Xiang-Sheng Chen1, Sunil Khaparde2, Turlapati L N Prasad2, Vani Srinivas3, Chukwuma Anyaike4, Gbenga Ijaodola4, Evelyn Ngige4, Grace Tembo Mumba5, Carolline Phiri5, Bushimbwa Tambatamba5, Laxmikant Chavan6, Nicole Seguy6, Taiwo A Oyelade7, Malumo Sarai Bvulani8, Lori M Newman9. 1. National Center for STD Control and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China. Electronic address: chenxs@ncstdlc.org. 2. National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India. 3. Jhpiego India Country Office, New Delhi, India. 4. National AIDS/STI Control Programme, Federal Ministry of Health, Abuja, Nigeria. 5. Ministry of Community Development, Mother and Child Health, Lusaka, Zambia. 6. World Health Organization, New Delhi, India. 7. World Health Organization, Abuja, Nigeria. 8. World Health Organization, Lusaka, Zambia. 9. World Health Organization, Geneva, Switzerland.
Abstract
OBJECTIVE: To estimate maternal syphilis and its associated adverse pregnancy outcomes in India, Nigeria, and Zambia. METHODS: An online estimation tool was used to generate point estimates and uncertainty ranges of maternal syphilis and adverse pregnancy outcomes due to mother-to-child transmission (MTCT). The most recent data (2010-2012) on antenatal care coverage, syphilis seroprevalence, and syphilis screening and treatment coverage at the subnational level in India, Nigeria, and Zambia were used to estimate disease burden for 2012. Sensitivity analysis was conducted for three screening and treatment scenarios (current coverages, current coverages minus 20%, and ideal coverages consistent with WHO targets for eliminating MTCT of syphilis). RESULTS: A total of 103 960, 74 798, and 9072 pregnant women with probable active syphilis were estimated to occur in India, Nigeria, and Zambia, resulting in 53 187, 37 045, and 2973 adverse outcomes, respectively; approximately 1.6%, 4.8%, and 37.0% of these were averted under the current service coverages in India, Nigeria, and Zambia. The disease burden varied significantly in its subnational distribution within India and Nigeria, but was distributed evenly across Zambia. CONCLUSIONS: The obtained results suggest an ongoing, unaverted high burden of maternal syphilis and associated adverse outcomes in India, Nigeria, and Zambia. Screening and treatment for syphilis must be scaled-up significantly in these countries to achieve elimination of MTCT of syphilis.
OBJECTIVE: To estimate maternal syphilis and its associated adverse pregnancy outcomes in India, Nigeria, and Zambia. METHODS: An online estimation tool was used to generate point estimates and uncertainty ranges of maternal syphilis and adverse pregnancy outcomes due to mother-to-child transmission (MTCT). The most recent data (2010-2012) on antenatal care coverage, syphilis seroprevalence, and syphilis screening and treatment coverage at the subnational level in India, Nigeria, and Zambia were used to estimate disease burden for 2012. Sensitivity analysis was conducted for three screening and treatment scenarios (current coverages, current coverages minus 20%, and ideal coverages consistent with WHO targets for eliminating MTCT of syphilis). RESULTS: A total of 103 960, 74 798, and 9072 pregnant women with probable active syphilis were estimated to occur in India, Nigeria, and Zambia, resulting in 53 187, 37 045, and 2973 adverse outcomes, respectively; approximately 1.6%, 4.8%, and 37.0% of these were averted under the current service coverages in India, Nigeria, and Zambia. The disease burden varied significantly in its subnational distribution within India and Nigeria, but was distributed evenly across Zambia. CONCLUSIONS: The obtained results suggest an ongoing, unaverted high burden of maternal syphilis and associated adverse outcomes in India, Nigeria, and Zambia. Screening and treatment for syphilis must be scaled-up significantly in these countries to achieve elimination of MTCT of syphilis.
Authors: Charity Warigon; Wondimagegnehu Alemu; Fiona Braka; Hallah Tashikalmah; Yared Yehushualet; Kulchumi Hammanyero; Samuel Bawa; David Oviaesu; Sisay Tegegne; Mustapha Umar Maiiyali; Anne Eudes Jean Baptiste; Peter Nsubuga; Collins Boakye Agyemang Journal: BMC Public Health Date: 2018-12-13 Impact factor: 3.295