Evaluating the progress to eliminate mother-to-child transmission (MTCT) of syphilis in Hunan Province, China: A study based on a health service delivery model

To prevent mother-to-child transmission (MTCT) of syphilis, Hunan Province launched a free syphilis screening and treatment programme in 2011. Thus far, the programme has been implemented for 6 years. This study aimed to assess progress toward the elimination of MTCT of syphilis in Hunan Province from 2011–2016. Estimates of syphilis-related adverse pregnancy outcomes (APOs) were based on the health service delivery model developed by the WHO, which were then translated into disability-adjusted life years (DALYs). Default values in the model were replaced by a Chinese version. The progress of this programme was assessed through the reduction of estimated DALYs with and without screening and treatment services. The results showed that the estimated number of syphilis-related APOs in Hunan Province from 2011 to 2016 was 3,840, more than 70% of which occurred among women who had at least one antenatal care visit but were not screened or treated for syphilis during pregnancy. The public health burden resulting from maternal syphilis-related APOs was 192,528 DALYs over six years, and with the current screening and treatment coverage, approximately 163,794 expected DALYs (46%) were averted. Our estimates indicate that in Hunan Province, syphilis in pregnancy continues to be an important cause of APOs, which can lead to substantial perinatal morbidity and mortality. Approximately half of the expected public health burden resulting from syphilis-related APOs was averted by the current screening and treatment services, which suggests progress toward the elimination of MTCT of syphilis in Hunan Province.