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Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study

BACKGROUND: Syphilis infection during pregnancy leads to avoidable morbidity and mortality and remains a significant problem in sub-Saharan Africa. Despite global initiatives to increase the proportion of pregnant women screened, implementation has been slow. We sought to investigate the feasibility...

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Autores principales: Manabe, Yukari C, Namale, Gertrude, Nalintya, Elizabeth, Sempa, Joseph, Ratanshi, Rosalind Parkes, Pakker, Nadine, Katabira, Elly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302122/
https://www.ncbi.nlm.nih.gov/pubmed/25583097
http://dx.doi.org/10.1186/s12879-014-0739-1
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author Manabe, Yukari C
Namale, Gertrude
Nalintya, Elizabeth
Sempa, Joseph
Ratanshi, Rosalind Parkes
Pakker, Nadine
Katabira, Elly
author_facet Manabe, Yukari C
Namale, Gertrude
Nalintya, Elizabeth
Sempa, Joseph
Ratanshi, Rosalind Parkes
Pakker, Nadine
Katabira, Elly
author_sort Manabe, Yukari C
collection PubMed
description BACKGROUND: Syphilis infection during pregnancy leads to avoidable morbidity and mortality and remains a significant problem in sub-Saharan Africa. Despite global initiatives to increase the proportion of pregnant women screened, implementation has been slow. We sought to investigate the feasibility of adding syphilis screening within an integrated antenatal HIV clinic. METHODS: Pregnant women attending the HIV antenatal clinic were sequentially enrolled and consenting participants answered a questionnaire on sexual behavior and previous pregnancies, provided sociodemographic data, and were tested using rapid plasmin reagin (RPR). If positive, participants were treated with benzathine penicillin. All were given a partner notification slip and were followed up after delivery to determine birth outcomes. RESULTS: 584 of 606 (95.7%) women approached and consented to test for syphilis. 570 women were enrolled (median age 29 (IQR 25–32) with a median (IQR) CD4 of 372 (257–569) cells/μL). Of the 5.1% (29/570) with a positive RPR, all were asymptomatic, were successfully contacted, and treated with benzathine penicillin without adverse reactions. Overall, 61 (12.1%) of the participants had an adverse birth outcome. In the bivariate analysis, only age was significantly different between those with and without a positive RPR (RR = 1.15, 95% CI 1.065-1.248; p < 0.001). Partners of only 10 (34.5%) participants returned for treatment. CONCLUSIONS: Structural interventions such as opt-out testing for syphilis within integrated HIV-antenatal care clinics are feasible and capitalize on the excellent care programs that have already been established for HIV care. Novel approaches are required for partner notification.
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spelling pubmed-43021222015-01-23 Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study Manabe, Yukari C Namale, Gertrude Nalintya, Elizabeth Sempa, Joseph Ratanshi, Rosalind Parkes Pakker, Nadine Katabira, Elly BMC Infect Dis Research Article BACKGROUND: Syphilis infection during pregnancy leads to avoidable morbidity and mortality and remains a significant problem in sub-Saharan Africa. Despite global initiatives to increase the proportion of pregnant women screened, implementation has been slow. We sought to investigate the feasibility of adding syphilis screening within an integrated antenatal HIV clinic. METHODS: Pregnant women attending the HIV antenatal clinic were sequentially enrolled and consenting participants answered a questionnaire on sexual behavior and previous pregnancies, provided sociodemographic data, and were tested using rapid plasmin reagin (RPR). If positive, participants were treated with benzathine penicillin. All were given a partner notification slip and were followed up after delivery to determine birth outcomes. RESULTS: 584 of 606 (95.7%) women approached and consented to test for syphilis. 570 women were enrolled (median age 29 (IQR 25–32) with a median (IQR) CD4 of 372 (257–569) cells/μL). Of the 5.1% (29/570) with a positive RPR, all were asymptomatic, were successfully contacted, and treated with benzathine penicillin without adverse reactions. Overall, 61 (12.1%) of the participants had an adverse birth outcome. In the bivariate analysis, only age was significantly different between those with and without a positive RPR (RR = 1.15, 95% CI 1.065-1.248; p < 0.001). Partners of only 10 (34.5%) participants returned for treatment. CONCLUSIONS: Structural interventions such as opt-out testing for syphilis within integrated HIV-antenatal care clinics are feasible and capitalize on the excellent care programs that have already been established for HIV care. Novel approaches are required for partner notification. BioMed Central 2015-01-13 /pmc/articles/PMC4302122/ /pubmed/25583097 http://dx.doi.org/10.1186/s12879-014-0739-1 Text en © Manabe et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Manabe, Yukari C
Namale, Gertrude
Nalintya, Elizabeth
Sempa, Joseph
Ratanshi, Rosalind Parkes
Pakker, Nadine
Katabira, Elly
Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title_full Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title_fullStr Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title_full_unstemmed Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title_short Integration of antenatal syphilis screening in an urban HIV clinic: a feasibility study
title_sort integration of antenatal syphilis screening in an urban hiv clinic: a feasibility study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302122/
https://www.ncbi.nlm.nih.gov/pubmed/25583097
http://dx.doi.org/10.1186/s12879-014-0739-1
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