scholarly journals An eight-year retrospective analysis of antenatal screening results for syphilis: is it still cost effective?

2015 ◽  
Vol 9 (09) ◽  
pp. 1011-1015 ◽  
Author(s):  
Tugba Ensari ◽  
Ayse Kirbas ◽  
Ayse Seval Ozgu-Erdinc ◽  
Sibel Gokay Saygan ◽  
Salim Erkaya ◽  
...  
Keyword(s):  
Congenital Syphilis ◽  
Venous Blood ◽  
Treponema Pallidum ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Seroprevalence Rate ◽  
Antenatal Screening ◽  
Tertiary Referral Hospital ◽  
Serological Screening ◽  
Treatment And Prevention

Introduction: This study aimed to document the prevalence of syphilis among pregnant women in Turkey. Methodology: In this retrospective cohort study, a total of 63,276 sera obtained between January 2007 and June 2014 from women who were routinely screened for syphilis as a part of antenatal care at a tertiary referral hospital in Turkey were analyzed. Serological screening was done with the rapid plasma reagin (RPR) test on venous blood samples. Treponema pallidum hemagglutination assay (TPHA) was the confirmation test for the diagnosis of syphilis in patients who had positive results in the screening test. Results: Between 2007 and the first six months of 2014, 41 RPR+ and only five confirmed syphilis-positive patients were determined. The syphilis seroprevalence rate was 0.0648%. Within these years, there was no case of congenital syphilis detected in the hospital. Conclusion: As there is evidence of effective screening of syphilis contributing to the effective treatment and prevention of adverse outcomes, routine antenatal screening of syphilis is recommended. The rationale depends on the consideration of the serious results of not treating the disease and the cost effectiveness of screening.

Syphilis (Treponema pallidum)

2018 ◽  
Author(s):  
Mark N. Gilroy ◽  
Juan C. Salazar
Keyword(s):  
Congenital Syphilis ◽  
Transmitted Disease ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Adverse Outcomes ◽  
Global Public Health ◽  
Serological Screening ◽  
Sexually Transmitted

Syphilis, a chronic, sexually transmitted disease caused by the extracellular spirochete Treponema pallidum, has exhibited a remarkable resurgence in recent years. Despite the existence of inexpensive, easily administered, and highly effective antibiotic treatments, maternal and neonatal syphilis infections continue to be a major global public health problem. In addition to its potential to cause morbidity in the mother, untreated gestational syphilis (GS) can lead to serious adverse outcomes in the offspring, including stillbirth, prematurity, low birth weight, and neonatal death. Congenital syphilis (CS) is regarded as a missed opportunity during the antenatal care of the mother, resulting from socioeconomic, demographic, and behavioral factors that promote mother-to-child transmission (MTCT) of syphilis. This chapter emphasizes emerging concepts about screening aimed at controlling the ongoing epidemic, including serological screening of mother and infant, newer paradigms of “reverse screening,” clinical presentation, therapy, and long-term neurodevelopmental disabilities that must be a component of follow-up care.

scholarly journals The reality of 13 years of prenatal care to pregnant women with syphilis in Sergipe state (2007-2019)

2019 ◽  
Vol 31 (4) ◽  
pp. 123-130 ◽  
Author(s):  
Rute de Oliveira Farias ◽  
Izailza Matos Dantas Lopes ◽  
Letícia Goes Santos ◽  
Amanda Silveira de Carvalho Dantas
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Considerable Increase ◽  
Congenital Syphilis ◽  
Treponema Pallidum ◽  
Serological Screening ◽  
Cross Sectional ◽  
Infant Deaths ◽  
Clinical Phase ◽  
High Prevalence

Introduction: Syphilis is an infectious disease caused by Treponema pallidum, its two main routes of transmission are sexual and transplacental (vertical). The latter is of particular worrisome, since it can generate congenital syphilis and can be avoided by early maternal serological screening. Objective: To analyze the conditions of prenatal care for syphilitic pregnant women in Sergipe State between 2007 and 2019. Methods: A cross-sectional, retrospective, and descriptive study was carried out, with the collection of notified cases of gestational and congenital syphilis in the Brazilian Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN). Results: There was a considerable increase in the number of reported cases of gestational syphilis in the last 13 years. About 36% of pregnant women were identified in the 3rd trimester of pregnancy, 68.1% were brown, 56.8% had studied for up to 8 years, and 50.1% were between 20 and 29 years old. The clinical phase latent to the diagnosis was responsible for 70.3% of the cases, followed by the primary (11%) and tertiary (7.3%) phases. Of the total number of pregnant women, 20.2% did not perform the non-treponemal test, and 97.2% were treated with penicillin. Regarding the numbers of congenital syphilis, although 75% of the mothers performed prenatal care, 37.8% received the diagnosis at the time of delivery/curettage, resulting in 72.9% of infant deaths from the disease. Moreover, there was a predominance of untreated partners (77.7%) in relation to those treated (10.8%). Conclusion: Although most of them performed prenatal care, there was a predominance of diagnoses performed only in the 3rd trimester of pregnancy, mainly at the time of delivery or curettage, not respecting the minimum therapeutic interval of 30 days before delivery. Thus, in Sergipe State, the most important factor in the high prevalence of vertical transmission of syphilis is the ineffectiveness of prenatal care provided to infected pregnant women, which remains.

Congenital syphilis: Need for intensification of antenatal screening and clinician awareness

2021 ◽  
pp. 004947552110412
Author(s):  
Minu P Sunny ◽  
C Krishnan ◽  
PR Sabeel Abdulla ◽  
MG Geeta
Keyword(s):  
Congenital Syphilis ◽  
Renal Involvement ◽  
Treponema Pallidum ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Antenatal Screening ◽  
Cutaneous Manifestations ◽  
Direct Invasion ◽  
Complex Deposition ◽  
Maternal Syphilis

Congenital syphilis occurs due to trans-placental transmission of Treponema pallidum or rarely, intrapartum contact with infectious lesions. Even though preventable, congenital syphilis occurs sporadically in India, owing to lack of antenatal screening as well as the lack of awareness among clinicians about the burden of syphilis in the community. Since a significant overlap of clinical manifestations exists with many systemic diseases, awareness among clinicians is crucial for an early diagnosis. Renomegaly, nephrotic syndrome and nephritis can all be the signs of renal involvement in congenital syphilis, which can provide clues of the diagnosis. Direct invasion by spirochetes, hypersensitivity reactions and immune complex deposition in glomeruli contribute to the pathogenesis. We report a case of congenital syphilis characterised by delayed diagnosis with renal as well as cutaneous manifestations from missed maternal syphilis during the antenatal period and owing to the lack of antenatal screening.

Epidemiological Characterization of the Infection by Treponema Pallidum in Pregnant Women in Beira City, Sofala, Mozambique

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Nchowela Guido
Keyword(s):  
Pregnant Women ◽  
Congenital Syphilis ◽  
Health Centre ◽  
Treponema Pallidum ◽  
Timely Manner ◽  
Pregnancy And Childbirth ◽  
Epidemiological Characterization ◽  
Active Syphilis ◽  
Structured Questionnaire

Introduction: Syphilis is one of several diseases that can be transmitted during pregnancy and childbirth, which can lead to complications during pregnancy and in the newborn. This is especially so when the pregnant woman is not diagnosed or treated properly and in a timely manner. Methodology: Data from 262 pregnant women prospectively included, aged 18-41years, attended at the Ponta Gêa Health Centre for antenatal clinics has been analyzed from January to September of 2016. In the prospective study, a rapid treponemal and a non-treponemal test were performed. A structured questionnaire was used to collect socio demographic and clinical variables, which was developed from the literature review. Results: The prevalence of active syphilis was 11.8%; the majority of reactive pregnant women were aged 18-25years (55.4%), (61.3%) of pregnant women were treated with doses below those recommended; only a small number of the partners were treated successfully. The highest seroprevalence of syphilis was found in housewives (77%), in those who attended primary education (71.6%) in those who had a monthly income of 1000- 3000 MZN (70.3%), in those with two or more pregnancies (55.7%) and living with someone has husband and wife (63.5%). The syphilis/HIV co-infection rate was high. Conclusion: According to the results obtained in this study, urgent measures are needed to assess the problems encountered and to improve the screening approach, treatment and monitoring of syphilis during pregnancy in order to prevent the cases of congenital syphilis.

scholarly journals Metabolic Acidosis in Patients with CKD: Epidemiology, Pathogenesis, and Treatment

2021 ◽  
pp. 1-16
Author(s):  
Marcin Adamczak ◽  
Stanisław Surma
Keyword(s):  
Metabolic Acidosis ◽  
Sodium Bicarbonate ◽  
Current Knowledge ◽  
Venous Blood ◽  
The Body ◽  
Hydrogen Ions ◽  
Ckd Progression ◽  
New Drug ◽  
Treatment And Prevention

<b><i>Background:</i></b> Metabolic acidosis in CKD is diagnosed in patients with plasma or venous blood bicarbonate concentration lower than 22 mmol/L. Metabolic acidosis occurs in about 20% of patients with CKD. Metabolic acidosis may lead to dysfunction of many systems and organs as well as CKD progression. Currently, sodium bicarbonate is mainly used for pharmacological treatment of metabolic acidosis in patients with CKD. Veverimer is a new drug dedicated to treatment of metabolic acidosis in patients with CKD. Orally given veverimer binds hydrogen ions in the intestines and subsequently is excreted from the body with feces. Clinical studies have shown that veverimer is effective in increasing serum bicarbonate concentrations in CKD patients with metabolic acidosis. Here, we present review of the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients. <b><i>Summary:</i></b> Metabolic acidosis is common in patients with CKD and contributes to CKD progression and many complications, which worsen the prognosis in these patients. Currently, sodium bicarbonate is mainly used in metabolic acidosis treatment. The role of the new drug veverimer in the metabolic acidosis therapy needs further studies. <b><i>Key Message:</i></b> The aim of this review article is to summarize the current knowledge concerning the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients.

scholarly journals Would Universal Antenatal Screening for HIV Infection Be Cost‐Effective in a Setting of Very Low Prevalence? Modelling the Data for Australia

2004 ◽  
Vol 190 (1) ◽  
pp. 166-174 ◽  
Author(s):  
Nicholas Graves ◽  
Damian G. Walker ◽  
Ann M. McDonald ◽  
John M. Kaldor ◽  
John B. Ziegler
Keyword(s):  
Hiv Infection ◽  
Cost Effective ◽  
Antenatal Screening ◽  
Low Prevalence

Infections Caused by Spirochetes: Syphilis, Lyme Disease, Leptospirosis

2018 ◽  
Author(s):  
Patrick Duff
Keyword(s):  
Lyme Disease ◽  
Latent Infection ◽  
Congenital Syphilis ◽  
Ixodes Scapularis ◽  
Severe Disease ◽  
Erythema Migrans ◽  
Treponema Pallidum ◽  
Mild Disease ◽  
Drug Of Choice ◽  
In Pregnancy

Syphilis is caused by the spirochete Treponema pallidum. It is classified as primary, secondary, tertiary, and latent infection. If left untreated, syphilis can cause devastating injury to the fetus. The drug of choice for treatment of syphilis in pregnancy is penicillin. Lyme disease is caused by Borrelia burgdorferi and is transmitted by the Ixodes scapularis tick. The principal clinical manifestation of Lyme disease is erythema migrans, but patients may also develop arthritis and cardiac and neurologic abnormalities. Congenital Lyme disease has not been reported. The drug of choice for treatment of Lyme disease in pregnancy is amoxicillin. Leptospirosis is usually acquired from direct contact with urine of infected animals or through contaminated water, soil, or vegetation. Pregnant women with mild disease should be treated with oral amoxicillin. Patients with severe disease should be hospitalized and treated with intravenous penicillin or ampicillin. This review contains 5 figures, 5 tables, and 19 references. Key Words: clinical infection, congenital syphilis, latent infection, leptospirosis, Lyme disease, syphilis

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