Khaliq Olive P, Jassen Ahmad, Tabane Nomakhuwa E, Moodley Jagidesa
Department of Paediatrics and Child Health, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein, South Africa.
Department of Obstetrics and Gynaecology, School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
S Afr J Infect Dis. 2025 May 31;40(1):724. doi: 10.4102/sajid.v40i1.724. eCollection 2025.
Maternal syphilis (MS) is of special concern because of the risks of vertical transmission resulting in high rates of stillbirths and neonatal infections, especially in low- and middle-income countries (LMICs), such as South Africa (SA).
To assess the clinical management of MS at two primary healthcare clinics.
This was a retrospective evaluation of the antenatal records from 2020 to 2023 at two clinics in the Free State, SA. Demographic and clinical data, including MS mono rapid plasma reagin test and HIV status measured using the mono rapid HIV test, foetal and perinatal outcomes were collected.
668 records were reviewed. Fifteen tested (2.3%) positive for MS, but only 12/15 received complete treatment. Of the syphilis negative women, only 365 (55.3%) were retested. 28% of all pregnant women were HIV-positive. Four of the 15 (27%) women with MS had HIV, while 11 of the 15 (73%) of the HIV-negative pregnant women had syphilis. Among syphilis-exposed neonates, two had complications due to syphilis exposure and one had low birthweight despite maternal treatment.
The prevalence of MS at the study sites was 2.3%. 44.7% of the women who tested negative for syphilis were not retested, and three women with syphilis did not receive complete treatment. Incomplete treatment of the mothers' results in complications in syphilis-exposed neonates. There is an urgent need for continuing training for the nurses and midwives on antenatal screening and treatment protocols for MS at primary healthcare settings in the Free State, SA.
This work will benefit the community by alerting the Department of Health on the short comings found at antenatal care clinics, with the goal to improve the management of pregnant women.
由于母婴传播风险会导致高死产率和新生儿感染率，孕产妇梅毒（MS）备受关注，尤其是在南非（SA）等低收入和中等收入国家（LMICs）。
评估两家初级保健诊所对孕产妇梅毒的临床管理情况。
这是一项对南非自由州两家诊所2020年至2023年产前记录的回顾性评估。收集了人口统计学和临床数据，包括孕产妇梅毒单克隆快速血浆反应素试验以及使用单克隆快速艾滋病毒检测测定的艾滋病毒状况、胎儿和围产期结局。
共审查了668份记录。15人（2.3%）孕产妇梅毒检测呈阳性，但只有12/15接受了全程治疗。在梅毒检测阴性的女性中，只有365人（55.3%）进行了复查。所有孕妇中有28%艾滋病毒呈阳性。15名孕产妇梅毒患者中有4人（27%）感染了艾滋病毒，而15名艾滋病毒阴性的孕妇中有11人（73%）感染了梅毒。在梅毒暴露的新生儿中，有两人因梅毒暴露出现并发症，尽管母亲接受了治疗，但仍有一名新生儿出生体重低。
研究地点的孕产妇梅毒患病率为2.3%。44.7%梅毒检测阴性的女性未进行复查，三名梅毒患者未接受全程治疗。母亲治疗不彻底会导致梅毒暴露新生儿出现并发症。迫切需要对南非自由州初级卫生保健机构的护士和助产士进行持续培训，使其掌握孕产妇梅毒产前筛查和治疗方案。
这项工作将通过向卫生部通报产前护理诊所发现的不足之处，使社区受益，目标是改善对孕妇的管理。
