Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, 7925, South Africa.
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg 2131, South Africa.
J Trop Pediatr. 2024 Apr 5;70(3). doi: 10.1093/tropej/fmae010.
Congenital syphilis (CS) is preventable through timely antenatal care (ANC), syphilis screening and treatment among pregnant women. Robust CS surveillance can identify gaps in this prevention cascade. We reviewed CS cases reported to the South African notifiable medical conditions surveillance system (NMCSS) from January 2020 to June 2022.
CS cases are reported using a case notification form (CNF) containing limited infant demographic and clinical characteristics. During January 2020-June 2022, healthcare workers supplemented CNFs with a case investigation form (CIF) containing maternal and infant testing and treatment information. We describe CS cases with/without a matching CIF and gaps in the CS prevention cascade among those with clinical information.
During January 2020-June 2022, 938 CS cases were reported to the NMCSS with a median age of 1 day (interquartile range: 0-5). Nine percent were diagnosed based on clinical signs and symptoms only. During January 2020-June 2022, 667 CIFs were reported with 51% (343) successfully matched to a CNF. Only 57% of mothers of infants with a matching CIF had an ANC booking visit (entry into ANC). Overall, 87% of mothers were tested for syphilis increasing to 98% among mothers with an ANC booking visit. Median time between first syphilis test and delivery was 16 days overall increasing to 82 days among mothers with an ANC booking visit.
Only 37% of CS cases had accompanying clinical information to support evaluation of the prevention cascade. Mothers with an ANC booking visit had increased syphilis screening and time before delivery to allow for adequate treatment.
先天性梅毒（CS）可通过及时的产前保健（ANC）、孕妇梅毒筛查和治疗来预防。健全的 CS 监测可发现这一预防链中的差距。我们回顾了 2020 年 1 月至 2022 年 6 月期间向南非传染病监测系统（NMCSS）报告的 CS 病例。
CS 病例使用包含有限婴儿人口统计学和临床特征的病例报告表（CNF）报告。在 2020 年 1 月至 2022 年 6 月期间，医护人员使用包含母婴检测和治疗信息的病例调查表（CIF）补充 CNF。我们描述了有/无匹配 CIF 的 CS 病例，并描述了有临床信息的 CS 预防链中的差距。
在 2020 年 1 月至 2022 年 6 月期间，NMCSS 报告了 938 例 CS 病例，中位数年龄为 1 天（四分位距：0-5）。9%的病例仅根据临床体征和症状诊断。在 2020 年 1 月至 2022 年 6 月期间，共报告了 667 份 CIF，其中 51%（343 份）成功与 CNF 匹配。在有匹配 CIF 的婴儿的母亲中，只有 57%进行了 ANC 预约（进入 ANC）。总体而言，87%的母亲接受了梅毒检测，而在有 ANC 预约的母亲中，这一比例增加到 98%。在所有母亲中，第一次梅毒检测和分娩之间的中位数时间为 16 天，而在有 ANC 预约的母亲中增加到 82 天。
只有 37%的 CS 病例有伴随的临床信息来支持对预防链的评估。有 ANC 预约的母亲梅毒筛查率增加，分娩前的时间增加，以确保进行充分的治疗。
