Chen Xiang-Sheng, Khaparde Sunil, Prasad Turlapati L N, Srinivas Vani, Anyaike Chukwuma, Ijaodola Gbenga, Ngige Evelyn, Tembo Mumba Grace, Phiri Carolline, Tambatamba Bushimbwa, Chavan Laxmikant, Seguy Nicole, Oyelade Taiwo A, Bvulani Malumo Sarai, Newman Lori M
National Center for STD Control and Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India.
Int J Gynaecol Obstet. 2015 Jun;130 Suppl 1:S4-9. doi: 10.1016/j.ijgo.2015.04.014. Epub 2015 Apr 24.
To estimate maternal syphilis and its associated adverse pregnancy outcomes in India, Nigeria, and Zambia.
An online estimation tool was used to generate point estimates and uncertainty ranges of maternal syphilis and adverse pregnancy outcomes due to mother-to-child transmission (MTCT). The most recent data (2010-2012) on antenatal care coverage, syphilis seroprevalence, and syphilis screening and treatment coverage at the subnational level in India, Nigeria, and Zambia were used to estimate disease burden for 2012. Sensitivity analysis was conducted for three screening and treatment scenarios (current coverages, current coverages minus 20%, and ideal coverages consistent with WHO targets for eliminating MTCT of syphilis).
A total of 103 960, 74 798, and 9072 pregnant women with probable active syphilis were estimated to occur in India, Nigeria, and Zambia, resulting in 53 187, 37 045, and 2973 adverse outcomes, respectively; approximately 1.6%, 4.8%, and 37.0% of these were averted under the current service coverages in India, Nigeria, and Zambia. The disease burden varied significantly in its subnational distribution within India and Nigeria, but was distributed evenly across Zambia.
The obtained results suggest an ongoing, unaverted high burden of maternal syphilis and associated adverse outcomes in India, Nigeria, and Zambia. Screening and treatment for syphilis must be scaled-up significantly in these countries to achieve elimination of MTCT of syphilis.
评估印度、尼日利亚和赞比亚的孕产妇梅毒及其相关不良妊娠结局。
使用在线评估工具生成孕产妇梅毒及母婴传播（MTCT）所致不良妊娠结局的点估计值和不确定性范围。利用印度、尼日利亚和赞比亚次国家级层面关于产前保健覆盖率、梅毒血清阳性率以及梅毒筛查和治疗覆盖率的最新数据（2010 - 2012年）来估计2012年的疾病负担。针对三种筛查和治疗方案（当前覆盖率、当前覆盖率减去20%以及与世界卫生组织消除梅毒母婴传播目标一致的理想覆盖率）进行了敏感性分析。
估计印度、尼日利亚和赞比亚分别有103960例、74798例和9072例可能患有活动性梅毒的孕妇，分别导致53187例、37045例和2973例不良结局；在印度、尼日利亚和赞比亚当前的服务覆盖率下，这些不良结局中分别约有1.6%、4.8%和37.0%得以避免。在印度和尼日利亚，疾病负担在其国内次国家级层面的分布差异显著，但在赞比亚分布较为均匀。
所得结果表明，印度、尼日利亚和赞比亚的孕产妇梅毒及相关不良结局负担持续存在且未得到缓解。这些国家必须大幅扩大梅毒筛查和治疗规模，以实现消除梅毒母婴传播。
