Revollo Rita, Tinajeros Freddy, Hilari Carolina, García Sandra G, Zegarra Lourdes, Díaz-Olavarrieta Claudia, Conde-González Carlos J
Proyecto Sífilis Materna-Population Council, Bolivia.
Salud Publica Mex. 2007 Nov-Dec;49(6):422-8. doi: 10.1590/s0036-36342007000600009.
Assess frequencies of maternal and congenital syphilis, mother-child transmission and variables associated with syphilis in six urban hospitals in Bolivia.
A cross-sectional study was performed between May and September 2004. We administered the Abbot Determine-TP rapid test and quantitative RPR to postpartum women without prior RPR. Sociodemographic variables and prior prenatal care visits were studied. Newborns of syphilis positive mothers were studied with Western Blot IgM p47 and ELISA IgM. Serum samples were analyzed at the Central Reference Laboratory (INLASA). Statistical analysis included bivariate and multivariate analyses to establish association with positive diagnosis of T. pallidum.
Syphilis prevalence among 1 594 postpartum women was 7.2%. Mother to child transmission was 15.7%. Congenital syphilis prevalence by serology was 1.1% and 94% of these newborns displayed no symptoms. Despite 70.5% prenatal care coverage in Bolivia some women still go directly to a facility to give birth without prior routine tests for syphilis. Low education levels in both parents (< 8 years) and failure to attend prenatal care were strong predictors of congenital syphilis.
Rapid syphilis tests constitute an important tool to strengthen early diagnosis of syphilis during pregnancy. Preventing congenital and maternal syphilis in Bolivia remains a public health priority.
评估玻利维亚六家城市医院中孕产妇梅毒和先天性梅毒的发病率、母婴传播情况以及与梅毒相关的变量。
于2004年5月至9月进行了一项横断面研究。我们对之前未进行过快速血浆反应素环状卡片试验（RPR）的产后妇女进行了雅培梅毒螺旋体明胶颗粒凝集试验（Abbot Determine-TP）快速检测和定量RPR检测。研究了社会人口统计学变量和产前检查次数。对梅毒阳性母亲的新生儿进行了蛋白印迹法IgM p47和酶联免疫吸附测定法IgM检测。血清样本在中央参考实验室（INLASA）进行分析。统计分析包括双变量和多变量分析，以确定与梅毒螺旋体阳性诊断的相关性。
1594名产后妇女中梅毒患病率为7.2%。母婴传播率为15.7%。血清学检测的先天性梅毒患病率为1.1%，其中94%的新生儿无症状。尽管玻利维亚的产前检查覆盖率为70.5%，但仍有一些妇女在未进行梅毒常规检查的情况下直接前往医疗机构分娩。父母双方教育水平低（<8年）和未进行产前检查是先天性梅毒的有力预测因素。
梅毒快速检测是加强孕期梅毒早期诊断的重要工具。在玻利维亚预防先天性和孕产妇梅毒仍然是公共卫生的重点。
