Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes


Watson-Jones, D; Gumodoka, B; Weiss, H; Changalucha, J; Todd, J; Mugeye, K; Buve, A; Kanga, Z; Ndeki, L; Rusizoka, M; Ross, D; Marealle, J; Balira, R; Mabey, D; Hayes, R; (2002) Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes. The Journal of infectious diseases, 186 (7). pp. 948-57. ISSN 0022-1899 DOI: https://doi.org/10.1086/342951

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Abstract

Treatment for maternal syphilis with single-dose benzathine penicillin (2.4 million units intramuscularly) is being implemented in many parts of sub-Saharan Africa. To examine the effectiveness of this regimen, a prospective cohort of 1688 pregnant women was recruited in Tanzania. Birth outcomes were compared among women treated for high-titer (n=133; rapid plasma reagin [RPR] titer > or = 1:8 and Treponema pallidum hemagglutination assay [TPHA]/fluorescent treponemal antibody [FTA] positive) and low-titer (n=249; RPR titer <1:8 and TPHA/FTA positive) active syphilis and 950 uninfected women. Stillbirth or low-birth-weight live births were observed in 2.3% and 6.3%, respectively, of women treated for high-titer active syphilis and in 2.5% and 9.2%, respectively, of seronegative women. There was no increased risk for adverse pregnancy outcome for women treated for high-titer active syphilis (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.4-1.4) or low-titer active syphilis (OR, 0.95; 95% CI, 0.6-1.5), compared with seronegative women. Single-dose treatment is effective in preventing adverse pregnancy outcomes attributable to maternal syphilis.

Item Type: Article
Keywords: Adolescent, Adult, Cohort Studies, Comparative Study, Female, Gestational Age, Human, Injections, Intramuscular, Odds Ratio, Penicillin G, Benzathine/administration & dosage/*therapeutic use, Penicillins/administration & dosage/*therapeutic use, Pregnancy, Pregnancy Complications, Infectious/epidemiology/microbiology/*prevention, & control, Pregnancy Outcome, *Prenatal Care, Prospective Studies, Support, Non-U.S. Gov't, Syphilis/complications/*drug therapy/epidemiology, Syphilis Serodiagnosis, Tanzania/epidemiology, *Treponema pallidum, Adolescent, Adult, Cohort Studies, Comparative Study, Female, Gestational Age, Human, Injections, Intramuscular, Odds Ratio, Penicillin G, Benzathine, administration & dosage, therapeutic use, Penicillins, administration & dosage, therapeutic use, Pregnancy, Pregnancy Complications, Infectious, epidemiology, microbiology, prevention & control, Pregnancy Outcome, Prenatal Care, Prospective Studies, Support, Non-U.S. Gov't, Syphilis, complications, drug therapy, epidemiology, Syphilis Serodiagnosis, Tanzania, epidemiology, Treponema pallidum
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Tropical Epidemiology Group
Malaria Centre
Population Studies Group
PubMed ID: 12232835
Web of Science ID: 177991100009
URI: http://researchonline.lshtm.ac.uk/id/eprint/16348

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