Prevention of congenital syphilis within antenatal PrEP services in South Africa: missed opportunities

Syphilis in pregnancy and congenital syphilis are increasing globally, especially in locations with poor access to antenatal testing and due to global shortages of benzathine penicillin.3,4 In South Africa, the National Institute for Communicable Diseases (NICD) reported a steady increase in clinica...

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Bibliographic Details
Published in:The Lancet infectious diseases 2024-06, Vol.24 (6), p.571-572
Main Authors: Joseph Davey, Dvora, de Voux, Alex, Hlatshwayo, Lerato, Nelson, Aurelie, Frigati, Lisa, Bheemraj, Kalisha, Wara, Nafisa, Mvududu, Rufaro, Myer, Landon
Format: Article
Language:English
Subjects:
Babies
Female
Gestational age
HIV
HIV Infections - epidemiology
HIV Infections - prevention & control
Human immunodeficiency virus
Humans
Infant, Newborn
Infants
Infectious Disease Transmission, Vertical - prevention & control
Laboratory tests
Neonates
Penicillin
Plasma
Pre-Exposure Prophylaxis - methods
Pregnancy
Pregnancy Complications, Infectious - prevention & control
Prenatal Care
Prevention
Prophylaxis
Reagin
Sexually transmitted diseases
South Africa - epidemiology
STD
Syphilis
Syphilis, Congenital - prevention & control
Womens health
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Summary:Syphilis in pregnancy and congenital syphilis are increasing globally, especially in locations with poor access to antenatal testing and due to global shortages of benzathine penicillin.3,4 In South Africa, the National Institute for Communicable Diseases (NICD) reported a steady increase in clinical notifications of congenital syphilis cases and rapid plasma reagin-positive results in infants and children aged younger than 2 years between 2017 and 2020.5,6 Pregnant women are at increased risk of HIV acquisition and syphilis, and are a key population for HIV prevention through pre-exposure prophylaxis (PrEP) services.7,8 There is growing concern around congenital syphilis globally; however, little data are available regarding the burden of syphilis in pregnant women using PrEP and their infants in Africa. Per local standard of care, women were tested with an onsite rapid treponemal test to guide treatment, followed by laboratory testing (Treponema pallidum antibody test [TPHA] with rapid plasma reagin testing). Maternal and infant data were extracted from antenatal care files, neonatal clinical records, and National Health Laboratory Systems data.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(24)00259-7