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Related Experiment Videos

Routine antenatal syphilis screening--a case against.

K A Obisesan1, Y Ahmed

  • 1Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.

African Journal of Medicine and Medical Sciences
|February 24, 2001
PubMed
Summary

Current antenatal syphilis screening using the VDRL test is not cost-effective due to low specificity. Reintroducing the TPHA test is recommended for improved accuracy in syphilis detection among pregnant women.

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Area of Science:

  • Medical Science
  • Public Health
  • Epidemiology

Background:

  • Syphilis screening during pregnancy is crucial for preventing congenital syphilis.
  • The University College Hospital, Ibadan, has utilized VDRL testing for antenatal syphilis screening.
  • Assessing the cost-effectiveness and diagnostic accuracy of current screening methods is essential.

Purpose of the Study:

  • To evaluate the deficiencies of the current antenatal syphilis screening protocol.
  • To determine the cost-effectiveness of syphilis screening based on specificity and disease severity.
  • To analyze the prevalence of syphilis and pregnancy outcomes in seropositive women.

Main Methods:

  • Analysis of VDRL test results from pregnant women over a 10-year period (1988-1997).

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  • Review of case notes for 110 sero-reactive patients to assess pregnancy outcomes.
  • Evaluation of screening specificity and disease impact.

    • Main Results:

    • A seropositivity rate of 1.1% was observed among pregnant women.
    • Only 3 seropositive patients received empirical penicillin treatment.
    • No cases of congenital syphilis were recorded during the study period.
    • The current VDRL-based screening was found to be not cost-effective.

    Conclusions:

    • The current antenatal syphilis screening method at the University College Hospital, Ibadan, is not cost-effective.
    • Low specificity of the VDRL test leads to wasted resources and patient costs.
    • Reintroduction of the more specific TPHA test is recommended to improve screening accuracy and efficiency.