Abstract
This study was aimed to describe the standardized treatment rate of syphilis-infected pregnant women in Hunan province and to explore the determinants for standardized treatment. All syphilis-infected pregnant women registered in the Information System of Prevention of Mother-to-Child Transmission of Syphilis Management (IPMTCT) in Hunan between January 2015 and December 2018 were included in this study. Among 9,059 pregnant women with syphilis, 7,797 received syphilis treatment, with a treatment rate of 86.1%, and 4,963 underwent standardized syphilis treatment, with an average standardized treatment rate of 54.8%. The facilitators for the standardized treatment included abnormal reproductive histories (aOR = 1.15, 95%CI:1.03–1.28), time of first prenatal care within 1–12 weeks (aOR = 5.17, 95%CI:4.19–6.37) or within 13–27 weeks (aOR = 5.56, 95%CI:4.46–6.92), previous syphilis infection (aOR = 1.64, 95%CI: 1.48–1.81), and definite syphilis infection status of sexual partner (negative: aOR = 1.73, 95%CI:1.57–1.91; positive: aOR = 1.62, 95%CI:1.34–1.95). The barriers included marital status being unmarried/divorced/widowed (aOR = 0.81, 95%CI: 0.65–0.99), pluripara (aOR = 0.58, 95%CI: 0.46–0.74), number of children ≥ 2 (aOR = 0.45, 95%CI: 0.35–0.57), and syphilis clinical stage being primary/secondary/tertiary (aOR = 0.72, 95%CI: 0.58–0.88) or unclear (aOR = 0.78, 95%CI: 0.70–0.86). Though the treatment rate of syphilis-infected pregnant women was high, the standardized treatment rate was low. The facilitators and barriers on standardized treatment of gestational syphilis were identified at the patient level.
Highlights
Syphilis is a chronic sexually-transmitted disease caused by Treponema pallidum infection and invades multiple systems
During the initial five years of the implementation of Prevention of Mother-to-Child Transmission of Syphilis (PMTCT) in Hunan, the prenatal syphilis detection rate among pregnant women was significantly increased from 44.2% in 2011 to 90.8% in 2015, but the maternal syphilis treatment rate, especially the standardized treatment rate, was still unclear[12]
The inclusion criteria were: (1) pregnant women at age ≥ 18; (2) syphilis-infected pregnant women who were positive in both non-T. pallidum antigen serological (NTPAS) tests and T. pallidum antigen serological (TPAS) tests; (3) diagnosis time of syphilis infection being between January 1, 2015 and December 31, 2018
Summary
Syphilis is a chronic sexually-transmitted disease caused by Treponema pallidum infection and invades multiple systems. Along with the implementation of PMTCT in China, the prenatal syphilis detection rate and treatment rate among pregnant women were significantly improved from 67.4 to 94.1% and from 58.8 to 89.4% respectively from 2012 to 201610. During the initial five years of the implementation of PMTCT in Hunan, the prenatal syphilis detection rate among pregnant women was significantly increased from 44.2% in 2011 to 90.8% in 2015, but the maternal syphilis treatment rate, especially the standardized treatment rate, was still unclear[12]. Studying the determinants on standardized treatment of gestational syphilis helps to identify the barriers and facilitators for standardized treatment and to underlie the further improvement of standardized treatment rates, thereby promoting the effective implementation of measures against mother-to-child syphilis transmission. The determinants on standardized treatment of syphilis among pregnant women were investigated, which scientifically underlay the management of gestational syphilis
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