Research Methodology
Population Characteristics
Demographic Factors
Population
Sexually Transmitted Diseases
Reproductive Tract Infections
Infections
Diseases
Examinations and Diagnoses
Measurement
Pregnancy
Reproduction
Mortality
Population Dynamics
Infant Mortality
Biology