Introduction of Rapid Syphilis Testing Within Prevention of Mother-to-Child Transmission of HIV Programs in Uganda and Zambia

Strasser, Susan; Bitarakwate, Edward; Gill, Michelle M.; Hoffman, Heather J.; Musana, Othiniel; Phiri, A; Shelley, Katharine D.; Sripipatana, Tabitha; Ncube, Alexander Tshaka; Chintu, Namwinga

doi:10.1097/qai.0b013e318267bc94

Cited by 51 publications

(87 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, we estimated a considerably lower prevalence of syphilis than other national estimates [17]. This difference might have been due to local differences in syphilis rates, or recent improvement in syphilis testing and treatment programs in Uganda [10]. In spite of the similar or lower prevalence obtained in this study, the HIV, syphilis and HIV-syphilis co-infection rates are still alarming and signal an urgent need to improve efforts to prevent, detect and treat syphilis and HIV in similar populations.…”

Section: Discussionmentioning

confidence: 88%

“…Screening for HIV and syphilis are recommended as part of a comprehensive dual elimination strategy [9]. Moreover, integrating rapid syphilis screening and HIV testing for pregnant women has been found to be feasible, cost-effective, and effective in preventing MTCT of syphilis and HIV [10]. However, while many countries have adopted policies recommending integration, comprehensive implementation has not been achieved [10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the SD BIOLINE HIV/syphilis Duo assay at a rural health center in Southwestern Uganda

et al. 2014

View full text Add to dashboard Cite

BackgroundPoint-of-care tests have the capacity to improve healthcare delivery by reducing costs and delay associated with care. A novel point-of-care immunochromatographic test for dual diagnosis of both HIV and syphilis by detecting IgG, IgM and IgA antibodies to HIV, and specific and recombinant Treponema pallidum antigens has recently been developed, but has not been evaluated in rural field settings. We evaluated the performance of the SD Bioline Syphilis/HIV Duo (Duo) assay at a healthcare center in rural Uganda.MethodsA convenience sample of pregnant women attending Kinoni Health Centre IV from March to May, 2013 was enrolled. Venous blood was collected and centrifuged for plasma isolation. Samples were tested with the Duo assay and compared with the Treponema pallidum hemaglutination assay and paired HIV rapid antibody tests as the reference standards. The ease of use and time required for the Duo assay were also assessed by laboratory technicians.ResultsTwo hundred twenty women were enrolled with a mean age of 25.00 years (SD 5.41). The sensitivity and specificity of the Duo assay were 100% (95% CI 79.0 – 100%) and 100% (95% CI 97.6 – 100.0) respectively, for syphilis, and, 100% (75.9 – 100%) and 99.5% (96.8 – 99.9%) respectively, for HIV. The duo kit was found to be faster and easier to use than the current HIV and syphilis testing techniques.ConclusionThe sensitivity and specificity of the SD Bioline HIV/Syphilis Duo test were excellent in a field setting in Uganda. The Duo assay should be further evaluated in alternate populations and with point-of-care specimens (e.g. whole blood from finger stick specimens), but shows promise as a tool for improved HIV and syphilis surveillance, diagnosis, and treatment in field settings.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Evaluation of the SD BIOLINE HIV/syphilis Duo assay at a rural health center in Southwestern Uganda

et al. 2014

View full text Add to dashboard Cite

show abstract

“…8 In SSA, women may attend only one ANC visit during pregnancy and using these tests, syphilis detection and treatment can be offered on the same day. 9 This approach is considered feasible on a large scale, 10 and widespread implementation of this strategy may support global initiatives by the World Health Organization (WHO) to eliminate congenital syphilis and considerably reduce associated adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

Estimating the Public Health Burden Associated With Adverse Pregnancy Outcomes Resulting From Syphilis Infection Across 43 Countries in Sub-Saharan Africa

Kuznik¹,

Habib²,

Manabe³

et al. 2015

Sexually Transmitted Diseases

View full text Add to dashboard Cite

Background Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. The study aimed to estimate the public health burden resulting from adverse pregnancy outcomes due to syphilis infection among pregnant women not screened for syphilis in 43 countries in sub-Saharan Africa (SSA). Methods Estimated country-specific incidence of syphilis was generated from annual number of live births, the proportion of women with ≥1 antenatal care (ANC) visit, the syphilis prevalence rate, and the proportion of women screened for syphilis during ANC. Adverse pregnancy outcome data (stillbirth, neonatal death, low birth weight, and congenital syphilis) were obtained from published sources. Disability-adjusted life year (DALY) estimates were calculated using undiscounted local life expectancy, the neonatal standard loss function and relevant disability weights. The model assessed the potential impact of raising antenatal care coverage to ≥95% and syphilis screening to ≥95% (WHO targets). Results For all 43 SSA countries, the estimated incidence of adverse pregnancy outcomes was 205,901(95% CI: 113,256–383,051) per year, including stillbirth: 88,376 (95% CI: 60,854–121,713), neonatal death: 34,959 (95% CI: 23,330–50,076), low birth weight: 22,483 (95% CI: 0–98,847), and congenital syphilis: 60,084 (95% CI: 29,073–112,414), resulting in approximately 12.5 million DALYs. Countries with the greatest burden are (in DALYs, millions) Democratic Republic of the Congo: 1.809, Nigeria: 1.598, Ethiopia: 1.466, and Tanzania: 0.961. Attaining WHO targets could reduce the burden by 8.5 million DALYs. Conclusions Substantial infant mortality and morbidity results from maternal syphilis infection concentrated in countries with low access to ANC or low rates of syphilis screening.

show abstract

“…The introduction of PMTCT in ANC offers an excellent opportunity to leverage the investment in HIV prevention services to strengthen other maternal health interventions, such as syphilis screening and treatment, family planning, and malaria prevention, and can lead to high uptake of these services. A study conducted in Zambia documented an increase in maternal syphilis screening from 62.5% to 80.8% following introduction of PMTCT services in ANC [12,13].…”

Section: Introductionmentioning

confidence: 99%

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

Balira

Mabey

Weiss

et al. 2015

Intl J Gynecology & Obste

View full text Add to dashboard Cite

a b s t r a c t a r t i c l e i n f oKeywords: HIV Integration PMTCT Pregnancy SyphilisObjective: To assess the operational integration of maternal HIV testing and syphilis screening in Mwanza, Tanzania. Methods: Interviews were conducted with 76 health workers (HW) from three antenatal clinics (ANC) and three maternity wards in 2008-2009 and 1137 consecutive women admitted for delivery. Nine ANC health education sessions and client flow observations were observed. Results: Only 25.0% of HWs reported they had received training in both prevention of mother-to-child transmission (PMTCT) and syphilis screening. HIV and syphilis tests were sometimes performed in different rooms and results recorded in separate registers with different formats and the results were not always given by the same person. At delivery, most women had been tested for both HIV (79.4%) and syphilis (88.1%) during pregnancy. Of those not tested antenatally for each infection, 70.1% were tested for HIV at delivery but none for syphilis. Conclusion: Integration of maternal HIV and syphilis screening was limited. Integrated care guidelines and related health worker training should address this gap.

show abstract

Introduction of Rapid Syphilis Testing Within Prevention of Mother-to-Child Transmission of HIV Programs in Uganda and Zambia

Abstract: Integrating RST in PMTCT programs increases screening and treatment for syphilis among HIV-positive pregnant women and does not compromise HIV services.

Cited by 51 publications

References 7 publications

Evaluation of the SD BIOLINE HIV/syphilis Duo assay at a rural health center in Southwestern Uganda

Evaluation of the SD BIOLINE HIV/syphilis Duo assay at a rural health center in Southwestern Uganda

Estimating the Public Health Burden Associated With Adverse Pregnancy Outcomes Resulting From Syphilis Infection Across 43 Countries in Sub-Saharan Africa

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

Contact Info

Product

Resources

About