Elimination of mother-to-child transmission of syphilis: Is it a reality in Nigeria by 2020?

Abstract

Congenital syphilis is a global health problem, yet it has received little attention in recent years. Despite cost-effective syphilis screening and treatment, it continues to contribute hugely to perinatal morbidity and mortality worldwide. To determine the prevalence and treatment coverage trend for syphilis among pregnant women in the national prevention of mother-to-child transmission programme in Nigeria and to evaluate progress towards the elimination of congenital syphilis in the country. A retrospective analysis of validated national health sector performance data on pregnant women attending antenatal care at prevention of mother-to-child transmission clinics from 2013 to 2016 in Nigeria. The proportion of new antenatal care attendees who annually received serological testing for syphilis increased from 12.2% in 2013 to 16.3% in 2016 (p-trend<0.0001). Although the prevalence of maternal syphilis decreased from 3.2% in 2013 to 1.4% in 2016 (p-trend<0.0001), the syphilis treatment coverage during pregnancy has decreased from 71.3% in 2013 to 54.9% in 2016 (p-trend<0.0001). Maternal syphilis screening and treatment in Nigeria are inadequate to meet the elimination aspirations. A rapid scale-up of antenatal care syphilis screening and treatment are crucial to averting an epidemic in Nigeria by 2020.