Objectives: To understand the disease epidemiology of syphilis in pregnant women, and to evaluate the effectiveness of the screening and intervention programme, for the purpose of controlling mother-to-child syphilis transmission in Shenzhen, in the People's Republic of China (PRC). Methods: At the Shenzhen Center for Disease Control and Prevention (SZCDC), we used the toluidine red unheated serum test (TRUST) for the primary screening of pregnant women, and confirmed positive results with the Treponema pallidum particle agglutination (TPPA) test. We informed and treated those with positive results. For the women who chose to proceed with the pregnancy, we clinically screened their babies for congenital syphilis using the 19S-IgM FTA-Abs test. Among the 1020 infants born to these women, 92 (9.0%) were confirmed to have congenital syphilis. If we exclude the mothers who had syphilis positive babies without undergoing prenatal screening, the project's success rate for mother-to-child transmission intervention was 99.1%. Conclusions: After four years of implementation, we proved the programme to be successful in preventing mother-to-child syphilis transmission. Further work should be done to ensure the earlier screening and treatment of pregnant women. S yphilis has become a serious problem in China, particularly in pregnant women. If syphilis remains untreated in pregnancy, then miscarriages, fetal and neonatal deaths, and congenital syphilis may result.1 2 Shenzhen had almost eradicated syphilis back in the 1960s. However, syphilis cases started to re-emerge in 1983. There were fewer than 25 annual cases before 1994. From 1995 to 1999, the incidence rate increased by an average of 1.68 times each year, resulting in a five-year growth from 4.4 cases per 100 000 people in 1994, to 66.2 cases per 100 000 people in 1999. 3 The serological positive rate in pregnant women ranged from 0.4% to 0.5%, based on sera surveillance. 4 In 1996, the first congenital syphilis case was reported in the city, and in 2001 the number had increased to 36 cases. To tackle this problem, and especially to prevent mother-to-child transmission, the Shenzhen local government initiated the syphilis prevention programme for pregnant women in 2001.5 Supported by a government special fund, this programme aimed at providing free syphilis screening for all pregnant women living in Shenzhen, and if they tested positive, free follow-ups and treatment too. As recommended by the World Health Organization (WHO) in 1994, the screening instruments and treatment medicines for syphilis were simple, inexpensive, and effective. ScreeningFor pregnant women seeking prenatal care at registered medical institutions or clinics, free screenings were given based on informed consent. The sera we obtained from pregnant women were tested with the toluidine red unheated serum test (TRUST) (Rongsheng Bio-technology Limited Corporation, Shanghai, China). 8 We retested all positive results with the Treponema pallidum particle agglutination (TPPA) test (Fujirebio Inc, Jap...

Screening for antenatal syphilis combined with intervening during gestation is highly effective in China. Reducing the percentage of spontaneous/induced abortion would be one of the most effective methods of further increasing the benefits of this screening.

Background: China has been experiencing a rapidly growing syphilis epidemic since the early 1990s, with the reported incidence of congenital syphilis increasing from 0.01 cases per 100 000 live births in 1991 to 19.7 cases per 100 000 live births in 2005. Detailed studies of risk factors for syphilis in pregnant women are needed to inform new preventive interventions. Objective: To investigate factors associated with recent syphilis infection among pregnant women and recommend strategies for improved preventive interventions in the community. Methods: A case-control study was conducted among women attending antenatal clinics in Shenzhen City, South China. Cases were antenatal clinic women testing positive for early syphilis, based on laboratory results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. Results: 129 cases and 345 controls were recruited. Syphilis was significantly associated with unmarried status, less education, multiple sex partners, travel of sex partner in the past 12 months, a history of induced abortion, and previous sexually transmitted infections. Overall, there were no differences between syphilispositive and negative women in household registration status (hukou), living district and duration in Shenzhen, monthly income, and age at first sex. Conclusions: Many demographic and behavioural risk factors are associated with syphilis among pregnant women. In the government congenital syphilis control programme, comprehensive preventive interventions should be provided in all clinical settings in addition to the current procedures for syphilis screening among antenatal women.

The effectiveness of a peer-led education intervention in HIV/AIDS prevention was assessed in the Chinese children of migrant workers. A prospective study was conducted in 12 junior high schools for migrant children. Among the intervention group, a peer-education-based HIV/AIDS prevention was implemented for three months. The results during the baseline survey indicated that the level of knowledge on HIV/AIDS was lower in children of migrant workers. After three months of peer-led intervention, compared with the control group, students in the intervention group positively increased their HIV/AIDS-related knowledge, modified their attitude and improved their protection self-efficacy. Compared with attitude, intervention was more effective in the improvement of knowledge and protection self-efficacy, especially knowledge. The findings suggest that peer-led education was an effective method in improving knowledge, attitude and protection self-efficacy in Chinese children of migrant workers. Heightened concerns targeting the group students were particularly necessary, given their lower level of related knowledge and vulnerability to HIV infection.

The risk of CS could be predicted by the interaction between GW x log (1/T). Early treatment given to women with syphilis during antenatal care may be the only effective method to decrease the risk of CS.