Preventing Congenital Syphilis—Opportunities Identified by Congenital Syphilis Case Review Boards

Rahman, Mohammad; Hoover, Ashley; Johnson, Chaquetta; Peterman, Thomas A.

doi:10.1097/olq.0000000000000909

Cited by 20 publications

(22 citation statements)

References 15 publications

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“…A California study of missed opportunities for prevention of congenital syphilis identified gaps in multiple steps of the prevention cascade and found that early prenatal care is critical to preventing congenital syphilis and that multifaceted efforts are needed (9). Establishment of congenital syphilis case review boards in Louisiana identified specific missed opportunities, including lack of screening and treatment delay (10). These data support the need for tailored interventions based on local epidemiology and analysis of missed prevention opportunities.…”

Section: Discussionmentioning

confidence: 89%

Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018

Kimball¹,

Torrone²,

Miele³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

131

114

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Section: Discussionmentioning

confidence: 89%

Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018

Kimball¹,

Torrone²,

Miele³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

131

114

View full text Add to dashboard Cite

“…16 A study conducted in Louisiana, the state with the highest rate of congenital syphilis, found that one-third of the cases could have been prevented during the mothers' appointments with their prenatal care providers. 17 Another study found only seven states follow CDC syphilis screening recommendations for pregnant women; six states still do not require prenatal syphilis screening at any stage of pregnancy or birth and the majority of states only require syphilis screening at the first prenatal visit. 18 To sustainably reduce congenital syphilis rates, all states must fully comply with the CDC's syphilis screening recommendations for all women at first prenatal visit and repeat screenings for at-risk pregnant women during the third trimester and at delivery.…”

Section: All Primary Care Providers Should Implement Opt-out Std Testingmentioning

confidence: 99%

From Control to Crisis: The Resurgence of Sexually Transmitted Diseases

et al. 2019

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At the turn of the century, the Centers for Disease Control and Prevention (CDC) reported that many sexually transmitted diseases (STDs) in the United States (US) were on the decline. 1 National objectives presented in the CDC's Healthy People program to reduce Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and syphilis morbidity by 2000 were reportedly reached or were moving towards their target. 2 Public health officials reveled in the success of prevention, testing, and treatment efforts to control STD incidence, even redirecting the conversation towards plans to eliminate syphilis. 3 Unfortunately, federal funds allotted to STD prevention began to decline beginning in 2002 -decreasing by one-third by 2018, after adjusting for inflation (see Figure 1). 4,5 In nearperfect synchrony, the US experienced a severe resurgence of STDs. 6 According to the newly released CDC STD Report, the number has increased to a combined total of nearly 2.3 million reported cases of CT, NG, and primary and secondary (P&S) syphilis in 2017 alone-more than twice the number of cases reported in 2000. 7 In response, the National Coalition of STD Directors has called on the US President and the Department of Health and Human Services to declare STDs a public health crisis. 6 How did we get to this public health crisis? There is no one answer, but many factors related to federal STD prevention budget cuts help explain this resurgence: health departments are shrinking, community clinics are closing, contact tracing is dwindling, and sexual health education is minimal. 8,9 Safeguarding the public's health is a government responsibility; advocates must engage US legislators in the difficult conversation to increase funding for STD prevention, testing, and treatment services. While this plays out, we present three reasonable, evidence-based steps to address the STD crisis-learned from the efforts of

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“…More than half of congenital syphilis cases resulted in premature labor, miscarriage, stillbirth, low birth weight, and even death of the neonates . The condition is preventable when all pregnant women are screened and treated appropriately . This has led the World Health Organization (WHO) to set a goal for the elimination of mother‐to‐child transmission of syphilis to 50 cases per 100 000 live births by 2030 .…”

mentioning

confidence: 99%

“…1 The condition is preventable when all pregnant women are screened and treated appropriately. 2 This has led the World Health Organization (WHO) to set a goal for the elimination of mother-tochild transmission of syphilis to 50 cases per 100 000 live births by 2030. 3 The objective was set in 2014, 4 but syphilis in pregnancies still remains a significant health concern worldwide.…”

mentioning

confidence: 99%

Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

Anugulruengkitt

Yodkitudomying²,

Sirisabya

et al. 2020

Pediatrics International

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Background The World Health Organization has set a goal to eliminate mother‐to‐child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention. Methods A retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria. Results From 2013 to 2017, 69 syphilis‐infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78–164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18–32) years and 12 (17%) women had human immunodeficiency virus co‐infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non‐reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non‐reactive rapid plasma reagin at the age of 7 months. Conclusions Congenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.

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Preventing Congenital Syphilis—Opportunities Identified by Congenital Syphilis Case Review Boards

Abstract: CS case review boards identified practices with inadequate screening, treatment, or reporting. Sharing these findings with providers changed practices and may prevent future cases.

Cited by 20 publications

References 15 publications

Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018

Missed Opportunities for Prevention of Congenital Syphilis — United States, 2018

From Control to Crisis: The Resurgence of Sexually Transmitted Diseases

Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

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