Syphilis among Pregnant Women Attending the National Prevention Maternal Transmission to Child Program

Keywords

Syphilis
Pregnant women
PMTCT
Rapid test
Cambodia

Abstract

Introduction

Over two million pregnant women (PW) around the world contract syphilis, the majority of whom are not tested and do not receive appropriate treatments. Untreated syphilis will infect 50% of fetuses, with serious complications, including stillbirth, neonatal death, low birth weight, or congenital infection. Currently, in Cambodia, the rate of estimated maternal transmission to child (MTCT) for syphilis is 9.4% (9.0–9.8%). We aimed to describe the characteristics of pregnant women infected by syphilis and the proportion of partners of pregnant women who were treated for syphilis.

Methods

We used the national PMTCT data of positive pregnant women with rapid TP syphilis tests who accessed services in Cambodia between 1 January 2019 and 31 December 2020. Data were analyzed in Stata 15.1. The mean and frequency distribution of quantitative variables such as age, number of antenatal care (ANC) visits and partner treatment were calculated.

Results

In total, 470 were positive for syphilis by the TP rapid test, when confirmed, 98.0% (301/307) were reactive to rapid plasma reagin (RPR). Close to 35% (163/470) were missing for RPR test. Most of the pregnant women were aged between 21 and 30 years old (54.8%). Many PW who tested syphilis positive accessed ANC1 (60%), but only 14.3% of them had ANC4. PW aged < 30 years who had 3 doses of benzathine penicillin G (BPG) treatment were higher than PW aged ? 30 years (72% vs 68%, p value = 0.350). The proportion of PW partners with syphilis who received BPG treatment was 53.4%.

Conclusion

This study found a relatively high proportion of syphilis infection among women visiting ANC services. These PW should be encouraged for ANC visits so that they can better receive syphilis tests and treatment properly, resulting in a greater impact of the PMTC program. Additionally, appropriate partner treatment should be promoted and encouraged. These data have few variables that are limited to evaluating treatment and prevention efforts. Also, many missing values are observed, resulting in bias or misinterpretation of the results of this study. Finally, the data quality should be improved, and important program variables should be revised and followed up.