Rosalind Parkes-Ratanshi1, Joshua Mbazira Kimeze2, Edith Nakku-Joloba3, Matthew M Hamill4, Mariam Namawejje2, Agnes Kiragga2, Josaphat Kayogoza Byamugisha5, Anne Rompalo4, Charlotte Gaydos4, Yukari C Manabe4. 1. Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda; and Institute of Public Health, University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK; and Corresponding author. Email: rp549@medschl.cam.ac.uk. 2. Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda. 3. School of Public Health, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda. 4. Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA. 5. School of Medicine, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.
Abstract
Background Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. METHODS:Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1:1:1 to receive either notification slips (NS; standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. RESULTS:Between 2015 and 2016, 17130 pregnant women were screened; 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3%; 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up; there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75; 95% confidence interval 2.36-3.21; P < 0.001). CONCLUSIONS: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
RCT Entities:
Background Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. METHODS: Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1:1:1 to receive either notification slips (NS; standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. RESULTS: Between 2015 and 2016, 17130 pregnant women were screened; 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3%; 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up; there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75; 95% confidence interval 2.36-3.21; P < 0.001). CONCLUSIONS: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
Authors: Emma J Swayze; Mary Catherine Cambou; Marineide Melo; Eddy R Segura; Julia Raney; Breno Riegel Santos; Rita Lira; Raquel Borges Pinto; Ivana Rosangela Dos Santos Varella; Karin Nielsen-Saines Journal: AJOG Glob Rep Date: 2022-02-04
Authors: Caroline Free; Melissa J Palmer; Ona L McCarthy; Lauren Jerome; Sima Berendes; Megan Knight; James R Carpenter; Tim P Morris; Zahra Jamal; Farandeep Dhaliwal; Rebecca S French; Ford Colin Ian Hickson; Anasztazia Gubijev; Kaye Wellings; Paula Baraitser; Ian Roberts; Julia V Bailey; Tim Clayton; Karen Devries; Phil Edwards; Graham Hart; Susan Michie; Louis Macgregor; Katy M E Turner; Kimberley Potter Journal: BMJ Date: 2022-09-28