An Evaluation of The Syphilis Screening Program Among Pregnant Women In Gaborone Clinics, Botswana: A Five Year Retrospective Analysis

A.B Ganiyu,L Mason,L.H Mabuza

doi:10.2174/1874944501710010117

Abstract

Background: Syphilis in pregnancy is a public health problem mainly in developing countries. If untreated, it can lead to pregnancy and fetal complications. Nation-wide screening at antenatal care is an important intervention for early detection and treatment to prevent complications. Objective: The aim was to evaluate the proportions and trends in the syphilis screening program of pregnant women who were attending the 15 public health care facilities in Gaborone Botswana during the period 2004 and 2008. Method: We conducted a cross-sectional study in the antenatal care facilities in Gaborone. Data was obtained from the antenatal registers from 7th to 25th September 2009 using a structured data collection sheet. We recorded the number of pregnant women registered for antenatal care, those screened and those not screened for syphilis. The SPSS 14.0 for windows software was used for data analysis. Results: The overall trends in the proportions of pregnant women screened for syphilis from 2004 to 2005 increased from 87.2% (95% CI, 86.4-88.0) to 89.7% (95% CI, 89.0-90.4), compared to the 2005 to 2006 estimates that showed a declined from 89.7% (95% CI, 89.0-90.4) to 79.0% (95% CI, 77.9-80.1). Seventy five percent of the clinics showed rising trends in the proportions of pregnant women screened for syphilis from 2004-2008. Conclusion: There were marked variations in the trends among pregnant women screened and those not screened for syphilis in the clinics around Gaborone. The overall trend was an increase screening coverage in the years 2004-2008. There is a need to investigate the factors associated with these variations.

Highlights

Syphilis is a sexually transmitted infection caused by the spirochete Treponema palladium, and is considered a serious public health challenge if left untreated
The overall trends in the proportions of pregnant women screened for syphilis from 2004 to 2005 increased from 87.2% to 89.7%, compared to the 2005 to 2006 estimates that showed a declined from 89.7% to 79.0%
There were marked variations in the trends among pregnant women screened and those not screened for syphilis in the clinics around Gaborone

Summary

Introduction

Syphilis is a sexually transmitted infection caused by the spirochete Treponema palladium, and is considered a serious public health challenge if left untreated. In pregnancy, this major public health problem is preventable and treatable, to the benefit of especially the resource constrained countries [1]. Untreated active syphilis infection causes adverse outcomes in 50-80% of pregnancies surviving past 12 weeks gestation. The non-treponemal tests (RPR, VDRL) are non-specific as they measure the reagin (mixture of IgG and IgM) in the patient’s serum. They are relatively accurate, can be titrated and quantified. Nation-wide screening at antenatal care is an important intervention for early detection and treatment to prevent complications

Results

Discussion

Conclusion